How hard is it to just do gyn?

[caliga16]

Do most people want to do gyn vs ob just because ob requires an unpredictable lifestyle?
Or are people able to find jobs that would allow them to be more gyn heavy?

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[anonperson]

Most residents graduate and become generalists who do both OB and GYN. Most people do enjoy the OB portion so it isn't that bad. If you're in a big enough group, then you only take call on a certain day of the week while the other days your partners are on call which mitigates the unpredictable nature of obstetrics.

If you are dead set on just doing GYN that is more challenging. A few options that will increase the ability to just do GYN:

1. Do a fellowship in Urogyn, Gyn Onc, or REI. Your practice by its nature will not have anything to do with OB/Labor and delivery. To a smaller degree you could do a MIS fellowship but I am not sure you could solely do GYN based on that fellowship but it is possible
2. Join a health system that prefers OB GYNs to become highly specialized. At Mayo and some Kaiser programs, only certain OB GYNs are on labor and delivery, while others are gynecologists (and that is even subdivided in some only doing smaller procedures such as hysteroscopy, Essures, tubals etc while others do major cases)
3. Hang your own shingle as a solo practitioner and just do GYN. This is less likely in today's economic climate to be honest.

 

[HumbleMD]

OB is stressful, has unpredictable and inconvenient hours, and the law suits it comes with are really draining and taxing to your psyche. Lots of us got into the field thinking about OB then dropped after spending time on a hectic labor floor. At the same time, some people love it and want to be a generalist or an MFM.

I switched to GYN in my first year, applying in GYN ONC now. If you do any fellowship in ONC, UROGYN, REI, Family planning, you will not do OB ever. As the prior poster said, MIS is a pathway to doing GYN only, but can still be tough depending on the state and even city climate.

Few people just do OB "sometimes" as the malpractice insurance is such a burden for you or your employer. It'll depend on what state and city you practice in, but GYN only jobs are often more desirible and not something you can land right out of residency. Not impossible though.

 

[sia_simba]

Was just sent an advertisement for a Job opportunity doing just GYN and no OB. There are places that exist.

Fellowships are usually geared towards that specialty, hence "subspecialty".

Some of the MIS trained fellows still cover OB calls. There are a few that I know who are deem "Director of Minimally invasive gyn" but still have to cover calls.

Doing JUST gynecology may not cover your overhead for private practice if that's what you are aiming for, unless you are going into an existing practice that has a lot of patients and surgery.
i.e. If I perform an annual gyn-well women exam for a patient, I may get $75-125 pending location
If I do a delivery, may be $1000 pending insurance and location, and each visits can be billed separately for $50-100 pending insurance and location.
If I perform a hysterectomy, $600-800 pending insurance and location.
The above numbers are approximate for NYC & mostly Medicaid and Medicaid HMO.

Some of the hospitals right now are only looking for laborist, which covers only labor & delivery. Then they hire physicians who will only do gyn and gyn surgeries. This is a cost effective model because people who cover OB, usually have higher malpractice insurance.
i.e. In NYC, if you cover OB, your malpractice is about $170,000. if you cover only GYN major, then its about $90,000.

So to answer your question in short,

It is HARD to do just GYN if you are opening a new practice.
It should NOT be too difficult if you join an existing practice looking for a GYN surgeon only.