Ob or Peds Help!

[Meggiemarie114]

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I am a third year who is completely torn between Ob and peds. My whole life I always thought I would do some type of pediatric subspecialty, but then I fell in love with Ob too. So I am currently trying to figure out where I would fit in best. One important thing is that I desire to practice medicine where I have the ability to establish continuity and bonds with my patients, and I feel I could get that with either.
I'll start with ObGyn. I never expected to like it, but I loved every aspect of ObGyn. I not only liked delivering babies, but I also liked dealing with cancer. I love that there also is an endocrine side to it. Even early on I noticed that I was very comfortable having what other people in my rotation considered awkward conversations about sex with my patients. What surprised me the most is that I enjoyed the OR so much! In summary, I like the fact that ObGyn has so many different facets to it, so that my ADD nature does not get bored, and I enjoy that I can get to know the whole family by delivering the children then caring for them when they are of age. My biggest concern is that my personality does not align with those in Ob. Some say it has a stereotype of having harder personalities, but I like to think I am the opposite and am a pretty cheery person.
So pediatrics... I always thought that I would go into pediatrics because I absolutely adore children. I have always said that children still have their whole lives ahead of them so I want to be able to help children live that life. I even had this discussion with my 13 yo patient today, and she told me I should do peds because I was good with kids. I know that I would not do general pediatrics because I want to be more specialized, in order to know more about one area of medicine. I like more critical thinking subspecialties such as nephrology or endocrinology, and I also like critical care. With peds though, I miss my chance to be in the OR. Most importantly, don't know if I just love kids or if I am meant to also be their doctor. I worry that I have too much of a soft spot for children and when things go wrong, I worry that it will start to get to me.

So any advice picking between the two? The salary and hours don't make a difference to me. If I am happy what I am doing, it will make balancing all aspects of my life easier.

Ps I also tried the test in a delivery of who I gravitated more towards- the baby or the mom. I was completely split between the two.

 

[Osteoth]

I am a third year who is completely torn between Ob and peds. My whole life I always thought I would do some type of pediatric subspecialty, but then I fell in love with Ob too. So I am currently trying to figure out where I would fit in best. One important thing is that I desire to practice medicine where I have the ability to establish continuity and bonds with my patients, and I feel I could get that with either.
I'll start with ObGyn. I never expected to like it, but I loved every aspect of ObGyn. I not only liked delivering babies, but I also liked dealing with cancer. I love that there also is an endocrine side to it. Even early on I noticed that I was very comfortable having what other people in my rotation considered awkward conversations about sex with my patients. What surprised me the most is that I enjoyed the OR so much! In summary, I like the fact that ObGyn has so many different facets to it, so that my ADD nature does not get bored, and I enjoy that I can get to know the whole family by delivering the children then caring for them when they are of age. My biggest concern is that my personality does not align with those in Ob. Some say it has a stereotype of having harder personalities, but I like to think I am the opposite and am a pretty cheery person.
So pediatrics... I always thought that I would go into pediatrics because I absolutely adore children. I have always said that children still have their whole lives ahead of them so I want to be able to help children live that life. I even had this discussion with my 13 yo patient today, and she told me I should do peds because I was good with kids. I know that I would not do general pediatrics because I want to be more specialized, in order to know more about one area of medicine. I like more critical thinking subspecialties such as nephrology or endocrinology, and I also like critical care. With peds though, I miss my chance to be in the OR. Most importantly, don't know if I just love kids or if I am meant to also be their doctor. I worry that I have too much of a soft spot for children and when things go wrong, I worry that it will start to get to me.

So any advice picking between the two? The salary and hours don't make a difference to me. If I am happy what I am doing, it will make balancing all aspects of my life easier.

Ps I also tried the test in a delivery of who I gravitated more towards- the baby or the mom. I was completely split between the two.

Advice I was given was when choosing between two specialties you really love, choose the one with the better lifestyle and your future sanity and family will thank you for it.

Why not do peds then do a peds surgery fellowship if you really can't live without the OR later on?

 

[togaedere]

not a surgeon, but fairly certain you have to go through gen surg first before pediatric surgery fellowship. highly competitive.

unless there's a pathway i'm not familiar with?

Advice I was given was when choosing between two specialties you really love, choose the one with the better lifestyle and your future sanity and family will thank you for it.

Why not do peds then do a peds surgery fellowship if you really can't live without the OR later on?

 

[Perrotfish]

not a surgeon, but fairly certain you have to go through gen surg first before pediatric surgery fellowship. highly competitive.

unless there's a pathway i'm not familiar with?

You are correct. All of the peds surgery fellowships are fellowships off of a surgery residency. Peds surg is a surgery fellowship, peds neurosurg is a neurosurgery fellowship, etc. The only exception is Peds CT surgery, which is a sub fellowship: gen surg, then peds surgery, then peds CT surg.

 

[mvenus929]

You could be an interventional cardiologist--some time in the 'OR' (cath lab), some time in clinic, some time in the ICU. But their personalities are pretty hard too. Basically anything dealing with the OR is.

GI is also a possibility--they do lots of scopes.

I think there are some peds endo docs working on reproductive endo, if that fascinates you. Some, I think, do FNAs for thyroid issues, but I think that scope is moving towards the pathologists/ENT surgeons.

Depending on where you want to practice, you may be able to do some of all of OBGYN by being a generalist, but otherwise, you would also have to specialize and wouldn't get all the variety that you seem to love.

You could do peds GYN, though. We have one of them that everyone loves that our peds residents rotate with.

I don't know which is the best fit for you, but I would recommend doing a couple of fourth year rotations and seeing how you feel. If you get letters for OB-GYN, just request that they don't mention a specialty because you aren't sure which you want to do, and you can use those for peds. Not sure about the reverse.

 

[BigRedBeta]

The only exception is Peds CT surgery, which is a sub fellowship: gen surg, then peds surgery, then peds CT surg.

Actually it's Gen Surg -> CT surg (or an integrated program) ->Peds CT surg. Not much need to spend two years learning how to do Ladd's or Kasai's when you're going to be north of the diaphragm almost exclusively.

Ps I also tried the test in a delivery of who I gravitated more towards- the baby or the mom. I was completely split between the two.

That's usually the best indicator. But since it wasn't...

The big question is how much do you need the OR? And, did you love the OR on your General Surgery clerkship, or was this something that came out of the blue during your GYN rotation.

If you NEED the OR to feel complete as a professional, then the choice is clear, do OB/GYN. And that's how I would phrase it to yourself, not "could I be happy without it?" because the answer will inevitably be "yeah, I can be happy". I'm talking about making sure there won't be a hole in your identity as a physician. Because while something like interventional cards or GI has procedures, you're going to be doing a lot of training before you really get to be in the cath lab or the GI room on any sort of regular basis. At least with OB/GYN you'll be getting in there regularly from early on.

If you have done your general surgery rotation, and DIDN'T love the OR then, I think you need to explore why that wasn't as intriguing to you. Was it the cases? Was it the people? Something else?

If you haven't done surgery yet, then pay close attention to how much you like it with a different set of attendings and different case load. While I'm not expecting you to have an identical response to watching your 18th lap chole, the people who love the OR generally love it in all forms. They find something about that environment that speaks to them and enjoy the process.

I always caution students to focus on the medicine and ignore the fact that you had great residents or attendings. The people you're around will change, but the medicine will always be the same. Let that be your guide.