OB/GYN AMA for DO students

[objleakT]

Hey everyone,

For what it’s worth, I am a DO going into my fourth year of OB/GYN residency and can answer any questions anyone might have now that I have been through applications both as a resident and sit on our interview committee.

Let me know!

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[IssaDr]

Hi OMS-II here! Seeing that you're in your fourth year, you applied prior to the merger. Did you take both COMLEX and USMLE and apply to both ACGME and AOA? If you don't mind sharing, what were your scores? How many interview invites did you receive vs how many did you attend? Also what kind of program are you at (academic/university, community, urban, rural, etc.) and was it your top choice?

 

[objleakT]

You’re right, I applied just before the merger. I had 8 interviews to former DO residencies and 8 interviews to MD residencies. I took step 1 of USMLE but it wasn’t as strong as the rest of my app so I didn’t take step 2. My stats were:

COMLEX Level 1: 654
COMLEX Level 2: 662
COMLEX PE: pass
USMLE Step 1: 216
8th in med school class

Based on the strength of my COMLEX scores and the fact that I had overall a stellar app otherwise, I decided to not take step 2. I went on roughly 7 former DO interviews and 6 of the MD interviews before I had made up my mind. I ultimately chose a former DO program that was one of the first to achieve accreditation by the ACGME. I’m at a community hospital branch of a large academic center, which IMO gives me the “best of both worlds.” This was my top choice, and I did not “audition” at the program I am at.

Community vs academic programs is a little bit of a misnomer in OBGYN and here is why.... I think if you are interested in a fellowship then you should pursue an academic program or a program like mine that is affiliated with a larger academic center. However, I feel like if you want to be a great generalist with strong skills, community programs are much more beneficial. In general, at community programs, surgeries are unopposed by fellows. OBGYN now is going the route of MIGS doing a lot of the laparoscopic hysts, gyn onc doing all cancer, urogyn doing all suspensions, etc. At a community program though, a lot of these subspecialists are present without fellows, meaning I currently will do the entire surgery with these attendings since the end of year 2, which has really grown my surgical skills. I already feel more comfortable than a lot of my academic center counterparts in surgery for this reason.

 

[stickgirl390]

From your experience on the interview committee, how does your program view Step scores? Do you weigh scores very heavily or do you just have a minimum requirement and the rest of the application is weighed more heavily? Thanks!

 

[objleakT]

From your experience on the interview committee, how does your program view Step scores? Do you weigh scores very heavily or do you just have a minimum requirement and the rest of the application is weighed more heavily? Thanks!

We have a minimum requirement for both COMLEX and USMLE scores. Essentially that is what we use to narrow down the candidate pool, and it does narrow it down dramatically. Our cutoff ranges from 210-220 usually for USMLE and 525-550 for COMLEX. After that, we look at LORs, transcripts, and to a lesser extent personal statements to decide how to grant interviews. Of course, if an applicant gets a 235, 250, 650, 675 on steps/levels one and two, we would weigh that more heavily than someone that just makes the cutoff.

 

[deleted849476]

OMS-II here, thanks for the thread

How much women's primary care do you really get to do? Can OB/GYNs truly replace say, FM, and manage HTN, basic cold/flu stuff, etc., just as good as FM or IM can? For example, could an OB/GYN run an urgent care (in theory)?

Along those lines, what factors would you tell someone to consider when choosing between OB residency and being a family med doc who does a lot of OB?

Is there any demographic of women who particularly choose an OBGYN for their primary provider over an FM or IM doc? (I'm guessing they might prefer OB if they're planning on becoming pregnant?)

Is OB/GYN the happy medium it seems to be between some clinic, some surgery, delivering babies, etc.? I see a lot of people complain about the call schedule, but if that doesn't really bother me, then at first glance it seems like a good choice for someone who would like to do some surgery and some primary care and have a varied practice. Any thoughts or pros/cons I'm missing?

Last, have you seen any OB/GYNs do cosmetic or reconstructive surgery in their practice or is that pretty much limited to plastics? (at least for breasts/vulva, and if I understand correctly this is not the focus of "female pelvic med & reconstructive surgery" ... right?)

Thanks again!

 

[objleakT]

OMS-II here, thanks for the thread

How much women's primary care do you really get to do? Can OB/GYNs truly replace say, FM, and manage HTN, basic cold/flu stuff, etc., just as good as FM or IM can? For example, could an OB/GYN run an urgent care (in theory)?

Along those lines, what factors would you tell someone to consider when choosing between OB residency and being a family med doc who does a lot of OB?

Is there any demographic of women who particularly choose an OBGYN for their primary provider over an FM or IM doc? (I'm guessing they might prefer OB if they're planning on becoming pregnant?)

Is OB/GYN the happy medium it seems to be between some clinic, some surgery, delivering babies, etc.? I see a lot of people complain about the call schedule, but if that doesn't really bother me, then at first glance it seems like a good choice for someone who would like to do some surgery and some primary care and have a varied practice. Any thoughts or pros/cons I'm missing?

Last, have you seen any OB/GYNs do cosmetic or reconstructive surgery in their practice or is that pretty much limited to plastics? (at least for breasts/vulva, and if I understand correctly this is not the focus of "female pelvic med & reconstructive surgery" ... right?)

Thanks again!

These are good questions! As far as primary care, in residency and beyond, a lot of OB/GYNs do some but not a lot of the conditions you mentioned. We can’t replace FM. As an OB/GYN I feel comfortable with taking care of young women with high blood pressure after pregnancy, but I would still recommend they see a PCP. As women age, we take care of mammogram/colonoscopy/DXA orders or referrals, but management of diabetes/HTN/CHF need to be done by a PCP for better quality of care. Not to mention that as you build an OB/GYN practice, you likely won’t want to do those things because it will take away from obstetrics, surgical procedures, etc. It also creates less revenue

I would tell you that unless you are going to practice in a very rural area, the FM doc who does a lot of OB are very few anymore. Due to the extremely litigious nature of obstetrics, this is rare, although maybe does have its place in extremely underserved areas that need someone to deliver the occasional baby.

The old saying is that women are the entry point for medical care in the family unit. Meaning a woman is seen by her OBGYN for pregnancy, and will bring her kids to the doctor and then influence her significant other to attend physician visits as well. For this reason, women will usually seek out and OBGYN strictly because they become pregnant, and then get set up for annual exams after that. It’s then usually up to us as gynecologists to know our limits with medical history and refer to the appropriate provider.

In the real world, obgyn is 3-4 days in the office with a surgery day usually. The call schedule can vary and can be in house or home call, ranging from 1:2 in rural areas to 1:10 in well populated areas. I do think it is a great balance and variety of practice, even in the office we do procedures such as mass removal, LARC placement, EMB, LEEPs, etc.

I have seen OBGYNs do vaginal rejuvenation (Mona Lisa) and there are new things like that some of them do for extra money. Some are certified in Botox, although I have rarely seen this. FPMRS are not involved with the breast at all and usually focus on things like prolapse, incontinence surgeries. As a general OBGYN I will never do any type of elective cosmetic vulvar reconstruction, although perhaps a FPMRS trained obgyn may want to do so depending on clientele. Really performing things outside your scope of medicine is a disservice to your patients if you haven’t seen or done many of them, because mastery takes time to achieve and if you only do one of these surgeries a year it is important to just refer them to someone better.

 

[JimBone905]

Can I do OB with a 540 comlex?

 

[Cranjis McBasketball]

Can I do OB with a 540 comlex?

Whats your step score

 

[JimBone905]

Whats your step score

Waiting until july 7th to find out. Is it possible with just comlex?

 

[Cranjis McBasketball]

Waiting until july 7th to find out. Is it possible with just comlex?

I mean its possible but not probable. Definitely come back with your step score. Especially with a 540. Thats a good score, but its not a 600 or 700+ ya know?

 

[objleakT]

A 540 would get you past the cutoff of most former DO only programs, but it would definitely limit you in competitiveness.

 

[FistLength]

Since AMA...

the archetype of unhappy obgyn residents, dare I say "malignant", seemed to check out. What was/has been your experience?

 

[FutureDoctor5000]

Waiting until july 7th to find out. Is it possible with just comlex?

You are game for the former AOA programs, there's 27 of them, I would focus on them plus community MD programs if you do terrible(<220) on STEP1.

 

[mommieofthree]

When did you start getting interview offers for ob/gyn

 

[mommieofthree]

How many programs did you apply to

 

[deleted1100659]

i dunno if OP still checks this since the original post is fairly old. I wonder if I should do this for psychiatry tho