To branch off of that, do some of your ob/gyn colleagues not perform elective abortions? Wondering how common it is for docs to decline to do them due to personal beliefs.
TERMINATIONS & PROVIDER CHOICE
I live in the South. It is
extremely common for ObGyns here not to participate in elective terminations (and actually quite common to run into people who will not participate in ANY terminations - even medically indicated - if the fetus is still alive). Additionally, there are still many hospitals which do not even allow elective terminations to be performed in the facility. We even have difficulty staffing our ORs (and occasionally our L&Ds) for medical terminations. The culture of where I am located drives this and elective terminations are performed almost exclusively at dedicated facilities.
STERILIZATION/CONTRACEPTION
Additionally, there are still hospitals in this part of the country which operate under a Catholic religious base and do not even allow surgical sterilization (tubals, Essure, etc.) to be performed in their facility. On the extreme of that there are Catholic-based clinics which limit contraceptive options which can be prescribed (no IUDs, no emergency contraception, etc.).
I interviewed at a program (not the program I chose, but it's not far from here) where the residents could not learn tubal ligation at their primary facility and were actually having to pre-op their patients and schedule their tubals at a hospital across town then go over there for their sterilization training. Welcome to The Bible Belt.
Do you enjoy the OR time more or managing deliveries more or the GYN part?
OPERATING VS OFFICE VS LABOR/DELIVERY
Interestingly I chose this field thinking I'd love the Ob and tolerate the operating and office-Gyn through residency then make my way to an REI (reproductive endocrinology & infertility) fellowship and never do any of that nonsense again.
I really, truly did not enjoy surgery as a student. I hated standing there for hours watching people do things I didn't understand or enjoy. I was uncomfortable. People seemed on edge. It never felt smooth. I was afraid to move or touch anything.
During residency I absolutely
fell in love with the OR. I love surgery and got very, very close to applying to an Onc fellowship because I enjoyed it so much. I have received such excellent generalist and operative training that it convinced me I couldn't do a fellowship, because I was really sad at the thought of giving up any one area of the field.
So, I really love all of it. Managing labor is fun, but we do it so much that I will not miss having dedicated L&D board days when I get into the real world. I look forward to being able to do clinic and OR then head to L&D for deliveries/checks/management when needed! Among my colleagues I expect that I will have a far more OR-heavy practice than some of the others.
Any advice for men entering the field? I hear a lot about how it's not a friendly specialty to male medical students and that it's getting harder for men to match. To me this seems like skewed perspective (you tell ten people about a bad experience, but only one person about a great one).
Any thoughts?
MALE OB/GYNS
Great input above (similar question I answered and also an answer from
@Dr G Oogle . Our male residents are well-loved by the program, their patients, the nurses (omg the nurses...there is SO much Estrogen from patients to nurses to residents to staff...they will advocate EMPHATICALLY for a male applicant they've never met just to get some testosterone into L&D). If you love the field you will not feel out of place due to being male. No probs.
Since I have always wanted to be in OB/GYN what do you think of the stereotypethat everyone is mean? So many horror stories on SDN, yet my experience is completely different, with most attendings being happy, fulfilled and proud of making a difference.
THOSE BITCHES
The age old question. I find myself commiserating this with my colleagues often.
I have a couple of theories. Who really knows...it's definitely a pervasive belief among incoming MS3s.
Where I went to med school there was one somewhat grumpy resident, she made a quiet/reserved med student cry mid-L&D hallway on my rotation. This got perpetuated into "the mean Ob/Gyn residents" even though every other resident was amazing (and, in fact, an ObGyn resident won the all-department yearly teaching award my 3rd year of med school and two of the years I've been in residency at a different program - so we can't all be that terrible).
One issue I see is that there is a subset of students who expect to be guided through things and when you work in an environment that is high-stress and non-stop people will feel ignored. Being short/direct/goal-oriented can get interpreted as being harsh/mean when it's meant only as efficiency.
Another issue is that we are nearly all strong-personalities. For whatever reason this field attracts sarcastic, take-no-****, obsessive people. It can be overwhelming to be in that environment if you tend towards more reserved/shy. People with strong personalities do extremely well on their Ob rotation, as long as they know how to harness their actions/words and not come off as holier-than-thou.
Surgery residents (particularly female surgery residents) also seem to get this reputation and I think it's for a really similar reason.
It's very interesting on this side, because I have a tendency to get glowing reviews from about 50% of the students, then average good-not-amazing-not-terrible reviews from about 25%, and "she ignored me/she's mean/she told me I was wrong" from the others. I can always predict when I have a group of students who will give me mediocre or bad reviews - there are factors from my end that play into it (what rotation I'm on, how busy we are, the number of ****ty outcomes we've had, how tired I am, if my baby refused to sleep, if my night call turned into a 36hr shift bc L&D was insanity, etc) and there are student factors that play into it (how prepared each student was - I do not beat around the bush when I'm frustrated that a student doesn't know their patient or anatomy in the OR, how interested they were - not that you need to LOVE Ob, but some people just have an obvious desire to learn and others do not, what point in the year it is for their rotations, how the group communicates with each other and with us, etc.).
Anyway, we aren't dinguses, but most of us do set the bar high and have no problem letting people know when we're disappointed. Some people do this with more tact than others and some students appreciate it while others are very offended. I think if you come in prepared, eager to learn, and work hard you will have no problem seeing the happy side of Ob.
That being said, I'm also at a very non-malignant program and went to a non-malignant med school.
🙂
Thanks for doing this. Did boards studying affect your marriage at all? And how did you go about discussing geography and residency options when it came time to rank, babies and all?
STUDYING/MARRIAGE
I'm assuming by boards you mean USMLE Step (currently studying for my written Ob/Gyn boards). I don't think board-studying was much different than med school in general. My husband is extremely self-sufficient and low-maintenance and has taken training in stride with very little complaints. As mentioned earlier, strong relationships will be fine and rocky relationships will have every little crack magnified. My marriage has not been affected negatively by training, but we've been together since we were 20yo and have made very directed efforts to keep our goals in line and our family/marriage a priority.
GEOGRAPHY/RESIDENCY
We knew we didn't want to go anywhere super cold, since that was important to us we drew a line across the US and decided to apply only South of too-effing-cold. It seems arbitrary, but something has to help you narrow down a starting point. We found programs where I'd get good training in vaginal surgery and forceps and made sure to apply to those. After interviews I ranked based on a number of things - how much we liked the people (super important), location/proximity to family (we're still not super close to most of our family), cost-of-living (resident salaries do not vary much by COL, so this was super important to us coming in with 2 kids), etc.