hours after residency

[nightowl]

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Hello,

I have been interested in ob/gyn, but I have heard some really discouraging comments about post-residency hours. I don't mind having to put in 80 hours/week during residency, in fact, I expect that. I can handle that level of commitment for four years. But after residency, I really hope to have a family. My husband is going into surgery, so it's just not feasible for me to work really long hours and have a family post-residency. I've actually heard that hours would be *better* if I did general surgery, and then a breast oncology fellowship. I think I would really enjoy breast surg as well, but it would take six years and a gen surg residency. As far as the residency, I know ob/gyn and surg are comparable. I'm mainly concerned with after residency.

I've heard some optimistic ob's-to-be mention the "hospitalist movement" in ob, which allows for less call in practice. I've heard some people say that ob can be anything you make it- if you're willing to take a pay cut- you can pretty much work the hours you want. So which is it? anyone out there that actually knows what to expect after all of this training?

 

[Wednesday]

Hi,

I completed my internship in ob/gyn and switched to psych after PGY-1 because of these issues. I LOVE ob/gyn, but had a 1 1/2 yr old who I never saw. I kept thinking that it would eventually get better, but when I looked at the job listings in the trade journals (call is usually 1 in 3), talked to attendings (private and academic) and asked SPECIFIC questions of them about what they meant by "you can have a life" I did not get the answers I was interested in. Sure, plenty of people have families and practice ob/gyn, but it wasn't the way I want to be as a parent. I heard things like "you can usually go to the big soccer game, the big play", etc. "You can usually switch a call night to go to your kid's birthday." One of my attendings told a story about her own mother, an ob/gyn, who made the kids get up at 6 am every day so they could have breakfast together. One of my chiefs told me that she let her kids sleep in her bed so she could spend time with them (while they all slept!). I wanted to be able to work part time feasibly and to be able to have breakfast AND dinner with my family daily (or nearly daily). I want to let my kids sleep in their own beds and not change their course of development to fit my needs. When you are a surgeon, your physical presence is needed when there is an emergency. I decided that I couldn't do that to myself or my family.

Don't get me wrong, ob/gyn is an awesome field. I think that as a med student, asking specific questions of many people who are already out of residency, about what their life is actually like, and trying to figure out how these stories jive with what you would like for your life, is VERY important. I just sort of took people's word for it that it would all work out and ended up having to make a lot of hard decisions in the midst of my intern year. I think having a child already made things somewhat easier because I could see the effects my choices were having on my kid and had a real sense of what type of parent I really wanted to be. Find some laborists (if you can, it's not that wide spread in my area) and find out what sacrifices they are making (one thing I've heard is that people fear they will lose their gyn skills and so don't take these jobs). Do people work part time in your area (not feasible in some areas due to high malpractice costs making it basically a wash salary-wise). Look at job listings, talk to attendings. And really think about a two surgeon household and what that realistically would mean for your kids.

Good luck with your decisions. It's tough but SPECIFIC questions will help, I promise!

 

[kelaskov]

Hi,

I completed my internship in ob/gyn and switched to psych after PGY-1 because of these issues. I LOVE ob/gyn, but had a 1 1/2 yr old who I never saw. I kept thinking that it would eventually get better, but when I looked at the job listings in the trade journals (call is usually 1 in 3), talked to attendings (private and academic) and asked SPECIFIC questions of them about what they meant by "you can have a life" I did not get the answers I was interested in. Sure, plenty of people have families and practice ob/gyn, but it wasn't the way I want to be as a parent. I heard things like "you can usually go to the big soccer game, the big play", etc. "You can usually switch a call night to go to your kid's birthday." One of my attendings told a story about her own mother, an ob/gyn, who made the kids get up at 6 am every day so they could have breakfast together. One of my chiefs told me that she let her kids sleep in her bed so she could spend time with them (while they all slept!). I wanted to be able to work part time feasibly and to be able to have breakfast AND dinner with my family daily (or nearly daily). I want to let my kids sleep in their own beds and not change their course of development to fit my needs. When you are a surgeon, your physical presence is needed when there is an emergency. I decided that I couldn't do that to myself or my family.

Don't get me wrong, ob/gyn is an awesome field. I think that as a med student, asking specific questions of many people who are already out of residency, about what their life is actually like, and trying to figure out how these stories jive with what you would like for your life, is VERY important. I just sort of took people's word for it that it would all work out and ended up having to make a lot of hard decisions in the midst of my intern year. I think having a child already made things somewhat easier because I could see the effects my choices were having on my kid and had a real sense of what type of parent I really wanted to be. Find some laborists (if you can, it's not that wide spread in my area) and find out what sacrifices they are making (one thing I've heard is that people fear they will lose their gyn skills and so don't take these jobs). Do people work part time in your area (not feasible in some areas due to high malpractice costs making it basically a wash salary-wise). Look at job listings, talk to attendings. And really think about a two surgeon household and what that realistically would mean for your kids.

Good luck with your decisions. It's tough but SPECIFIC questions will help, I promise!

Great post, thanks. Anyone else with any insight ? Residents ?

 

[pruritis_ani]

Well, generally the hours will suck. Many post residency docs I know are working harder (some by quite a bit) than I am as a resident. That said, there are plenty of opportunities to work a bit less....

But, the fact remains, Ob/gyn practiced well demands a lot of time. You be a laborist or do office gyn only, or focus on pelvic pain, etc...these things can certainly improve your lifestyle. But, it will cost you many of the skills you learned in residency. If these are things that interest you, great! If not, it may not be worth it.

Some academic positions offer a great lifestyle. But, that can change. In today's world, we residents are quite protected. I have noticed a change over the last 3 years. And, the slack has been picked up by attendings, in many cases. So, be aware that the sweet academic spot may not stay so sweet.

I would say a two surgeon household would be close to impossible to manage any semblance of a normal family life. Maybe working for a large HMO like Kaiser, I guess. But, working it out is the exception rather than the rule. It seems as though you will have to make a hard choice. Work your family around your career, or pick a career that works with a family. You may not be able to have both.

Good luck.

 

[StarboardMD]

So what you're saying is that it is going to be very difficult to be there for my family as well as to do OB/GYN? No matter how passionate I might be about my job, my family is more important. Looks like OB is moving further down the list of potential careers...

 

[taehong81]

I heard that ob/gyn are doing what the hospitalist are doing, where they work shifts, is this not true?? I assume shift work shouldn't be too bad since you never have to be on call when you are not working. Is there many opportunities for part-time in ob/gyn??

 

[beffie84]

I'm having the same issue - I'm a 3rd year interested in Ob-Gyn and my fiance is still undecided but leaning towards either Ob-Gyn or IM. To complicate things, I'm military (he's not) - so even though I love Ob-Gyn I am condering other options. There are several family medicine docs in my area that practice uncomplicated Ob - any comments on lifestyle for a family doc that does OB vs one of an Ob-Gyn?

 

[nightowl]

Well, just to update everyone- I talked to a surgery cheif resident who is married to an ob/gyn who just graduated this year. She apparently is in a group of 8 ob/gyns, all women, and is working very reasonable hours. She's taking call 1:8 and one weekend/2 months or so. Apparently, she doesn't get to the office until 7 or 8 and is done by 5 usually. I know this isn't the norm at all, based on what I've heard but she's get a great set-up. I also wonder if this becomes more common as more and more women enter the field. I talked to another ob/gyn who is married to an interventional cardiology fellow and they have two children and are managing. She is really happy, albeit very busy, but with the help of a nanny she is making her life work. She is in academics, so I think this might lessen her call load.

I'm thinking that if I do end up choosing ob/gyn, and all of my optimistic ideas about it end up being false, and I'm working unreasonable hours, etc. there is always the option to just do gyn. That way, you still get some OR time and continuity of care, even if I do have to give up delivering babies. But if my family needs me more than my job and OB isn't fulfilling anymore, I can live with just doing gyn. I am going to do a fourth year rotation, just to be sure that it's worth it to me... and I've still got to rule out general surgery, the only rotation I have left in third year.

Good luck to everyone else trying to make this decision. I know that we all have probably heard really discouraging advice (which is appreciated as well, bc I want to be informed), but I just wanted to spread the word that I've talked to some ob/gyns who are very happy and have found a balance.

 

[civic4982]

bigger groups = FTMFW...

 

[DermMatch]

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[civic4982]

hmm... too late now for me I suppose.

I just hope I can manage somehow to make my personal life not a failure.

It's a frightening part of choosing this specialty and other demanding ones like it.