I want to switch to Ob/gyn from Derm

[doc84]

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Hi

I matched into dermatology last match season and will start in July 2011. I have always been battling whether to enter ob/gyn vs dermatology but chose dermatology. I like both but chose dermatology bc of family responsibilities. Now as an intern I miss the OR and the surgical experience of ob/gyn. What should I do? I am very confused.

 

[sunkists]

well, it sounds like you might need some time to talk things through with good friends, family and mentors. going into derm to stay family oriented is a valid concern as general OB/GYNs in some practices take frequent in-house overnight call and have more unpredictable schedules. that being said, there are large groups that are employing OB/GYNs within a hospitalist model where you are required to work something like 16 shifts per month. additionally, pursuing advanced training in any of the subspecialties like reproductive endocrinology or maternal fetal medicine (additional 3 years) can free up a lot of personal time as these physicians generally do not take overnight call.

my opinion is that if being an OB/GYN is truly a personal dream, don't let things get in your way! with hard work and prioritization, you can make any job work with any situation. good luck 🙂

 

[sainteligius]

I highly recommend that you stay in Dermatology. As much as you like Ob/gyn, it's not worth the sacrifice of NOT spending precious time with your family (and children if you have them). Furthermore, you must consider your working environment, and while every residency program (regardless of specialty) has their bad apples, I'm almost CERTAIN that your dermatology attendings will be much more pleasant to work with than the "sleep deprived, short-fused" OB/GYN attendings.

I'm in a "lifestyle specialty" now and I remember during my transitional year, I also contemplated switching to Surgery because I really enjoyed scrubbing in and participating in the surgical procedures.

But, once I started my PGY-2 year, it was SOOOO much better
to be at home with the sun still up and work only ~50-60 hours/week with most free weekends. I was able to reconnect with friends, start dating again, ate more healthy, and exercised everyday and I probably look more vibrant and younger than I did intern year. I remembered what it was like to take care of myself again.

My roommate (who was Categorical Surgery) continued on being at the hospital by 5:30am and didn't get home till past 8pm and barely had 3-4 days off/month...he couldn't take it anymore as it was affected his relationships with his girlfriends and he lost a lot of weight and was just miserable from the stressful environment, so he eventually quit the program and luckily got into a "lifestyle specialty" and is MUCH happier.

So my suggestion is that you at least TRY to start dermatology
next year and if after a few months you still aren't happy with your work and feel miserable, then consider switching.

Good luck!

 

[sunkists]

well, here is where we agree to disagree. i am a PGY-3 at a top 5 OB/GYN program (per USN&WR) and we average approximately 64 hours per week per resident since our new PD arrived here 4-5 years ago. we keep clean duty hours with rare violations. we have happy residents and faculty as i am sure there are at many other places. of course, there are some rotations where i am needed at the hospital as early as 5:30AM but i have many rotations where my first clinic appointments start at 8AM.

i think trying out PGY-2 year would be reasonable option but if you didn't like it, you would be hard pressed to change programs in the middle of the academic year. you'd most likely have to finish out the year and start your PGY-3 year as an OB/GYN intern and do 4 more years.

lastly, a very misunderstood aspect of OB/GYN are career options. OB/GYN has 4 board certified subspecialties (3 of which are surgical) and all of them (including 3 or 4 additional unofficial specialties) allow for a fantastic lifestyle. not that this should affect your judgment but all 4 BC specialties will offer higher compensation than derm.

no one can make this decision for you but it's important that you stay informed before you make your next move.

 

[sainteligius]

Yes, you have 3 options for surgical specialites in OB/GYN but that
will be an ADDITIONAL THREE or more years of a grueling fellowship (Gyn-Onc, REI, etc.) after an already demanding ob/gyn residency.

That's a total of SEVEN more years of a residency salary and capitalization of the interest on your student loans (assuming you have govt loans which can no longer be deferred because of George Dubya's Bill, but must go into FORBEARANCE).

Yes some OB/GYN programs may work only 50hours/week (not sure how that's possible as there's A LOT of procedures to learn), but even if
dermatology was the same 50 hours/week, in dermatology you usually
are doing only consultations and outpatient clinic without carrying an inpatient service, so it will be less stressful and you'll have more time
to study for your Derm Boards and again more time with your precious family.

You already are a PGY-1 and only have 3 more years of dermatology residency then you can finally be an attending, provide more for your family financially, and start paying off your loans! I have plenty of friends in Dermatology, who thought what you did during their intern year, but stuck through it and were HAPPY they did. 🙂

Our own OB/GYN Clerkship Director in medical school told us on our first day of the rotation: ".About 85% of all practicing obstetricians have been sued for bad outcomes associated with pregnancy; literally hundreds of millions of dollars have changed hands." .

Yes, there's still malpractice in Dermatology but probably not at this extent that you would experience in Ob/gyn. And if you decided to not to ob and just do Gyn-Onc, again it's 3 more years after 4 years of ob/gyn residency!!!!

Please save your sanity and your relationship with your spouse and family and stay in dermatology.

Again this is your decision but I personally think you should give Dermatology a chance next year as a PGY-2 since you worked so hard to get that very competitive spot.

 

[Global Disrobal]

I think both of you make great points; however, although I agree with SainteLigius's suggestion that Doc84 try her hand at Derm before making a switch, I must caution that his/her points are on the extreme side and not necessarily reflective of the actual truth. Speaking from experience, from having been in the field both in an academic and private setting, Fellowship trained, and having experienced training and teaching in this field, I must say:
1. OBGYN faculty are not as miserable, overworked, nor unhappy as you assert. Unfortunately, the attitudes of a few shape the impressions of many.
2. You can gear your practice setting/specifics to any lifestyle or income you seek.
3. Fellowship was not "grueling"
4. Most of us maintain our sanity, marriages, and personal lives.
5. Almost everyone I know or have known, has been satisfied about their career choice. Those few that were unhappy, often time were the cause if their own unhappiness (refusal to give up solo practice, refusal to settle for less cash in exchange for better life style)

To that end Doc84, I suggest you try your hand at Derm given that 1) it drew you the first time around, 2) it's an extremely competitive specialty that you nicely matched into, and 3) it may seem like the perfect fit for you once you start practicing it. If still unsatisfied, try OBGYN as life is long and a couple of more years at the end will not matter much. Besides, you stand to get credit for most of your intern year.
Best of luck to all of you!

 

[Oatcell]

omg, please don't make that mistake!!! please, please, please!!! you will regret it for the rest of your life!!! i did that and it was the worst decision i ever made.