Is it possible to match into a Ob/Gyn PGY1 spot, hold that spot for 1 year and do a preliminary surg

[whitecollege]

I don't want to be a general surgeon, but this ability to do surgery along with primary care is what attracted me to Ob/Gyn and I want to be a competent surgeon who can hold her own after graduation.

Looking at other surgical subspecialities like urology and optho, they need at least a year of general surgery but we don't even though we mess around in the abdomen and pelvis, and I think that's to our detriment. I've been talking to residents and attendings across different schools as I've been interviewing and on away rotations and at my home school. Ob/gyns do some cool stuff and I understand there's a time when you have to call the specialist, but there seems to be a general consensus that gynecologists are not strong surgeons no matter what program you go to and don't get formal training in basic surgical skills and handling our own patients in the ICU like venous/arterial access (line placement), airway management, proper wound care, incision closure, being able to read imagery for things other than pelvis, percutaneous draining of intraabdominal abscesses, being able to handle complications of our own surgery like bowel perf, or minor bladder injuries.

Learning all of this has me thinking about a prelim in surgery.

Do you think it would make a difference if I do a year in surgery?

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[Azarias59]

I would be interested in hearing the answer to this as well.

 

[ElwayFan]

Central lines/A-lines... you have a point. It would be nice to be able to do more lines as an OB/GYN resident.

C-sections should teach you basic surgical skills, wound care, and incision closure. The c-section is the most commonly performed major abdominal surgery in the USA. You'll get plenty of practice stitching Pfannenstiel/Maylard/Joel-Cohen incisions, and get some mass closures on vertical skin incisions on Gyn-onc. I'd imagine c-sections (laparotomy, hysterotomy, removal of fetoma/babyoma) are more common than ex-laps in any other specialty.

Airway management - The gravid patient's airway is notoriously difficult and something best left for our anesthesia colleagues. I would not want an obstetrician, general surgeon, transplant surgeon, ophthalmologist, or urologist intubating my wife during an emergent c-section... unless it was a last resort.

Handling surgical complications - I have repaired bladders as a PGY-2 OB/Gyn resident. Also remember all Gyn programs have GYN oncology and urogynecology where you'll probably learn some bowel/bladder repair techniques.

We also have some surgical skills other surgeons rarely use or utilize. If you don't believe me, see how many other surgical specialties use Heaney clamps, Zephyr clamps, or CTX needles on nearly every case... or have even heard of these. Also, see how many surgeons can operate through the vagina. Urogynecologists routinely fix incidental cystotomies vaginally, something no general surgeon ever does. Try to find a program strong in vaginal hysterectomy if you want a unique skill.

Finally, would 1 year of general surgery scutwork really teach you any of these skills you want to learn? I'm pretty sure PGY-1 surgical interns rarely do ex-laps, bladder surgery, or bowel reanastomosis, but rather are usually doing little elective hernia cases in between rounds, rounds, and more rounds... I could be wrong though.