ZigZag

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Did any of you guys here think about doing obgyn before deciding on g surgery?
If yes, what were the reasons to choose surgery.
 

Tenesma

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ask yourself if you want to be a surgeon (GS) or some wanna-be surgeon (OB)...
 

kinetic

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I've never met anyone who has had OB in a toss up with anything else. Either you like dealing with pregnant, hysterical, complaining wimmen and performing endless numbers of pelvic exams or you don't. And usually if you like that stuff, you're nuts.
 
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Blade28

Pelvic exam versus rectal exam...which do you prefer? :) (Said with tongue-in-cheek, of course.)
 

doc05

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why choose surgery? too many reasons to list.
why NOT choose ob? too many reasons to list.

I think you know the answer to this one.
 

tripod

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i mean, come on now. you're asking this question in the SURGERY forum. what answers did you expect to receive?
 

tom_jones

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Blade28 said:
Pelvic exam versus rectal exam...which do you prefer? :) (Said with tongue-in-cheek, of course.)

Rectovaginal exam, the best of both worlds.



Seriosly though, OB sucks ass
 

Celiac Plexus

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since at one point i asked the same question (very early in medical school), i will attempt a serious answer.

ob/gyn training consists of 4 years... the first 2 (in general) are spent managing pregnancies/deliveries, clinic patients, floor patients, etc... in essence they are non-op years. sure you will get to scrub in here and there on some hysterectomies, and probably a fair number of colposcopies, but most op exposure is limited.

in the last 2 years, you will get formal surgical training. the total abdominal hysterectomy and bilateral salpingoopherectomy will become your best friend. you will also do a lot of caesarean sections. probably do some purely ovarian cases as well. i don't know what the rrc numbers for ob/gyn are like, but whatever they are you'll have to get them in year 3 and 4.

so, in essence, you will only get 2 good years of surgical training doing a (compared to general surgery) narrow scope of surgery. this has some important implications. one of them is that the people who are training you have the same type of surgical training as you will be getting: ie. not much. you cannot learn to be a "surgeon" in the way that we think of the term in a mere 2 years. you will find that there are *many* differences between ob/gyn attendings in the or and other surgeons in the or. i won't get into that here... you'll see for yourself during your rotations.

if you find out in the middle of your ob/gyn residency that you really love the surgery aspect, but not so much the labor and delivery/vag itch aspect of the job, then you will probably lean toward the only hard core surgery fellowship out there for ob/gyns... gyn/onc. unfortunately gyn/onc is a very small field and a fellowship in this field is difficult to get. however i have found that gyn/onc surgeons tend to be way more similar to other surgeons in their skill levels, and technique.

in support of ob/gyn i will say that there is the potential for excellent continuity of care. you have the opportunity to get to know your patients extremely well (and their growing families). and for someone who truly is only interested in the female repro. system, he/she might be satisfied with the minimal surgical aspect of ob/gyn. and there are other fellowships one may pursue after an ob/gyn residency which some people think are pretty cool, e.g. maternal fetal medicine aka "mfm".

at any rate, there are some similarities between the fields, but now that i am firmly entrenched in my own general surgery residency, i believe that there are way more differences and that if you are considering both fields then you would probably be happier in general surgery. otoh if the thought of delivering babies, and doing vagitch clinic really fire you up, then ob/gyn would be a solid choice.

best of luck.
 

fourthyear

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Yes, I'll admit to being a current surgery resident who once briefly considered OB/gyn as a med student. It is similar in some ways - procedural, some OR time, busy fast-paced schedule, and you get to be a part of some amazing stuff - sorry, but I'll have to admit that pulling a baby out and being there for that important moment in a family's life as a baby is born is nearly as cool as saving someone's life as a general surgeon in the OR. You still get to do something fun that very few people in this world get an opportunity to experience. Both are cool jobs.

But, I chose surgery...The main reason is what everyone else is saying that you just aren't as good of a surgeon in OB/Gyn - they do have less time in the OR in training and it's a much smaller scope/variety of procedures they do compared to general surgery. And when they have big complications/problems in the OR, they sometimes have to call the general surgeon in to fix them, so that tells you who comes out the more skilled surgeon if that's what attracts you to these fields. I love surgery and I want to be trained to do a lot of it and do it well.

Another thing you may not have considered is lifestyle. Although surgeons have what is typically percieved as the worst lifestyle, OB/gyns do in my opinion - a baby can be born at any hour and I imagine that I myself would prefer to deliver most of my "regular" patients myself, meaning that I couldn't just sit at home and let my partner deliver lots of my patients for me, I'd feel like I had to do it myself after this woman has been building a relationship with me as her docor for 9 months. So, that sticks you will lots of middle of the night calls getting up to go in. Versus a general surgeon, whom most of the patients that need emergent operations in the middle of the night are new patients who it would be appropriate to leave to any doctor on call that night and you can get in a big call group and make it such that you don't take call nearly as frequently as an OB doc trying to keep up with all these delivieries.

One more difference is variety of patients and problems. General surgery sees the whole range of gender and age. General surgeons learn lots of medical management even for critically ill patients. OB/Gyn people seem to spend their residency un-learning medicine and would likely not even try to manage an ICU patient. So, again, I went with surgery because I wanted to learn all this medical stuff too and b/c I like a variety of patients. Now, if you prefer a simple straightforward patient with a focused problem or much of your practice dealing with healthy patients, maybe OB/Gyn is more for you.
 

eilis721

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I also chose gen surgery after briefly contemplating ob vs. gs. My reasons are similar to all those listed above. Not only are you only working with females, which cuts you off from a huge patient population. But also, think of all the medicine you're missing out on...Someone once told me that a gen surgeon is like an internist that operates. You have to have a very wide knowledge base, something that you definately don't get in OB.
 

Whisker Barrel Cortex

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My sister considered both as a career. She liked the surgical aspect of OB/GYN and thought the hours and people were a little nicer. She ended up not liking a lot of OB/GYN, mainly the OB and the primary care stuff. She is now doing a fellowship in urogynecology. At one point in residency, she wished she had gone into general surgery.
 

Foxxy Cleopatra

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As a student, I tossed the idea of OB/GYN around as well. Luckily, the OB residents at my medical school actually were pretty decent and I really enjoyed gyn surgery. I thought that was something I wanted to be able to offer my patients. I also was somewhat under the impression that OB residencies can be like girls' clubs, similar to how surgery programs can be stereotyped as good ol' boys.

However, I was not in love with delivering babies, and I outright was not interested in things such as fertility issues and prenatal management. I later did surgery and found that I liked dealing with a wide variety of pathology, some of the operating I enjoyed most was outside of the pelvis, and I was interested in learning critical care.

If I was very interested in women's issues and enjoyed some of the previously mentioned things more than I do, I may have picked OB; however, surgery clearly has been the right choice for me.
 

medgrad

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I would like to add something in defence of OBGYN:

OBGYN is similar to Gen surgery only in that they are both surgically oriented!OBGYN is more about women's healthcare these days and unlike surgery has certain 'medicinal' problems like management of preeclampsia/eclampsia, GDM,general medical disorders etc etc.The main reason I feel that is responsible for a very 'uterus-centric' approach of OBGYN specialists is that they have to look after two lives practically in obstetrics and if one is not certified in internal medicine it is better to consult an IM attending considering the probability of being sued for a minor error or misjudgement which in obstetrics could mean Intrauterine death of the fetus.(too long a sentence!)

OBGYN as a specialty is no way inferior to surgery.. Surgeons as abreed are generally bold and daring.OBGYNs on the other hand understand that their patients are mothers, daughters,wives, and sisters and are the ones who contribute in a major role to the structural and emotional well being of their families.So their lives are too precious!!!

Try reading Williams',Novac's,Arias' and Te Linde's and you will realise the intellectual complexity of OBGYN.May I mention that the first laprascopic appendicectomy was done by Kurt Semms,a GYNAECOLOGIST.

Go for OBGYN if you like bringing new lives in to this world on a daily basis.But remeber that unlike surgery you will experience great amount of stress post fellowship if you decide to continue practising obstetrics; the future of an unborn person lies in your hands or may I say ventousse/forceps.( I for one spent the first two months of my life in an ICU as I was given a skull # by my obstetrician during outlet forceps application for prolonged labour and maternal exhaustion)
 

SocialistMD

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For me, it was the scope of the knowledge and the patient population. ob/gyns see only female patients and deal with a very focused part of their anatomy. I like being able to take care of any issue in my patient that may arise, and that is why I chose general surgery over ob/gyn, urology and neurosurgery (the other fields I considered during my medical school career).

fourthyear, you made a comment about how general surgeons are called in to help ob/gyn's sometimes in their cases. I agree, but I don't think it is just limited to ob/gyn's. In the 4 months that I have had on a surgery service, I have seen general surgeons as backup to ob/gyn, urology, neurosurgery, orthopedics and ent. Furthermore, any patient in the surgical ICU is automatically managed by a general surgeon. As I said before, this is what attracts me to general surgery over the specialties; if there is a surgical patient with multi-system disease or one who is critically ill (unless the primary is neurosurgery), the patient's primary care is provided by a general surgery team.
 

avgjoe

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I also considered ob before switching to gs. what changed my mind was that I just wasn't excited about any of the pregnancy issues, bleeding, vomiting, etc and i wasn't also as excited about the gyn problems - again, pain with menstruation, regular checks for cervical cancer, etc as i was by acute abdomen and other surgical issues. Also i simply didn't enjoy the uncertainty during each labor process - how long will it take? when should we check her? should we start pit? there didn't seemto be any right answer to any of these most of the time, and it seemed like a big guessing game. and some things like how long will it take can never really be known, which was frustrating.
 

Smoke This

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I'm a third year and very seriously considering both. Obviously if I went into OB/GYN I would have a highly surgical bent, probably doing gyn oncology. On the other hand as a general surgeon I could deal with a lot more varied pathology and maybe spend a few years on a military forward surgical team after residency before I settle down in private practice (another idea I'm kicking around).

I think you could have a satisfying surgical career doing either. OB/GYN has the added element of medical management for issues like endometriosis, dysfunctional uterine bleeding, etc. and the continuity of care with long-term patients that surgery lacks. Surgery has office-based procedures too so I wouldn't lose the "clinic" time that I kinda like, but it's obviously a trade-off either way. It's a lot to think about.
 
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ZigZag

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Thank you everybody for your opinions. It was very helpful. Hopefully, surgery clerkship helps me to decide.
 

Tenesma

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don't be confused that doing gyn-onc will make you much of a surgeon --- you have about 11-12 months of OR exposure during your 4 year OB/GYN residency, followed by 24 months of OR exposure during your 3 year GYN/ONC fellowship - not to mention 1 month of ICU exposure (if you are lucky).... the only good gyn/onc people are the old guys/gals where gen surg was a prerequisite. It is amazing how quickly these guys get into trouble with potentially very sick people and can barely fight their way out of a wet paper bag. Sometimes I wonder if a gen. surgeon would be a better choice for a pelvic exenteration??