OB fellowship...

[Femtochemistry]

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Hey guys;

After finishing my two month stay over in OB land, I found myself really, really enjoying it. I worked at a place that does over 10,000 deliveries a year, so managed to rack-up pretty impressive numbers (epidurals/spinals). The workload at times was hectic but the group of attendings and nurses were very helpful and nice.

My question: what's the future for OB anesthesia? Pros and cons? Just finishing up my CA-1 year so still pretty naive about fellowships. I know I want to do one but I have no clue which. My top 3 are CCM, cardiac, and now, OB.

Cheers 😀

 

[urge]

Go for it. A friend of mine went to an OB only practice and she couldn't be happier.

 

[PMPMD]

If your program does 10k deliveries/yr, you probably dont need the OB fellowship unless you want to stay in academics. Even then, for many places, the OB fellowship is not mandatory.

I know several people who were on the fence between cardiac and CCM, including myself. See how you like the rotations, and talk your attendings' ears off.

 

[Doctor4Life1769]

Is OB an accredited fellowship?

 

[Lightwand]

Is OB an accredited fellowship?

It is going to be within the next few years.

 

[Doctor4Life1769]

It is going to be within the next few years.

Thanks.

I'd think there's no benefit to doing an unaccredited fellowship, right?

 

[cchoukal]

Thanks.

I'd think there's no benefit to doing an unaccredited fellowship, right?

Too soon to tell. It was only a few years ago that cardiac became accredited. On the surface, it would seem that an OB fellowship would only be useful in academics, but who knows what the future will hold.

 

[urge]

If your program does 10k deliveries/yr, you probably dont need the OB fellowship unless you want to stay in academics. Even then, for many places, the OB fellowship is not mandatory.

OB only practices are very lucrative. They tend to hire fellowshiped(wtf?) people. I wouldn't do it for the money, though. If you like OB, money is a good perk.

 

[Doctor4Life1769]

OB only practices are very lucrative. They tend to hire fellowshiped(wtf?) people. I wouldn't do it for the money, though. If you like OB, money is a good perk.

What's the ballpark range? I'd think lifestyle would be a tad sketchy, especially with o/n L/D calls, stat c/s's, etc.

 

[cfdavid]

The private/academic group at my hospital uses mostly OB fellowship people for OB work. Mostly, that is. It seems like it's a plus for sure, as this is a high paying group and therefore really seek fellowships whether accredited or not.

I can say that they are very well respected by the residents and attending OB/GYN's. Nurses just don't put in epidurals here. Maybe the docs work a little harder, but I think it's worth it when everyone sees them working hard and earning the respect of their colleagues.

 

[Doctor4Life1769]

The private/academic group at my hospital uses mostly OB fellowship people for OB work. Mostly, that is. It seems like it's a plus for sure, as this is a high paying group and therefore really seek fellowships whether accredited or not.

I can say that they are very well respected by the residents and attending OB/GYN's. Nurses just don't put in epidurals here. Maybe the docs work a little harder, but I think it's worth it when everyone sees them working hard and earning the respect of their colleagues.

Great points.
I'm not a fan of CRNA's putting in epidurals when in the future I can do it.

 

[pgg]

OB only practices are very lucrative. They tend to hire fellowshiped(wtf?) people. I wouldn't do it for the money, though. If you like OB, money is a good perk.

Location location location ...

I'm one of those apparently rare anesthesiologists who really likes doing OB, but the only OB I do is in my military practice. 98% young healthy, extensive and complete prenatal care (with documentation even!), 100% "insured" ... plenty of young & dumb 23 year olds on kid #5 🙂 but on the whole it's the lowest risk patient population one could imagine.

6 miles away, on the other side of the barbed wire, it's the polar opposite. Almost everyone is uninsured / self-pay, prenatal care is minimal, English is often a 2nd languange, many are not citizens. It is anything but profitable to anyone involved. The physician group I moonlight with wants nothing to do with it anymore and so 100% of OB anesthesia is done by an independent CRNA group now. (Used to be we were kind of an off-site "backup" to the CRNA on call, which was a really uncomfortable arrangement to me.) Anyway, I don't know how that place keeps the doors open.



I thought about doing an OB fellowship. I spent some elective time as a CA3 guest at very highly regarded institution that had fellows and actually left kind of skeptical that they were getting much out of it. They seemed satisfied though. My residency program did a TON of OB so I felt pretty good about my training in that area. I have no academic ambitions, my future locations don't include "desirable" cities where the line on my resume might open doors, the fellows I met didn't inspire me to want to be like them, so in the end I just didn't see the point.

 

[seinfeld]

Doesnt make you anything special at the end of the day. What special skills will you gain as a result of the fellowship? Certainly you wont be able to place a spinal or epidural better than I. IF you are interested in academics it may make area of research and rare procedures ie exit to ecmo, more within your grasp.

 

[cfdavid]

Doesnt make you anything special at the end of the day. What special skills will you gain as a result of the fellowship? Certainly you wont be able to place a spinal or epidural better than I. IF you are interested in academics it may make area of research and rare procedures ie exit to ecmo, more within your grasp.

I respect your opinion. Certainly you have more experience than I in this matter.

All I can comment on is from what I've seen at a large, multi-hospital, well-paying group. They are considered elite in the area and they absolutely do desire fellowship trained folks. That, or you better be chief resident from a good program. This is one group only, mind you.

I think that a fellowship may be very useful if the market constricts and if the political climate changes. That being said, clearly there can be opportunity cost to that extra year....

 

[seinfeld]

I think you reply does point to a key. If you know where you want to go and work, talk with that group, see what needs they have, and if an OB fellowship helps you in the door then great ( i would sign a contract though as to not have lost $200,000 plus for just trying to get in the door). I would not just do it because you like it without understanding that in most cases,not all, it will not help you.