Lifestyle and other questions...

[MeganRose]

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I've been really gung-ho EM since soph yr of college. I enjoyed my first EM rotation this yr as a 3rd yr but really enjoyed the Ob Gyn rotation more. I just really loved the diversity-- surgery, primary care, lots of procedures-- all rolled into one. The 4yr residency length sucks but what worries me more is the lifestyle. I've spoken to a lot of Ob-Gyns and other docs and the answer varies from "this is a poor choice if you want to have a life" to "I have plenty time w/ my kids and family" The biggest goals in my life have always been to become a doctor and be a mom. I really want to spend a lot of time w/ my children, being very involved in their life. Sooo... I'm sure that this is something that all the people here that are comitted to OB had to weigh out. A few questions for you all. What is the lifestyle of an average Ob-Gyn like? Are there lots of opportunities for job shares/part-time employment? What other specilities were you considering and why did you eventually go with OB?

Thanks in advance,
Megan

 

[lilycat]

Hmm... Well, I'm just getting ready to start out in the field, but I'll give you my observations. First off, most of the female OB/gyns that I know have families. All of the male ob/gyns have families. This is not necessarily true in fields like general surgery, where I think female residents and attendings are occasionally looked down upon when they become pregnant. Now, how successful these ob/gyn attendings and residents are at balancing their two lives I don't know -- some definitely seem to be better at it than others. As for the family-work balance being a reason NOT to go into the field -- this was a concern of mine, but everyone I talked to emphasized that it was possible. Yeah, it might be difficult if you want to have 6 kids or something, but if you're thinking a small family (1-3 kids), my impression was that if you are willing to make certain sacrifices, you can make that happen. Most attendings that I talked to seemed to rate compensation, general hours and malpractice issues higher on the list of why NOT to go into OB.

As for part-time or shared positions, I would check out the Kaiser model in California. I know for other fields you can essentially work part-time (for an obvious decrease in compensation), and I'm not sure if that applies to OB or not. The trade-offs of a position like that is obviously lower compensation, and less control or ownership over your patients because you are not the only one seeing them. This was briefly discussed on the insurance thread in this forum, but I have been told by a couple of attendings that part-time work in OB/gyn doesn't really exist due to malpractice, ie, if you only work 2-3 days a week, you're only covering your malpractice and incidental office costs, and not really bringing home a salary. I have a feeling this may vary from state to state -- again, that's why it might be worthwhile to check out the California Kaiser system.

Because lifestyle is becoming more and more of an issue with all specialties, not just ob/gyn, fields are reacting to this by making the necessary changes. It seems like the trend over the last 10 years in Ob has been towards laborists (the ob version of a hospitalist), larger groups which allow less frequent call, and the decision of some providers not to deliver their "own" patients if they are not on-call. Until I did my elective at a private group, I didn't realize what a double-edged sword this could be. On one hand, if you find your self in a 9-20 person group, it's great -- you're only taking call a couple of times a month max., and only 4-6 weekends a year. However, some of the doctors in the group would still come in when they weren't on call to deliver their own patients -- they felt this was instrumental to building their practice, and getting a good reputation among their patients, which led to referrals, which built up their client base... Some patients really don't want to hear that "their" doctor won't deliver them if they are not on-call. So, this is just another consideration to keep in mind.

You may also want to think about fellowships, such as REI, which has much more predictable hours, fewer calls in the middle of the night, etc. Fellowship takes 4 years, but if its something you are interested in, that might be an answer to your balance question.

Personally, I almost went into anesthesia for lifestyle reasons and switched to Ob at the last minute. I know my life will be more difficult in many ways, but I'm so much more interested and passionate about OB/gyn, that I *hope* the sacrifice will be worth it. I figure you still have to work 60 hours/week in most fields in medicine (certainly in anesthesia and OB), you might as well love what you are doing with those 60 hours.

Good luck.

 

[MeganRose]

LC--
I guess there's really no hard and fast solution, just a question of finding that balance btwn professional and personal happiness once we start practicing in the real world. I admire you for following your heart and I really appreciate your thoughtful response.
Thanks!
Megan

 

[MeganRose]

LC--
I guess there's really no hard and fast solution, just a question of finding that balance btwn professional and personal happiness once we start practicing in the real world. I admire you for following your heart and I really appreciate your thoughtful response.
Thanks!
Megan

Anyone else want to share their thoughts?

 

[gynonc]

so as an off-shoot question, how flexible are residency programs with residents who want to take some maternal leave? about how much time can we ask for off and not get kicked out of the program? Also, is it true that 3rd and 4th year are much lighter than say 2nd year (obviously intern year is the worst). so would it make more sense to get pregnant 3-4th year if at all during residency. i know a lot of specific questions but better to ask sooner than later 🙂 thanks.

 

[ShambhalaRed]

I've been really gung-ho EM since soph yr of college. I enjoyed my first EM rotation this yr as a 3rd yr but really enjoyed the Ob Gyn rotation more. I just really loved the diversity-- surgery, primary care, lots of procedures-- all rolled into one. The 4yr residency length sucks but what worries me more is the lifestyle. I've spoken to a lot of Ob-Gyns and other docs and the answer varies from "this is a poor choice if you want to have a life" to "I have plenty time w/ my kids and family" The biggest goals in my life have always been to become a doctor and be a mom. I really want to spend a lot of time w/ my children, being very involved in their life. Sooo... I'm sure that this is something that all the people here that are comitted to OB had to weigh out. A few questions for you all. What is the lifestyle of an average Ob-Gyn like? Are there lots of opportunities for job shares/part-time employment? What other specilities were you considering and why did you eventually go with OB?

Thanks in advance,
Megan

Hi Megan,
I can't really speak to the lifestyle of an Ob/Gyn yet, because I haven't experienced it myself (just finishing med school currently), but I do want to comment on your EM vs Ob/Gyn dilemma, as it's one that I went through as well. I was 99% sure upon entering medical school that I wanted to go into EM. I had worked as an EMT in an ED for three years prior to medical school, and it was that experience that inspired me to go into medicine in the first place. The emergency department at my medical school runs very differently from where I worked before, and the residents and attendings have different roles from what I was used to. As I progressed through the first three years, I began to question whether EM was really what I thought it was going to be, and I spent a lot of time asking people in emergency medicine what they liked about it, why they went into it, if they had any regrets, what kinds of new and exciting things were on the horizon for the specialty, etc. Mostly I got a shrug and "it's a good lifestyle."

This happened to coincide with my third year Ob/Gyn rotation, which took me completely by surprise. I was terrified of Ob, thought "what the hell do I know about taking care of pregnant women" etc, like most people who don't understand the full spectrum of what Ob/Gyns provide. Like you, I was a little nervous about the "bad lifestyle" rumors, but when I talked to Ob/Gyns and asked them the same questions, I got much more passionate and enthusiastic responses. We face a lot of obstacles in Ob/Gyn: high malpractice premiums, reproductive rights controversies, long hours, etc. But I think that means that the people who end up choosing Ob/Gyn do it because they absolutely love it and can't imagine doing anything else. I think it has a lot of the same draws as EM: variety, drama, lots of hands-on skill, etc. But I think it has additional perks like being able to establish relationships with some of your patients (while in EM, the only continuity you have is with the patients you never want to see again). I originally thought this wasn't important to me, but boy did I get sick of having to introduce myself to everyone for the first time during medical school...

Ultimately this has to be your personal decision. For me, I was willing to sacrifice my lifestyle for a while to go to work every day knowing I was going to love what I do. I didn't think the EM lifestyle was worth it. I saw a lot of EM folks getting beat up upon by medicine, surgery and virtually every other specialty who thinks they can do an emergency physician's job better. I didn't want to work three days a week at a job that didn't make me feel good and where other people were constantly second guessing my work. One of the great things about Ob/Gyn is that NO one else wants to do your job or thinks they know more about it than you do. I think there are still lots of emergency departments in the country where you can still be relatively autonomous as an EM physician and see the kinds of cases that make EM worth it. But I saw the EM physicians at my medical school basically playing triage and having to consult medicine or surgery residents for all the interesting stuff, and that's not what I wanted to do with my life. If that doesn't bother you, and you think it would be fine to have a career where you can just go to work, put in your hours and have lots of free time to do other things (please let me emphasize that I in no way condemn this approach, it's just not what I personally wanted), then EM is probably a great career choice.

Good luck with your decision! It's a tough one for sure!

 

[jessie]

on the topic of lifestyle, would it be best to avoid this specialty if a female doctor is NOT heterosexual even though it may be one's preferred specialty? i'm not sure how accepting patients would be to such a lifestyle...? i guess one could always avoid disclosing this info if it is going to create problems.

 

[fuzzyerin]

on the topic of lifestyle, would it be best to avoid this specialty if a female doctor is NOT heterosexual even though it may be one's preferred specialty? i'm not sure how accepting patients would be to such a lifestyle...? i guess one could always avoid disclosing this info if it is going to create problems.

I don't think one's sexuality usually comes up with one's patients. That being said, one of the women in my resideny program is gay, with a serious girlfriend and a child. Not an issue to any of us, any of the faculty, and I haven't seen a patient kick her out of any procedure. Actually, when I think about it, if I didn't know she was, I don't know if I would think she was. And really, I don't think our patients spend THAT much time with us to really know who we are - it's our job for us to get to know the patient, not the other way around.

Again, it's not a big deal. Don't let it stop you from entering great field!

 

[Diane L. Evans]

so as an off-shoot question, how flexible are residency programs with residents who want to take some maternal leave? about how much time can we ask for off and not get kicked out of the program? Also, is it true that 3rd and 4th year are much lighter than say 2nd year (obviously intern year is the worst). so would it make more sense to get pregnant 3-4th year if at all during residency. i know a lot of specific questions but better to ask sooner than later 🙂 thanks.

Usually 6 weeks is reasonale perhaps 8 weeks for Csec c complications. Any more time than 8 wks total /yr in the 1st 2 years will result in you making up time at the end.