I was wondering what are things to look for in an OB/GYN residency program? I know that in any specialty, residency is going to be hard and there are going to be long hours. However, for OB/GYN and other surgical specialities, I have heard of there being “malignant” residency programs. What does that mean? (Does that mean work hours, resident support culture for mental health, from attendings, and from other residents?)
Malignancy when it comes to OBGYN programs specifically I would say refers to the inter-resident culture less so than attending/admin vs. resident issues you would expect to see in surgical subspecialties, the obvious one being pressured into intentionally logging fewer work hours.
In OBGYN, you’re never going to get along well with all of your coresidents, especially in larger programs. However, there is a difference between just not hanging out or socializing and actively sabotaging. The latter happens in “malignant” programs where there is a culture of shifting blame or conscious scheduling decisions to certain residents and there is a lack of solidarity among the resident body. Residency is tough and residents are the boots on the ground, and so if you can’t rely on your fellow residents for patient care, bringing issues up to admin, or having your back whenever something happens then your life is going to be miserable.
There’s not a good way to tease that out when you’re doing interviews, but I would say the best way to get a feel for that is watching the interactions between residents during the pre-interview social event and in the social break room and if it seems that everyone is talking with everyone or if there are cliques you can pick up on. Obviously also look at how the residents interact with the attendings as well; for example, when I interviewed with the program I’m currently at, I watched residents from all classes literally shoot the **** with the
chair of the department. At many other programs there was a noticeable divide between the residents and the attendings present, which is a glimpse into how your future interactions with the attendings may be at that program. My program really feels more like a big family than a hierarchical organization and we don’t have a problem unbuttoning the proverbial collar even when on shift or in clinic, which makes things a little more fun, something that I didn’t know I would appreciate as much as I do as a resident in this field.
Another thing to be aware of in a residency program is how much clinical time is spent doing admin/clerical work. For example, at several programs the residents will do things that ancillary staff should be capable of doing, like scheduling and booking patients for surgery after you’ve spent the last 20 minutes consenting them for the procedure (a clinic RN is more than capable of giving the patient a list of dates and signing the consent forms after you’ve done your part; instead you spend another 10 minutes putting in the orders for the case and typing up and signing the consents) or arranging Anesthesia appointments prior to surgery that work with the patient’s schedule (again, a clinic RN or navigator can do this) or calling patients to follow up on why they no-showed their last appointment. And then when you go off rotation and there’s a patient that needs to be rescheduled the next team will probably have no idea and then the patient gets lost because the system relies on the residents to keep track of everything rather than one person or a group of people whose only job is surgical scheduling. I find those types of activities don’t add to your learning of how to be an OBGYN and you’d be surprised how much of your time gets eaten up doing those things, not to mention how it can compromise patient care.
It’s also good to know if your program/hospital routine delivers patients from outside clinics (through business agreements the hospital itself has with those clinics and not necessarily an agreement your program specifically has with them). I didn’t realize this would matter so much but it does when you’re admitting people for labor who you have zero ability to see medical records for so you don’t know what’s transpired during their prenatal care.
Does anyone know of a list of OB/GYN residency programs that are good to apply to? I am an Ohio resident and currently live in OH. I’m interested in applying to residency programs in the Midwest, East coast, and South since I have family support and connections in all of those areas.
Everyone’s list is going to be different, but it also depends on what you want out of a program. Subspecialization (which means research)? For your locations you want to look at:
Northwestern
UAB
Emory
U of Florida
U of Cincinnati
OSU
Vandy
Baylor
UNC
Duke
Any of the UTs
UPMC
Cleveland Clinic
Mayo MN
IU
I will disagree with the above that even mid-tier programs will be fine for UPRS/FPMRS/Urogyn. Spots are extremely limited and it’s a desirable field when it comes to lifestyle. I think MFM is also trending that way, becoming more popular as recent graduates are prioritizing work-life balance and community MFMs in many cities have a fairly excellent schedule (some don’t even take OB call).
