How to make change from surgery to Ob-gyn?

[person111]

---

Members don't see this ad.

I have resigned from a senior level position at a community general surgery residency program, where the faculty were incompetent surgeons and unenthusiastic about teaching, the residents were unhappy and unsupportive of each other, and case load was inadequate. In short, I was extremely unhappy and I have decided to make a career change into OB-GYN. Having been in surgery for so long, I don't know where to start. Where do I look for openings in OB-GYN? Can I enter into a more advanced position in OB-GYN? I would appreciate any practical advice I can use to help me make this transition.

 

[mcl]

I have resigned from a senior level position at a community general surgery residency program, where the faculty were incompetent surgeons and unenthusiastic about teaching, the residents were unhappy and unsupportive of each other, and case load was inadequate. In short, I was extremely unhappy and I have decided to make a career change into OB-GYN. Having been in surgery for so long, I don't know where to start. Where do I look for openings in OB-GYN? Can I enter into a more advanced position in OB-GYN? I would appreciate any practical advice I can use to help me make this transition.

The bad news is that the American Board of OBGYN will only allow a maximum of 6 months credit for your prior training. The good news is that ACOG posts of clearinghouse of available residency positions: http://www.acog.org/departments/dept_notice.cfm?recno=1&bulletin=122

It is possible that you could be accepted into a PGY 2 position and stay an extra six months after your 4th year in order to be Board eligible.

 

[Winged Scapula]

I have resigned from a senior level position at a community general surgery residency program, where the faculty were incompetent surgeons and unenthusiastic about teaching, the residents were unhappy and unsupportive of each other, and case load was inadequate. In short, I was extremely unhappy and I have decided to make a career change into OB-GYN. Having been in surgery for so long, I don't know where to start. Where do I look for openings in OB-GYN? Can I enter into a more advanced position in OB-GYN? I would appreciate any practical advice I can use to help me make this transition.

You've told us nothing about GS in particular that is causing you to leave. Is it THIS specific program or you've decided you made a mistake in medical school and have been miserable all along, and would be even in a great GS program?

At any rate, as noted by mcl above, OB programs will not allow you more than 6 mos credit from your GS residency, so you should expect to start all over (and as you probably know, ROLs were due a few weeks ago, you've missed the deadline to enroll in NRMP, with the match coming up next week). It may be too late to find a position for next year unless there is something left over after the scramble.

 

[person111]

It's really this particular program that has made me unhappy- the program is under probation, so there are problems that go beyond those that I have described. Realistically, however, I don't think I can apply to a senior level position at another program. For one thing, I resigned in the middle of the year, which is, I know, a red-flag for any program looking at my application. Secondly, my absite scores are not great, so I would be hard-pressed to find a program willing to take me. I still love working with my hands; I have decided that OB-GYN is the next best fit for me.

Do you know how I can find out which programs have open positions during the scramble even if I am not a part of the match?

 

[filter07]

Just to be clear, you resigned in part because of bad surgeons and now you want to switch to OB/Gyn?

I see a few PGY4 spots looking for residents:
http://www.apds.org/residency_positions_open.htm

 

[dpmd]

Do you know how I can find out which programs have open positions during the scramble even if I am not a part of the match?

There is no legitimate way, because the system is designed to only provide that information to people who have registered for the match (usually those who failed to match, but some people do pay to register so that they can then access this info). After the scramble period, info on programs remaining unfilled will be more easily (and legitimately) accessed.

 

[Winged Scapula]

It's really this particular program that has made me unhappy- the program is under probation, so there are problems that go beyond those that I have described.

Fair enough...so it still sounds like its a situational problem rather than a GS problem.

Realistically, however, I don't think I can apply to a senior level position at another program.

Well, you don't know until you try.

For one thing, I resigned in the middle of the year, which is, I know, a red-flag for any program looking at my application.

Yes, ANY program looking at your application -- including Ob-Gyn programs. If a GS program won't want you because of that, what makes you think Ob ones will? It doesn't look good and was probably a professional mistake, but you did what you felt you needed to do.

Secondly, my absite scores are not great, so I would be hard-pressed to find a program willing to take me.

Again, you don't know until you try. Not all the programs on APDS request high ABSITE scores, so there may be some places that would consider you.

I still love working with my hands; I have decided that OB-GYN is the next best fit for me.

Its up to you, but it seems like you are settling for what you admit is "next best" without even trying to get what you prefer.

Do you know how I can find out which programs have open positions during the scramble even if I am not a part of the match?

As above, no legitimate way. I'm sure the lists will be floating around but they are usually pretty carefully guarded (we've even stopped posting them here on SDN) since those that pay for them should have first dibs. NRMP will post lists ones the Scramble is over.

 

[DD214_DOC]

Just to be clear, you resigned in part because of bad surgeons and now you want to switch to OB/Gyn?

I'm glad someone else had the same thought!

 

[person111]

I'm glad someone else had the same thought!

That's an oversimplification of a complex problem. I'd appreciate you don't post if you have nothing to say that can help, thanks.

 

[person111]

Fair enough...so it still sounds like its a situational problem rather than a GS problem.



Well, you don't know until you try.



Yes, ANY program looking at your application -- including Ob-Gyn programs. If a GS program won't want you because of that, what makes you think Ob ones will? It doesn't look good and was probably a professional mistake, but you did what you felt you needed to do.



Again, you don't know until you try. Not all the programs on APDS request high ABSITE scores, so there may be some places that would consider you.



Its up to you, but it seems like you are settling for what you admit is "next best" without even trying to get what you prefer.



As above, no legitimate way. I'm sure the lists will be floating around but they are usually pretty carefully guarded (we've even stopped posting them here on SDN) since those that pay for them should have first dibs. NRMP will post lists ones the Scramble is over.

Believe me, I've already thought about the things you said- these were all factors that played a part in my decisions. However, after reading what you wrote about me trying to go back into general surgery, I spoke with my former program director. He was completely against it; he thinks going back into gs is going to be too difficult for someone in my position.

So that leads me back to the question of what to do next. More than anything, I love operating- I had considered surgical oncology during my career as a surgical resident. I guess you could say "the next best thing" is gynecologic oncology. I say if my goal is to use my hands to help cancer patients, I say surgery and gynecology are both suitable for me.

 

[filter07]

Isn't Gyn Onc pretty competitive to match into?

 

[Winged Scapula]

Believe me, I've already thought about the things you said- these were all factors that played a part in my decisions. However, after reading what you wrote about me trying to go back into general surgery, I spoke with my former program director. He was completely against it; he thinks going back into gs is going to be too difficult for someone in my position.

This is the PD from the program with "totally unsupportive and unenthusiastic about teaching" faculty? Is there something about this PD that makes you think he/she really knows you and what's best for you or how competitive you would be? Why is he/she *now* all of a sudden some font of wisdom about you and your career when he couldn't lead a program out of probation or incite some enthusiasm for his residents amongst the faculty? Doesn't sound like someone who any more business commenting on your career than I do. 😉

Why would you take anyone's (including the advice here on SDN) word for it without even trying?

So that leads me back to the question of what to do next. More than anything, I love operating- I had considered surgical oncology during my career as a surgical resident. I guess you could say "the next best thing" is gynecologic oncology. I say if my goal is to use my hands to help cancer patients, I say surgery and gynecology are both suitable for me.

That is true.

Gyn Onc is one of the most competitive fellowships out there but if you got into a good Ob program (expecting to start from scratch - PGY-1), then it sounds like a good fit.

I still am troubled that you would consider the "next best thing" without even trying to see if you could get into a GS program. What do you have to lose? APDS lists positions, you aren't charged for applying and the worse thing that can happen is that they say no.

Chances are that there aren't going to be a lot of PGY-1 Ob spots open after the scramble and you should be prepared to be sitting around without a job until July 1, 2012. I'd just think that looking for a GS position that might open up between now and then and which would allow you to follow your dreams and do so in *much* less time (even if you had to take a PGY-3 GS spot) than starting over with PGY-1 OB.

But that just my two cents...

 

[Winged Scapula]

That's an oversimplification of a complex problem.

Perhaps but he has a point.

You know, just as well as most others here do, that talking about bad surgical skill and/or attitude amongst general surgeons is an attribute *often* found in OB-Gyns. One only needs to read the Clinical Rotations threads here about how poorly treated medical students can be on that rotation.

So he has a point that if you are looking for warm and fuzzy and supportive residencies, Ob-Gyn is nowhere near the top of the list. (I have purposely left out any comment about surgical skills of OBs).

I'd appreciate you don't post if you have nothing to say that can help, thanks.

Insulting other posters is probably not the best way to get advice. Just ignore those who don't participate in any meaningful way; to do otherwise makes you appear ungrateful and the rest of us less likely to want to help.

 

[person111]

This is the PD from the program with "totally unsupportive and unenthusiastic about teaching" faculty? Is there something about this PD that makes you think he/she really knows you and what's best for you or how competitive you would be? Why is he/she *now* all of a sudden some font of wisdom about you and your career when he couldn't lead a program out of probation or incite some enthusiasm for his residents amongst the faculty? Doesn't sound like someone who any more business commenting on your career than I do. 😉

Why would you take anyone's (including the advice here on SDN) word for it without even trying?



That is true.

Gyn Onc is one of the most competitive fellowships out there but if you got into a good Ob program (expecting to start from scratch - PGY-1), then it sounds like a good fit.

I still am troubled that you would consider the "next best thing" without even trying to see if you could get into a GS program. What do you have to lose? APDS lists positions, you aren't charged for applying and the worse thing that can happen is that they say no.

Chances are that there aren't going to be a lot of PGY-1 Ob spots open after the scramble and you should be prepared to be sitting around without a job until July 1, 2012. I'd just think that looking for a GS position that might open up between now and then and which would allow you to follow your dreams and do so in *much* less time (even if you had to take a PGY-3 GS spot) than starting over with PGY-1 OB.

But that just my two cents...

In order for me to get ANY spot in surgery, I would have to submit a letter from my program director, which is why I approached him. If you look at APDS, every single posting states you must submit a letter from the program director. Unless anyone knows how to get around this requirement, my chances of going back into general surgery are dead.

 

[Winged Scapula]

In order for me to get ANY spot in surgery, I would have to submit a letter from my program director, which is why I approached him. If you look at APDS, every single posting states you must submit a letter from the program director. Unless anyone knows how to get around this requirement, my chances of going back into general surgery are dead.

That is true.

Therefore, are you stating that he/she is *unwilling* or *unable* to write you a supportive letter?

You may be able to get around the requirement with a letter from a supportive faculty member, but I agree that if your PD is unwilling to write such a letter, then it will be difficult.

But remember, if you apply to ANY specialty, programs will *still* want a letter from your former PD before offering you a position. This is not specific to surgery.

 

[dragonfly99]

This situation sucks. I think you can pretty much assume that you won't get a very supportive letter from your former PD. I'm not sure that should keep you from applying for surgical spots, although if he decided to rat you out to OB/gyn programs (assuming you applied to both) that would doubly suck. I agree with winged scapula though...I'm not sure you should take this person's word at face value. There may be a general surgical program out there that for whatever reason is really looking hard for a mid or upper level surgical resident, and might consider you. On another note, I'm not sure I get why it seems like almost all the surgical programs are super hung up on ABSITE scores. Personally, I'm generally a good standardized test taker so I'm one who tends to fall into the pro-test camp, but even I admit that there are just some people who don't test that well but who are definitely smart and clinically savvy and who I would want to work with. It seems like surgeons should care LESS about some test and MORE about the clinical stuff, since what they do depends so much on hand/eye stuff, being able to just generally "do" stuff clinically and integrate information. What is it that is on that test that is so darned important that it trumps everything else? What if someone had good USMLE scores, but only a so/so ABSITE score, or great everything else (med school grades, USMLE's, AOA, research, etc.) but a crappy ABSITE score? I'm just curious.

 

[Winged Scapula]

The ABSITE is similar to the written portion of the boards and doing poorly on the former predicts performance on the latter. Since all residents are required to take it and to take it every year, there is a large data set which shows the high predictive value.

And while I agree that programs place too much emphasis on it, the belief is that since a program is evaluated by their board pass rate, programs are inclined to prefer residents who do well on the ABSITE.

But I think DF is correct - there are senior level positions out there, and there may be some who wouldn't require a high ABSITE score. You never know unless you try.

 

[NotAProgDirector]

Usually by now, the conspiracy theorists have shown up and started questioning the OP's story.

I remain a bit confused about the details. The OP is was a "senior" level surgery resident, hence presumably a PGY-4 or 5. They resigned from their program because they thought it had too many problems. Still would like to do surgery, but can't get a letter from their PD. Thinking about OB.

It seems equally possible that the OP was terminated from their residency. Otherwise, it would have made much more sense to try to transfer gracefully rather than resign suddenly. Or, finish training and consider a fellowship if you didn't feel competent. Or, if the OP was a fine surgeon in a bad program and left, the PD might be willing to give him/her a letter to continue, as not all surgical PD's are vindictive lying bastards. Although, according to rumor, most are.

I'm not suggesting that the OP is lying. But, I get the sense that there is more to the story then we are hearing. And these are his/her only posts, so there's no backtrail to follow. Leaving an advanced surgical position without a fallback plan is exceeding foolish, IMHO. Sure, sounds like his/her program might have sucked. Is on probation. So is Mass General (Note: Tried to stick a link on that, won't work. You can look it up yourself here). There are other ways to address poor programs, other than dropping out -- which honestly hurts the resident and doesn't fix the program.

I need to go put my foil lined hat back on now, to keep out the mind control signals.

 

[Winged Scapula]

Usually by now, the conspiracy theorists have shown up and started questioning the OP's story.

True. Where are they?

I remain a bit confused about the details. The OP is was a "senior" level surgery resident, hence presumably a PGY-4 or 5.

I may be alone in this but I interpret junior resident as PGY2-3, Senior Resident as PGY4 (although some will include 3 and 4) and Chief as 5+.

It seems equally possible that the OP was terminated from their residency. Otherwise, it would have made much more sense to try to transfer gracefully rather than resign suddenly. Or, finish training and consider a fellowship if you didn't feel competent.

Again, true. Who leaves a program in the middle of the year, without a supportive letter from their PD or an "out"? Most surgical residents are very anal/Type As so leaving without an exit plan would be extremely unusual except in the case of being terminated or the resident who was giving up medicine altogether.

Or, if the OP was a fine surgeon in a bad program and left, the PD might be willing to give him/her a letter to continue, as not all surgical PD's are vindictive lying bastards. Although, according to rumor, most are.

I'm not suggesting that the OP is lying. But, I get the sense that there is more to the story then we are hearing. And these are his/her only posts, so there's no backtrail to follow. Leaving an advanced surgical position without a fallback plan is exceeding foolish, IMHO. Sure, sounds like his/her program might have sucked. Is on probation. So is Mass General (Note: Tried to stick a link on that, won't work. You can look it up yourself here). There are other ways to address poor programs, other than dropping out -- which honestly hurts the resident and doesn't fix the program.

Assuming it is an ACGME program, the following GS programs are currently on probation:

University of Arizona Program
University of Colorado Denver Program
Massachusetts General Hospital Program
St Joseph Mercy-Oakland Program
St Barnabas Medical Center Program
Staten Island University Hospital Program
Brooklyn Hospital Center Program
Jewish Hospital of Cincinnati Program
Geisinger Health System Program

 

[dr1day]

Usually by now, the conspiracy theorists have shown up and started questioning the OP's story.

I remain a bit confused about the details. The OP is was a "senior" level surgery resident, hence presumably a PGY-4 or 5. They resigned from their program because they thought it had too many problems. Still would like to do surgery, but can't get a letter from their PD. Thinking about OB.

It seems equally possible that the OP was terminated from their residency. Otherwise, it would have made much more sense to try to transfer gracefully rather than resign suddenly. Or, finish training and consider a fellowship if you didn't feel competent. Or, if the OP was a fine surgeon in a bad program and left, the PD might be willing to give him/her a letter to continue, as not all surgical PD's are vindictive lying bastards. Although, according to rumor, most are.

I'm not suggesting that the OP is lying. But, I get the sense that there is more to the story then we are hearing. And these are his/her only posts, so there's no backtrail to follow. Leaving an advanced surgical position without a fallback plan is exceeding foolish, IMHO. Sure, sounds like his/her program might have sucked. Is on probation. So is Mass General (Note: Tried to stick a link on that, won't work. You can look it up yourself here). There are other ways to address poor programs, other than dropping out -- which honestly hurts the resident and doesn't fix the program.

I need to go put my foil lined hat back on now, to keep out the mind control signals.

I've been reading this thread for the last few days and having the same thoughts, but since I'm just an MS4 hoping to match (into OB ironically enough), I decided to keep my 0.02 cents out of it.

 

[dragonfly99]

He probably quit and was near to being fired. It doesn't make much difference anyway...quit in the middle of the year versus fired in the middle of the year. Either way, he's not going to be getting some great letter from his program director. It's not that unbelievable to me that someone would get frustrated and just quit. I agree it's not wise, and the OP probably agrees it wasn't "wise" per se, but sometimes people just get fed up. If someone leaves a program usually they don't love their program director...people who love their PD's usually like how they are being trained...usually programs that suck don't have great PD's. They either don't attract them, or don't keep them. Basically, the OP is trying to find a surgical-type program without having high ABSITE scores and without having a good PD letter. I think in that situation I'd be trying everything, except perhaps surgical prelim years...every middle level general surg position, lower level OB if he wants it. He's in a bad corner.

 

[dragonfly99]

Sometimes people switch from surgery to anesthesia and end up liking it all right. Anesthesia has lots of procedures, and having done surgery gives you an initial advantage in understanding the OR, etc.