OBGYN vs. EM

[AbuJadenDO]

I didnt know whether to post this in here or in EM but I'd love to hear what you guys think are the pros/cons of obgyn vs. em?!?

i am getting to a crucial time where I have to decide between the two because I love them both and my fourth year is starting soon.

I want to see if you guys point out things that I haven't thought of.

thanks in advance!

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[tiredmom]

Both have a lot in common: Up and down nature of the work, sudden emergencies that require quick thinking and decision making, working with your hands.
The big differences I see are the continuity you get with ob/gyn and avoid with EM, as well as the surgery. I was told by our ER preceptor that "ER was all about thinking of the 10 worst things that it could be and trying to rule those out". Ob/gyn is more about managing risks and trying to prevent a complication or detect a problem early so that it's less damaging. ER requires a long differential to be safe; one of my favorite things about ob/gyn is that I can generally draw the differential out on one page with pictures.
Both have their share of socially difficult patients (noncompliant, drug users/seekers). You also get the lifestyle differences of shift work vs office time/OR time/L&D time/call.
On a personal note - It seems to be a bit of a different personality that goes into each one. Ob/gyns tend to be risk-adversive, where most of the ER docs I've known were attracted to risky behaviors/hobbies. This is just my personal observation from years in the hospital prior to med school - please don't flame me!

 

[Messerschmitts]

OMG, this is my EXACT same dilemma!! However, "luckily" (I use quotation marks, because I can't wait for the first two years to be over) I am still a first-year, so I've got some more time to ponder. Right now my two top choices are EM and OB/GYN.

My main concerns for EM is that getting into a good residency may be difficult, as EM is considerably more competitive than OB/GYN, in general. The lack of continuity of care also sucks a bit.

However, with OB/GYN, my overriding concern is that I am "unfortunately" male. Sure, many surveys have shown that most women claim to not have a preference, but I highly doubt, given a choice, many women would choose a male OB/GYN over a female one, and I really can't blame them. I mean, why wouldn't they? My own girlfriend says she would ("no offence, honey") never go to a male OB/GYN.

Right now I'm kind of trying to keep all my options open, doing some EM-related extracurriculars, and some OB/GYN related ones.

 

[bruinkid]

em and ob/gyn are very very different. i was actually deciding between both

the major differences that you need to think about are..

em- leave everyday without a sense of satisfaction that you've done something for a patient. often times, other teams in the ER take over and your role was almost pointless. also, if you like surgery, you will never be the OR again. all the surgeries you do are very minor.

this helped me make the final decision of ob/gyn

 

[Apollyon]

em- leave everyday without a sense of satisfaction that you've done something for a patient.

Au contraire - EM is all about satisfaction for patients "cured", not admitted, patients admitted appropriately, completion of tasks, successful procedures, and "scratching the itch" of the patient, whether it is resolving crushing chest pain or getting the patient a turkey sandwich. EM is "instant karma" - just because I don't see the same patient every day, or every week in clinic, or get one, two, or 10 calls per week from some nutty patient, or I don't follow up on every detail, doesn't mean I don't have a sense of satisfaction.

Now, individually, a student or off-service rotator may leave every day without a sense of satisfaction that they've done something for a patient, because they haven't. However, that is not generalizable.

 

[bruinkid]

What you are saying is true...I guess it does make a difference when you are a student vs an attending.
But that was just my feeling.

 

[Apollyon]

What you are saying is true...I guess it does make a difference when you are a student vs an attending.
But that was just my feeling.

Well, being a med student is as much deciding what you don't want to do, as deciding what you do want to do as a specialty. That's the good thing, that everyone (well, mostly) finds their own niche.

 

[Wednesday]

You should do fourth year rotations in both and see which you like better when they're compared side by side. When you're in the ED, do you wish you could get out of there as soon as possible to go triage some patients on L&D? When you're down seeing a vaginal bleeder on gyn, ask youself if you would rather stay and talk to the chronic hip pain patient in the next room or go to the OR and scrub in on a hysterectomy.

I think these fields are vastly different. I know that many people think that because they both have procedures and a quick pace, that they are simular (and many people end up choosing between the two). What I prefered about ob/gyn was that you are an expert in something, the specialist in a set of problems and a set of patients. I also enjoy the problems in ob/gyn and found the EM stuff pretty boring. In ob/gyn, even though you are the specialist, you also need to know a lot of primary care stuff since many women will only come to their gyn for all their medical care.

You still have some time to do research and try the fields out in fourth year (which is a lot different from 3rd year). Good luck with your decision!