Ob/gyn or Peds??

[Scarlett218]

MS3 here in an accelerated curriculum (they’re making us pick a specialty advisor now.)

I thought I had decided on Peds, enjoyed everything I’ve done in Peds so far, love working with kids and parents. But I am now on my OB rotation (final core rotation) and am unexpectedly loving it. Deliveries are amazing, and I realized I’ve really missed the OR and even if I’m just watching and cutting sutures time flies in a way it doesn’t elsewhere.

Yes, these are very different specialties, but they have a few things in common that are appealing to me: close patient relationships, the ability to long-term influence health habits, a fairly healthy population --- I was interested in MICU for a while until I rotated there and was disillusioned by how often the “cool procedures” that I had wanted to do seemed futile for the patients.

In a c-section, am I interested in finishing the section or resuscitating the baby – both! I do want to know how the baby is doing later if they need the NICU.

If I were to go into peds I already knew I’d want a procedure-heavy field i.e. PICU/NICU/cards.

Salary is not important to me, any physician makes as much as I realistically want/need.

Lifestyle – if I’m happy, hours fly, and if I’m not, 9-5 feels like a 24, so I’m okay with long hours / nights, but that said I am getting married soon (my fiancé is not in medicine, is super supportive of whatever I want to choose) and want a family eventually and want them to know who I am, and am a little bit scared by the fact that it seems like people often regret a career in OB/GYN for this reason. Also malpractice is scary.

Can anyone here who was choosing between OB and something more medicine-oriented help me out?

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[BigTumor]

Glad you’re excited! You may have to do a sub-I in both to find out. That happens sometimes. How do you feel about gynecology?

 

[Moose A Moose]

Your advisor won’t be able to provide anything more for you than you could accomplish yourself on Google.

Take your time deciding. Don’t try to cope; the two are very different specialties.

 

[anonperson]

MS3 here in an accelerated curriculum (they’re making us pick a specialty advisor now.)

I thought I had decided on Peds, enjoyed everything I’ve done in Peds so far, love working with kids and parents. But I am now on my OB rotation (final core rotation) and am unexpectedly loving it. Deliveries are amazing, and I realized I’ve really missed the OR and even if I’m just watching and cutting sutures time flies in a way it doesn’t elsewhere.

Yes, these are very different specialties, but they have a few things in common that are appealing to me: close patient relationships, the ability to long-term influence health habits, a fairly healthy population --- I was interested in MICU for a while until I rotated there and was disillusioned by how often the “cool procedures” that I had wanted to do seemed futile for the patients.

In a c-section, am I interested in finishing the section or resuscitating the baby – both! I do want to know how the baby is doing later if they need the NICU.

If I were to go into peds I already knew I’d want a procedure-heavy field i.e. PICU/NICU/cards.

Salary is not important to me, any physician makes as much as I realistically want/need.

Lifestyle – if I’m happy, hours fly, and if I’m not, 9-5 feels like a 24, so I’m okay with long hours / nights, but that said I am getting married soon (my fiancé is not in medicine, is super supportive of whatever I want to choose) and want a family eventually and want them to know who I am, and am a little bit scared by the fact that it seems like people often regret a career in OB/GYN for this reason. Also malpractice is scary.

Can anyone here who was choosing between OB and something more medicine-oriented help me out?

General OB GYN:
Typically is outpatient based. You can operate or turf your general gyn surgical cases. You will take L and D call which can be the main issue. Will you be fine taking call in 15 years? Remember, patients will deliver at 3am etc which can significantly impact your quality of life.

The patients you see in the office will consist of OB or GYN.
OB is fairly straightforward and uncomplicated pregnancies have minimal management issues. The higher risk stuff is generally co managed with MFM. Malpractice is an issue but if you practice in the right state, then premiums aren't too bad. The patient population can make or break this. If you have a non compliant population partaking in risky behavior (drugs, missed appointments etc), it can be exceedingly painful to care for them. And it's not like other specialties where you can discharge a patient easily. You can easily be stuck with a patient until delivery. Patients can and will sue for any perceived negative outcome. Nothing you can do about it other than practice good medicine. Typically from reading judgement reports in some of the throwaway journals, the general theme of physicians either ignoring warning signs or not intervening soon enough comes through.

GYN isn't overly difficult either. 95% of patient issues are as follows: bleeding, pain, discharge, abnormal pap smear management, fibroids/ovarian cysts, prolapse, menopausal issues. Lawsuits will occur from delayed diagnosis or missed diagnosis of cancer. Chronic pain or other organ injury after surgery. Proper informed consent should minimize this risk.

Don't forget the burnout rate in OB GYN is reasonably high and career dissatisfaction is reasonably high as well.
Call is the main issue at the end of the day. Obstetric call is physically demanding and can be potentially stressful. It's fine when you're younger, but it is challenging the further in your career you are.

I don't post this stuff to be overly negative but this is the reality of everyday practice.

 

[xoxo2016]

Hello!

Everything you mention: not worried about salary, enjoying babies etc points to doing something other than Ob. Particularly if you want to enjoy your family - residency is no joke. I'm an obgyn resident with a baby and a very supportive husband and it is still so hard. Most days I don't know if spending this many hours on L&D is even worth being away from my family. I went into Ob for the sake of a fellowship and that's what keeps me going each day. message me if you have any more questions 🙂