OBGYN vs. Gen Surg vs. What Else? Advice for a (probably too far) forward-thinking male M1

[cjmurph14]

So I'm an M1 at my state's allopathic program. I'm non-traditional, 27 yo, with a wife and 9 month old queen. Medicine is my passion. I'm super thankful to be where I am. I think it's incredible that I get to learn all this awesome stuff about the human body and then actually use it to make people better. This is like real-life Hogwarts for me. It's what I read books over or watch movies on. My path to medical school was a little windy and required a bit of soul searching. I was sitting in my first semester of nursing school when I had a quarter-life crisis and knew that I wanted something more for my life. Went back to grab some pre-reqs, study MCAT, all that jazz. Finally got in. So I KNOW that I'm a little too early in the game to be very concerned about specialty choice. I know that. I know that I'll find out more about what I want to do when 3rd year rolls around. I'm pretty sure I'll be one of those guys that will like almost anything. I could see myself (mildly) enjoying just about everything. But I'm really concerned with finding the real deal, the specialty that I'll be excited to get up in the morning for. I've worked jobs that sucked but paid (reasonably) well. I don't want to end up there.

I've taken all the specialty choice quizzes. I've listened to all the podcasts over specialties. I know that every single specialty has their tradeoffs. You can't have exactly everything you want. No specialty has no call, unlimited family time, great compensation, lots of fun procedures, no bad patients/etiologies, strong sense of purpose. I can dig that. So let me just spill out my thought process so far and if you have any advice for me or thoughts on this please let me know and please be genuine.

The one thing I keep returning to in my mind is that I would love to have a SUBSTANTIAL impact on a daily basis when treating patients. I lean a little more on the gratification side. I don't think that a specialty with a majority of long-term, slow building outcomes would work well for me. I'm also a big variation fan. The idea of working in only one part of the body and only on a handful of diseases isn't exciting to me. I know everyone has to (maybe) specialize a little, but doing 90% ankle replacements or 85% diabetes counseling doesn't rock my socks or anything. I'd like to be well-compensated of course, who wouldn't want to be? But it is not the most important thing for me. My wife and I are pretty low maintenance and I enjoy not filling my life up with a bunch of stuff. I do, however, enjoy a good Broadway show and tickets are not cheap.

So the two specialties I've been wrestling a bit with is OBGYN and General Surgery----->Trauma/Critical Care fellowship.

OBGYN:
Pros:
- Deliver babies (nobody else gets to do that)
- Great variation: little bit of surgery, little bit of clinic, L&D
- Relatively happy moments
- Patients seem like they take a good amount of responsibility for their health on the OB side at least.
- Some primary care
- Some long-term relationship would be nice, but I'm also not crazy about this

Cons:
- Female dominated field is a bit intimidating for me (expanded below)
- I hear that it's a highly litigated field
- On call schedule seems a little hectic if you don't have a large group or aren't academic

Gen Surg--->Trauma/Critical Care
Pros:
- Saving lives sounds pretty great
- Well-equipped physician in both medical and surgical skills
- Adrenaline
- Shift-based model
- Working with hands a lot
- Variation with trauma cases/ different pathologies

Cons:
- Residency sounds grueling
- Family life balancing seems a little difficult
- Bowel contents (not super bothersome by any means)
- Loss of life/notifying families
- Sleep-deprivation
- Stress load


So those are my lists so far. I know that there are other things that I don't know about that probably belong on there, but that's what I have so far. With OBGYN I am a little intimidated about the field for a few reasons. I'm just going to be honest here. I believe that who I work with is just about as important as what I'm doing. I mean your colleagues/peers can make or break experiences for you. If I'm doing a sucky activity, it can be turned around instantly with a good group of people that are sucking it up with me. I have made my best friends out of people that I've worked with. I will be seeing these people more than I will be seeing my family. I know that I can make friendships with women of course. Many of my greatest friendships are with women. However, it is easier for me to get along with guys. I can relate to more guy *stuff.* I generally feel more comfortable having guy friends and I'm sure my wife does as well. Also, I'm worried about how I'll be received as a provider for my future patients. I know that as a medical student I will likely be asked to leave a room for a pelvic exam or something. That's perfectly fine with me. I am a little worried about fostering a trustful relationship with exclusively female patients in this field. I understand now that how I feel being a prospective male OBGYN is very likely how many female medical students feel towards the myriad of male-dominated specialties. I'm worried about Mrs. So and So is here for her new OB appt and here I walk in tall, broad shouldered, with multiple visible forearm tattoos, and I'm trying to convince her that I'm the right person to help bring her most treasured thing into this world. I want to be able to give my patients complete faith and trust that I can care for both them and their child through their pregnancy, that I can have uncomfortable conversations about sexual health, that I can treat/care for them with complete respect and dignity. I know that I will have some patients that prefer female providers and some that will be fine with me. I suppose I'm just worried that I'm stacking the deck against myself. On the surface, all of these things seem like petty issues. But I can understand that petty issues over a long period of time can burn you out as well. There's a big part of me that believes I am overreacting to this side of things. Am I? The thing that really draws me to this field is that women are absolute rockstars, especially on the obstetric side of things. I mean it is absolutely incredible what they can do in that 9 month period and how they unfortunately bear difficulty during heartbreaking loss sometimes. I think I could have a real impact and sense of purpose in this field.

General Surgery. Man I hear residency sucks. I hear that you SHOULD NOT GO INTO GEN SURG IF YOU SEE YOURSELF DOING ANYTHING BESIDES THIS. I hear that the hours suck, you miss loads of family time, your marriage will suffer, your kids will hate you, all that stuff. I will say that I would like to make time with my family important in the future. I don't mind making my job my life as long as I effing enjoy what I'm doing. I don't think I would hate the call and hours if I can wake up knowing that I've got a real shot to turn something around for a patient. I came into medical school interested in EM due to the variety and shift work, but I hear the job market sucks now so I've basically taken that off the list. Saving lives sounds like the coolest thing ever. Being able to run a trauma in a trauma bay, recognize the source of the problem, then go and fix it is just extraordinary. I am a little worried about longevity in the field however. I know I can work hard. I can put in long hours and stay awake for a long time. I can push through a lot. All that being said, I'm afraid it might be a little too much for me and my family to handle.

So I guess I just need someone to tell me, "Hey yeah def don't go into general surgery if you're at all concerned about family life." Or maybe, "You know what, loads of people make it work and they love their job as a trauma surgeon."

Or I need someone to tell me, "Hey don't worry about being a male OB, you're just overreacting on it, it's no big deal at all." Or maybe "yeah honestly a lot of male OBs feel ostracized from the community of their specialty too."

I have shadowed OBGYN clinic and have a shift on L&D lined up to shadow. Also have some trauma/critical care time for shadowing lined up too so I know that I'll have a little bit more perspective on this coming up.

So if you have any advice, tips, suggestions, or thoughts, send them my way. I would greatly appreciate it. If there are some other specialties that you think may be a solid fit for me, let me know. Thanks for listening to the rant and Godspeed.

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[UsernameChecksOut]

Thank you for sharing all of this. You’ve come to the right place and I hope others can chime in with some different perspectives. Going to send you a DM.

 

[Matthew9Thirtyfive]

This really isn’t what you’re going to want to hear, but you really just need to rotate in those specialties. That’s a big part of what third year is for. I did all the same things with the quizzes and podcasts and shadowing and ish. Then I got into third year and fell in love with a specialty that was so far at the bottom of my list prior to third year that you’d have had to dig a 6 foot hole just to see it. And I didn’t even have an open mind when I started that rotation. It just pulled me in that hard.

So you’re right to be thinking about stuff like this, but when it comes down to it, you just have to see how things really are day to day. And surgeons (general and gyn) can easily have families and good family relationships as attendings. The ones who are working all the time and never seeing their families are choosing to do that for the most part.

 

[Doctoscope]

This really isn’t what you’re going to want to hear, but you really just need to rotate in those specialties. That’s a big part of what third year is for. I did all the same things with the quizzes and podcasts and shadowing and ish. Then I got into third year and fell in love with a specialty that was so far at the bottom of my list prior to third year that you’d have had to dig a 6 foot hole just to see it. And I didn’t even have an open mind when I started that rotation. It just pulled me in that hard.

So you’re right to be thinking about stuff like this, but when it comes down to it, you just have to see how things really are day to day. And surgeons (general and gyn) can easily have families and good family relationships as attendings. The ones who are working all the time and never seeing their families are choosing to do that for the most part.

What specialty is that if you don't mind me asking? I've been reading your posts since you were a med school applicant, so I'm curious haha.

 

[stickgirl390]

Going to echo what was said above: you need to rotate through the specialties in clerkships to find the answer you’re looking for.

I’m applying OBGYN, and as a female I can tell you, plenty of us are Harry Potter nerds who “like guy stuff”. Any specialty will have people you don’t mesh well with, both male and female. If you’re passionate about the field, you will get along with your coworkers who share that same passion.

 

[Matthew9Thirtyfive]

What specialty is that if you don't mind me asking? I've been reading your posts since you were a med school applicant, so I'm curious haha.

Obgyn coincidentally lol

 

[Matthew9Thirtyfive]

Oh and as a side note, in my obgyn rotation I only had one patient request to not have males in the room. I saw she was a devout Muslim patient before she even checked in, so I just asked the female student to see her. It is definitely not set in stone that you will be asked not to be involved.

At my rotation site, I interviewed all the patients first on my own. By the time it was time to do the pelvic exam, they were comfortable with me and we had a good rapport, and not a single one of them had an issue with me doing it. You just need to make the patients feel comfortable with you and trust you. It’s a skill you can learn, but just having real empathy and being personable is a great place to start there.

I’m male and will be applying obgyn, and I’ve gotten nothing but support from the female residents and faculty.

Also, obgyn is very surgical. It is a surgical residency. I didn’t realize how surgical it was until my rotation. You have to want to be in the OR.

 

[cjmurph14]

Oh and as a side note, in my obgyn rotation I only had one patient request to not have males in the room. I saw she was a devout Muslim patient before she even checked in, so I just asked the female student to see her. It is definitely not set in stone that you will be asked not to be involved.

At my rotation site, I interviewed all the patients first on my own. By the time it was time to do the pelvic exam, they were comfortable with me and we had a good rapport, and not a single one of them had an issue with me doing it. You just need to make the patients feel comfortable with you and trust you. It’s a skill you can learn, but just having real empathy and being personable is a great place to start there.

I’m male and will be applying obgyn, and I’ve gotten nothing but support from the female residents and faculty.

Also, obgyn is very surgical. It is a surgical residency. I didn’t realize how surgical it was until my rotation. You have to want to be in the OR.

That’s encouraging to hear. I’ll keep all of that in mind. Good luck on the match and thank you for the great advice, it’s much appreciated.

 

[DoctwoB]

Plug for the best specialty in medicine: Urology!

Great mix of clinic/med management, endoscopic procedures, and big whacks
Cool toys/tech. lots of laser based procedures, robotics, minimally invasive approaches, etc.
Great lifestyle post residency
Great pay/job market

Cons:
Tough residency hours/lifestyle
Tough to get into
Must be comfortable examining/discussing genitalia (honestly not a big deal at all, but difficult for some)

 

[Redpancreas]

Gastroenterology has quite a bit of variety if you're willing to train a decent amount. You do have to pidgeon hole yourself into IM and get through all of that first.

 

[Matthew9Thirtyfive]

Gastroenterology has quite a bit of variety if you're willing to train a decent amount. You do have to pidgeon hole yourself into IM and get through all of that first.

What kind of masochist willingly chooses IM?

 

[DOVinciRobot]

Going to vote for general surgery, but don’t do trauma. I will never understand why people love trauma, and I am at a program with a very high penetrating trauma volume where we go to the OR all the time. Lots of paperwork and babysitting patients for other surgical specialties (namely ortho and neuro).

Residency is really not that bad if you know what you’re signing up for. I’m done at 6 pretty much every single day with only a few exceptions, and I have a family with multiple children who don’t hate me (yet lol). And patients come in all shapes and sizes and you can literally fix a lot of patients and make them better quickly.

OB is surgical, but if you want to operate a lot you’ll likely need to do one of the more surgical fellowships MIGS/Onc/FPRS. This can be location dependent of course but all the general OB groups I’m familiar with operate a lot less than the General Surgery groups, or have certain fellowship trained partners that eat up the good surgery cases. If you love the OR I would suggest general surgery over general OB.

 

[Tenk]

Your preconception of OB/GYN is really off. Just judging from your pros/cons you will probably hate the actual thing.

Most trauma patients don’t go to the OR anymore unless you’re in an area with high violent crime rates (in which case you will hate your patient population). A lot of non stab/gunshot trauma are either non surgical or fixed by IR a lot of times or have chest tubes placed in the ED so you’re just babysitting them on the ward. It’s not as sexy as you’d think.

Best advice I can give you is to go into third year with an open mind for your core rotations. Talk to attendings (not residents) about what their life is like and what they like/dislike about their job. Then just network and figure out what would be a good fit. Good luck.

 

[Dr G Oogle]

I am a male OBgyn and FPMRS doc. There is some of what you’re concerned about as far as being a male OB but not as much as you’d think. I only do FPMRS and see women (and some men ) from age 17-95 and have not had any issues. I am the busiest of my partners (2 men and 2 women, and I am the most junior of the 5).

The thing for you to consider is this: what do you actually want to be doing in your day to day. In general surgery if you don’t do a fellowship you still do surgery all day long. In obgyn the only reliable way to do surgery on a consistent basis is to do a fellowship in MIGS, gyn onc or FPMRS; REI does do surgery but most people don’t go into it for that anymore; or be a rural generalist where you or the only show in town. If you line within driving distance of anything resembling a population center you will be predominantly doing OB with a a smattering of gyn; not necessarily a bad thing, but many people who go into OB think they are going to be doing majors weekly after a 4 year residency, the majority of which is obstetrics related.

 

[cjmurph14]

Your preconception of OB/GYN is really off. Just judging from your pros/cons you will probably hate the actual thing.

Most trauma patients don’t go to the OR anymore unless you’re in an area with high violent crime rates (in which case you will hate your patient population). A lot of non stab/gunshot trauma are either non surgical or fixed by IR a lot of times or have chest tubes placed in the ED so you’re just babysitting them on the ward. It’s not as sexy as you’d think.

Best advice I can give you is to go into third year with an open mind for your core rotations. Talk to attendings (not residents) about what their life is like and what they like/dislike about their job. Then just network and figure out what would be a good fit. Good luck.

What about my preconception of OB/GYN is off? Or did you mean my preconception of Trauma? I have heard that trauma has moved more non-surgical, but it’s helpful to hear exactly in the ways you've described.

 

[Tenk]

What about my preconception of OB/GYN is off? Or did you mean my preconception of Trauma? I have heard that trauma has moved more non-surgical, but it’s helpful to hear exactly in the ways you've described.

For OB. Pros: the patients. They are just as much a con as a pro. Ever see a birth plan? They only get worse with every coming generation.
Cons: you didn’t list dead babies or dead mothers. You won’t know what this is like until you experience it. When grandpa dies at 85 of a heart attack, sure it’s sad but it’s accepted. When a term baby dies in utero or mom dies of a PE, it ruins lives. It’s rare but it is not pleasant and is by far and away the worst part of OB.

 

[cjmurph14]

For OB. Pros: the patients. They are just as much a con as a pro. Ever see a birth plan? They only get worse with every coming generation.
Cons: you didn’t list dead babies or dead mothers. You won’t know what this is like until you experience it. When grandpa dies at 85 of a heart attack, sure it’s sad but it’s accepted. When a term baby dies in utero or mom dies of a PE, it ruins lives. It’s rare but it is not pleasant and is by far and away the worst part of OB.

I mean come on. We all know that terrible things happen in every (or at least most) aspects/specialties of medicine. It’s an understood CON that as a physician I will have to engage with the reality of death on some sort of routine basis. As unfortunate as that is, death isn’t restricted to OB/GYN although it is particularly saddening that it’s children or mothers. I don’t have a lot of experience interacting with OB/GYN patients, but I think I just disagree with you there on the matter of personal preference. I don’t think I misrepresented the specialty by leaving out obvious aspects like infant and mother mortality. But I get your point.

 

[Radetzky]

Ob gyn
Pros: variety
Cons: ureters

Surg/trauma
Pros: trauma
Cons: trauma patients

 

[Matthew9Thirtyfive]

Ob gyn
Pros: variety
Cons: ureters

Surg/trauma
Pros: trauma
Cons: trauma patients

OBGYNs are the ureter’s largest natural predator.

 

[Dral]

"- Deliver babies (nobody else gets to do that)"

Small correction. While I believe it's becoming rarer and rarer, family med also can do OB.

 

[Dr G Oogle]

It’s hard to say whether a young healthy patient with a laminated birth plan is more annoying than the fourth drunk driver you have to deal with on trauma call or if an IUFD or maternal is more tragic than a teenager who got hit by a stray bullet while crossing the road and is either going to die or be severely impaired for the rest of their life.

All fields have their terrible aspects, and I think it’s important to understand those and see if you have the emotional stamina for it. For a long time I wanted to be a peds cardiologist until I saw a couple of kids in heart failure who died and realized I couldn’t handle that even one more time in my entire career.

As far as natural predators the urologist causes more ureteral trauma they can just fix it so no one hears about it.

 

[Matthew9Thirtyfive]

"- Deliver babies (nobody else gets to do that)"

Small correction. While I believe it's becoming rarer and rarer, family med also can do OB.

Ime they don’t do OB as well as the OBs. Prob for obvious reasons.

 

[calivianya]

The one thing I keep returning to in my mind is that I would love to have a SUBSTANTIAL impact on a daily basis when treating patients. I lean a little more on the gratification side. I don't think that a specialty with a majority of long-term, slow building outcomes would work well for me. I'm also a big variation fan. The idea of working in only one part of the body and only on a handful of diseases isn't exciting to me.

Rads.

You see every pathology for every specialty - got to know everything from ortho to OB to pediatrics to cancer to whatever else you can possibly imagine. And if you're the person who caught the brand new teeny lung cancer in the patient who got a chest x-ray because he/she was in a car accident, you just saved that person's life outright because it got found before it was symptomatic (i.e. probably stage 4). Those incidental findings that aren't the major thing the other docs are looking for can be life or death.

Besides, rads is as hands-on and procedural as you want it to be. Want to sit in the reading room? Sure, go for it. Want a job where you do a lot of procedures? MSK rads is pretty much light IR a bunch of places. Ultrasound is also a ton of biopsies. Want all the procedures all the time and want be the last person other specialties call when they can't get to something? Go IR.

And the pay is great.

 

[Dr G Oogle]

I agree with everything about rads that was said, but One thing to consider with IR and rads that you don’t really have patient ownership, and as an IR end up fighting turf wars left and right; might be it’s a bit more protected now with an IR residency, but unlikely to claw back what was lost (most of vascular). In rads, you definitely will not get credit for finding the teensy cancer that saved someone’s life, while the rad did probably save the life; the doc who tells the patient about it and who does the surgery will get all the credit. And that is the downside of rads in general; patient facing docs will get the credit for your wins but you will still get yelled at for your misses

 

[Matthew9Thirtyfive]

It’s hard to say whether a young healthy patient with a laminated birth plan is more annoying than the fourth drunk driver you have to deal with on trauma call or if an IUFD or maternal is more tragic than a teenager who got hit by a stray bullet while crossing the road and is either going to die or be severely impaired for the rest of their life.

Yeah the dude I did compressions on with half his face blown off from a GSW was pretty damn tragic, and I had IUFD patients (also tragic).

And yeah, I’ll take a mom with a birth plan over another drunk driver threatening to kill me if I don’t give him back his phone.

 

[Lost in Translation]

I was in a similar boat to you with respect to field of choice so I'll chime in on what I can answer. I did an intern year in Gen Surg and for most of M3 year was thinking of going into it before OBGYN poached me.

So the two specialties I've been wrestling a bit with is OBGYN and General Surgery----->Trauma/Critical Care fellowship.

OBGYN:
Pros:
- Deliver babies (nobody else gets to do that)
- Great variation: little bit of surgery, little bit of clinic, L&D
- Relatively happy moments
- Patients seem like they take a good amount of responsibility for their health on the OB side at least.
- Some primary care
- Some long-term relationship would be nice, but I'm also not crazy about this

Depends on where you practice. Any major metropolitan area, there are quite a startling number of simply uneducated women with poor insight into their own health that have no business getting pregnant however because the system fails them they end up with unplanned pregnancies without many resources on how to manage them (be it termination or consistent prenatal care). It's not quite like this in private practice but that also can vary depending on if your private practice takes Medicaid.

Cons:
- Female dominated field is a bit intimidating for me (expanded below)

[...]

So those are my lists so far. I know that there are other things that I don't know about that probably belong on there, but that's what I have so far. With OBGYN I am a little intimidated about the field for a few reasons. I'm just going to be honest here. I believe that who I work with is just about as important as what I'm doing. I mean your colleagues/peers can make or break experiences for you. If I'm doing a sucky activity, it can be turned around instantly with a good group of people that are sucking it up with me. I have made my best friends out of people that I've worked with. I will be seeing these people more than I will be seeing my family. I know that I can make friendships with women of course. Many of my greatest friendships are with women. However, it is easier for me to get along with guys. I can relate to more guy *stuff.* I generally feel more comfortable having guy friends and I'm sure my wife does as well. Also, I'm worried about how I'll be received as a provider for my future patients. I know that as a medical student I will likely be asked to leave a room for a pelvic exam or something. That's perfectly fine with me. I am a little worried about fostering a trustful relationship with exclusively female patients in this field. I understand now that how I feel being a prospective male OBGYN is very likely how many female medical students feel towards the myriad of male-dominated specialties. I'm worried about Mrs. So and So is here for her new OB appt and here I walk in tall, broad shouldered, with multiple visible forearm tattoos, and I'm trying to convince her that I'm the right person to help bring her most treasured thing into this world. I want to be able to give my patients complete faith and trust that I can care for both them and their child through their pregnancy, that I can have uncomfortable conversations about sexual health, that I can treat/care for them with complete respect and dignity. I know that I will have some patients that prefer female providers and some that will be fine with me. I suppose I'm just worried that I'm stacking the deck against myself. On the surface, all of these things seem like petty issues. But I can understand that petty issues over a long period of time can burn you out as well. There's a big part of me that believes I am overreacting to this side of things. Am I? The thing that really draws me to this field is that women are absolute rockstars, especially on the obstetric side of things. I mean it is absolutely incredible what they can do in that 9 month period and how they unfortunately bear difficulty during heartbreaking loss sometimes. I think I could have a real impact and sense of purpose in this field.

As a male in OBGYN I can tell you that some programs are more "uptight" than others, though the vast majority of programs their residents are regular Joes and Janes. I also had some concerns about not being able to vent in a questionably-PC manner when I started OBGYN residency because of the same misconceptions that you have. But if anything, at my program the female residents are even more off the cuff than the males. I can banter and BS with them like I would anyone else, male or female, so it really all comes down to the culture of the program. Other OB residents I've interacted with from different programs are the same; very not-uptight. Will there be a few here and there that just can't relax, sure, but they're in the minority.

As far as dealing with patients, less than 1 in 20 patients that I've personally seen come through our unit decline male providers straight up. The vast majority do not care at all; they care more about the quality of care provided and the empathy that you offer. It really is a field about bedside manner. Make the woman feel comfortable and don't be awkward and things will be fine. And don't take it personally if they ask you to step out of the room. That's their autonomy and their choice.

Gen Surg--->Trauma/Critical Care
Pros:
- Saving lives sounds pretty great
- Well-equipped physician in both medical and surgical skills
- Adrenaline
- Shift-based model
- Working with hands a lot
- Variation with trauma cases/ different pathologies

For ever 1 cool gunshot/stabbing/run over by a car, bus, train patient there are 10 that have dead gut or perforated appendix or choledocolithiasis. Not super exciting stuff. And the dead gut patients, oh man, I can count on 1 hand how many of those patients made it out of the SICU alive. And that's after weeks of post-operative medical management and takeback surgeries. Really tragic patients.

But traumas definitely are fun. However, as a critical care surgeon, at most places you'll do 1 week of daytime trauma call then 1 week of daytime acute care call then 1 week of SICU management (with few surgeries) and 1 week of [something else, usually nights covering both trauma and ACS]. So it's not all trauma all the time. There are a few "traumatologist" positions where you only do trauma but those are few and far between and really old fashioned/getting phased out.

Cons:
- Residency sounds grueling
- Family life balancing seems a little difficult
- Bowel contents (not super bothersome by any means)
- Loss of life/notifying families
- Sleep-deprivation
- Stress load

Gen Surg residency is awful. At the beginning of my intern year I still had thoughts of doing Gen Surg, but that quickly went away after about 2 months. You literally couldn't pay me to do 5 years of that. Granted, Gen Surg intern is probably the worst intern year, but my seniors and chiefs were pulling crazy hours with OR cases. I like the OR, but I also like sleep.

The loss of life stuff isn't actually that nerve wracking. It sucks to say, but you get used to giving bad news.

General Surgery. Man I hear residency sucks. I hear that you SHOULD NOT GO INTO GEN SURG IF YOU SEE YOURSELF DOING ANYTHING BESIDES THIS.

This is 100% true. If you can see yourself being happy doing ANYTHING else. Literally anything else, do that instead.

I hear that the hours suck, you miss loads of family time, your marriage will suffer, your kids will hate you, all that stuff. I will say that I would like to make time with my family important in the future. I don't mind making my job my life as long as I effing enjoy what I'm doing. I don't think I would hate the call and hours if I can wake up knowing that I've got a real shot to turn something around for a patient. I came into medical school interested in EM due to the variety and shift work, but I hear the job market sucks now so I've basically taken that off the list. Saving lives sounds like the coolest thing ever. Being able to run a trauma in a trauma bay, recognize the source of the problem, then go and fix it is just extraordinary. I am a little worried about longevity in the field however. I know I can work hard. I can put in long hours and stay awake for a long time. I can push through a lot. All that being said, I'm afraid it might be a little too much for me and my family to handle.

Several of my coresidents had families. It was tough for sure but it's not nearly as bad as say Neurosurgery or even Ortho Trauma. And as a Gen Surg attending your hours generally are much better than your other surgical colleagues.

Hope this helps.

 

[Lost in Translation]

Ime they don’t do OB as well as the OBs. Prob for obvious reasons.

Unless they do a residency that's heavy in OB or do a family planning fellowship (which exists for FM, which is really amazing for patient access).

 

[cjmurph14]

I was in a similar boat to you with respect to field of choice so I'll chime in on what I can answer. I did an intern year in Gen Surg and for most of M3 year was thinking of going into it before OBGYN poached me.


Depends on where you practice. Any major metropolitan area, there are quite a startling number of simply uneducated women with poor insight into their own health that have no business getting pregnant however because the system fails them they end up with unplanned pregnancies without many resources on how to manage them (be it termination or consistent prenatal care). It's not quite like this in private practice but that also can vary depending on if your private practice takes Medicaid.



As a male in OBGYN I can tell you that some programs are more "uptight" than others, though the vast majority of programs their residents are regular Joes and Janes. I also had some concerns about not being able to vent in a questionably-PC manner when I started OBGYN residency because of the same misconceptions that you have. But if anything, at my program the female residents are even more off the cuff than the males. I can banter and BS with them like I would anyone else, male or female, so it really all comes down to the culture of the program. Other OB residents I've interacted with from different programs are the same; very not-uptight. Will there be a few here and there that just can't relax, sure, but they're in the minority.

As far as dealing with patients, less than 1 in 20 patients that I've personally seen come through our unit decline male providers straight up. The vast majority do not care at all; they care more about the quality of care provided and the empathy that you offer. It really is a field about bedside manner. Make the woman feel comfortable and don't be awkward and things will be fine. And don't take it personally if they ask you to step out of the room. That's their autonomy and their choice.


For ever 1 cool gunshot/stabbing/run over by a car, bus, train patient there are 10 that have dead gut or perforated appendix or choledocolithiasis. Not super exciting stuff. And the dead gut patients, oh man, I can count on 1 hand how many of those patients made it out of the SICU alive. And that's after weeks of post-operative medical management and takeback surgeries. Really tragic patients.

But traumas definitely are fun. However, as a critical care surgeon, at most places you'll do 1 week of daytime trauma call then 1 week of daytime acute care call then 1 week of SICU management (with few surgeries) and 1 week of [something else, usually nights covering both trauma and ACS]. So it's not all trauma all the time. There are a few "traumatologist" positions where you only do trauma but those are few and far between and really old fashioned/getting phased out.


Gen Surg residency is awful. At the beginning of my intern year I still had thoughts of doing Gen Surg, but that quickly went away after about 2 months. You literally couldn't pay me to do 5 years of that. Granted, Gen Surg intern is probably the worst intern year, but my seniors and chiefs were pulling crazy hours with OR cases. I like the OR, but I also like sleep.

The loss of life stuff isn't actually that nerve wracking. It sucks to say, but you get used to giving bad news.



This is 100% true. If you can see yourself being happy doing ANYTHING else. Literally anything else, do that instead.



Several of my coresidents had families. It was tough for sure but it's not nearly as bad as say Neurosurgery or even Ortho Trauma. And as a Gen Surg attending your hours generally are much better than your other surgical colleagues.

Hope this helps.

Thanks, it really does help. Shadowing SICU tomorrow and L&D the next day a bit just to see. Seriously though, thank you for the effort on the reply.

 

[DOVinciRobot]

10 that have dead gut or perforated appendix or choledocolithiasis.

Not super exciting stuff.

 

[crimsonly]

I was in a similar boat to you with respect to field of choice so I'll chime in on what I can answer. I did an intern year in Gen Surg and for most of M3 year was thinking of going into it before OBGYN poached me.


Depends on where you practice. Any major metropolitan area, there are quite a startling number of simply uneducated women with poor insight into their own health that have no business getting pregnant however because the system fails them they end up with unplanned pregnancies without many resources on how to manage them (be it termination or consistent prenatal care). It's not quite like this in private practice but that also can vary depending on if your private practice takes Medicaid.



As a male in OBGYN I can tell you that some programs are more "uptight" than others, though the vast majority of programs their residents are regular Joes and Janes. I also had some concerns about not being able to vent in a questionably-PC manner when I started OBGYN residency because of the same misconceptions that you have. But if anything, at my program the female residents are even more off the cuff than the males. I can banter and BS with them like I would anyone else, male or female, so it really all comes down to the culture of the program. Other OB residents I've interacted with from different programs are the same; very not-uptight. Will there be a few here and there that just can't relax, sure, but they're in the minority.

As far as dealing with patients, less than 1 in 20 patients that I've personally seen come through our unit decline male providers straight up. The vast majority do not care at all; they care more about the quality of care provided and the empathy that you offer. It really is a field about bedside manner. Make the woman feel comfortable and don't be awkward and things will be fine. And don't take it personally if they ask you to step out of the room. That's their autonomy and their choice.


For ever 1 cool gunshot/stabbing/run over by a car, bus, train patient there are 10 that have dead gut or perforated appendix or choledocolithiasis. Not super exciting stuff. And the dead gut patients, oh man, I can count on 1 hand how many of those patients made it out of the SICU alive. And that's after weeks of post-operative medical management and takeback surgeries. Really tragic patients.

But traumas definitely are fun. However, as a critical care surgeon, at most places you'll do 1 week of daytime trauma call then 1 week of daytime acute care call then 1 week of SICU management (with few surgeries) and 1 week of [something else, usually nights covering both trauma and ACS]. So it's not all trauma all the time. There are a few "traumatologist" positions where you only do trauma but those are few and far between and really old fashioned/getting phased out


Gen Surg residency is awful. At the beginning of my intern year I still had thoughts of doing Gen Surg, but that quickly went away after about 2 months. You literally couldn't pay me to do 5 years of that. Granted, Gen Surg intern is probably the worst intern year, but my seniors and chiefs were pulling crazy hours with OR cases. I like the OR, but I also like sleep.

The loss of life stuff isn't actually that nerve wracking. It sucks to say, but you get used to giving bad news.



This is 100% true. If you can see yourself being happy doing ANYTHING else. Literally anything else, do that instead.



Several of my coresidents had families. It was tough for sure but it's not nearly as bad as say Neurosurgery or even Ortho Trauma. And as a Gen Surg attending your hours generally are much better than your other surgical colleagues.

Hope this helps.

I was in a similar boat to you with respect to field of choice so I'll chime in on what I can answer. I did an intern year in Gen Surg and for most of M3 year was thinking of going into it before OBGYN poached me.


Depends on where you practice. Any major metropolitan area, there are quite a startling number of simply uneducated women with poor insight into their own health that have no business getting pregnant however because the system fails them they end up with unplanned pregnancies without many resources on how to manage them (be it termination or consistent prenatal care). It's not quite like this in private practice but that also can vary depending on if your private practice takes Medicaid.



As a male in OBGYN I can tell you that some programs are more "uptight" than others, though the vast majority of programs their residents are regular Joes and Janes. I also had some concerns about not being able to vent in a questionably-PC manner when I started OBGYN residency because of the same misconceptions that you have. But if anything, at my program the female residents are even more off the cuff than the males. I can banter and BS with them like I would anyone else, male or female, so it really all comes down to the culture of the program. Other OB residents I've interacted with from different programs are the same; very not-uptight. Will there be a few here and there that just can't relax, sure, but they're in the minority.

As far as dealing with patients, less than 1 in 20 patients that I've personally seen come through our unit decline male providers straight up. The vast majority do not care at all; they care more about the quality of care provided and the empathy that you offer. It really is a field about bedside manner. Make the woman feel comfortable and don't be awkward and things will be fine. And don't take it personally if they ask you to step out of the room. That's their autonomy and their choice.


For ever 1 cool gunshot/stabbing/run over by a car, bus, train patient there are 10 that have dead gut or perforated appendix or choledocolithiasis. Not super exciting stuff. And the dead gut patients, oh man, I can count on 1 hand how many of those patients made it out of the SICU alive. And that's after weeks of post-operative medical management and takeback surgeries. Really tragic patients.

But traumas definitely are fun. However, as a critical care surgeon, at most places you'll do 1 week of daytime trauma call then 1 week of daytime acute care call then 1 week of SICU management (with few surgeries) and 1 week of [something else, usually nights covering both trauma and ACS]. So it's not all trauma all the time. There are a few "traumatologist" positions where you only do trauma but those are few and far between and really old fashioned/getting phased out.


Gen Surg residency is awful. At the beginning of my intern year I still had thoughts of doing Gen Surg, but that quickly went away after about 2 months. You literally couldn't pay me to do 5 years of that. Granted, Gen Surg intern is probably the worst intern year, but my seniors and chiefs were pulling crazy hours with OR cases. I like the OR, but I also like sleep.

The loss of life stuff isn't actually that nerve wracking. It sucks to say, but you get used to giving bad news.



This is 100% true. If you can see yourself being happy doing ANYTHING else. Literally anything else, do that instead.



Several of my coresidents had families. It was tough for sure but it's not nearly as bad as say Neurosurgery or even Ortho Trauma. And as a Gen Surg attending your hours generally are much better than your other surgical colleagues.

Hope this helps.

Can you please elaborate on how OBGYN residency has better a better lifestyle/hours than GS since it sounds like you were able to experience both? Is it just that there’s generally shorter surgeries and less OR time in OBGYN?

 

[Lost in Translation]

View attachment 345560

You can only have GI refuse to do an ERCP and recommend an MRCP so many times before you get bored of it. Also, postop management of dead bowel is awful; 2 weeks of pressor titration and SBTs and the patient dies anyway.

 

[Lost in Translation]

Can you please elaborate on how OBGYN residency has better a better lifestyle/hours than GS since it sounds like you were able to experience both? Is it just that there’s generally shorter surgeries and less OR time in OBGYN?

GS residency has absolutely terrible hours if you're in a program with more than just a Gen Surg, Trauma, and Surg Onc department. If your program has dedicated Colorectal, Vascular, and Transplant divisions, all those rotations are incredibly time-intensive, particularly the last 2. Where I did my intern year the Vascular fellow would not infrequently be called in to fix a AAA in the middle of the night and then still have a full day of work the next day (that's still the fellow which sort of shields the chief from that but oftentimes the chief will be present anyway). For Transplant, the chief is always on call, be it for a transplant or a procurement. Even on the regular services, Trauma is always busy, and acute care surgery (gall bladders, appys, dead gut) happens a lot.

As an OBGYN resident there aren't nearly as many emergent things that roll through the door, really just the random STAT delivery or ruptured ectopic. Everything else is managed urgently or outpatient. L&D can get crazy busy but it's not like a patient is on the brink of death daily so depending on how many laboring patients you have you can afford to take it slowly.

In summary, as a GS resident you basically live in the hospital as a senior/chief. As an OBGYN it's very much shiftwork.

 

[DOVinciRobot]

GS residency has absolutely terrible hours if you're in a program with more than just a Gen Surg, Trauma, and Surg Onc department.

Not true. It’s all about schedule structure. We don’t have many fellows, and we have very robust services in almost all subspecialties. There is only 1 rotation where duty hours are routinely broken, and once you’re a 4/5 the only reason you break duty hours is because you want to stick around and do a big, cool case instead of passing it off to the night team.

It sounds like your prelim program just didn’t have the schedule worked out very well. Many OB Gyn programs have residency hours just as bad as General Surgery…

 

[guytakingboards]

In rads, you definitely will not get credit for finding the teensy cancer that saved someone’s life, while the rad did probably save the life; the doc who tells the patient about it and who does the surgery will get all the credit. And that is the downside of rads in general; patient facing docs will get the credit for your wins but you will still get yelled at for your misses

As a rad, this times a million. Few of my "best calls (/diagnoses)" got any recognition. Sometimes the only people who understand how good of a job you've done are your partners. "you made THAT call?!?! i never would have called that".

 

[Dr G Oogle]

Not true. It’s all about schedule structure. We don’t have many fellows, and we have very robust services in almost all subspecialties. There is only 1 rotation where duty hours are routinely broken, and once you’re a 4/5 the only reason you break duty hours is because you want to stick around and do a big, cool case instead of passing it off to the night team.

It sounds like your prelim program just didn’t have the schedule worked out very well. Many OB Gyn programs have residency hours just as bad as General Surgery…

On our oncology rotation; 6 months out of 48 I routinely came in to round at 430 am and left at 7 pm; and this is with a night float system. The night float system is itself pretty brutal and studies show it can take up to 3 or 4 years to recover from its impact if you subsequently have a normal sleep schedule. I dated a GS resident for part of residency and I was the one more consistently late or had to reschedule due my job than her.

Trying to say OB or GS has the better schedule is like saying one way to amputate your leg is better than the other. The both suck and institution dependent.

 

[Smurfette]

On our oncology rotation; 6 months out of 48 I routinely came in to round at 430 am and left at 7 pm; and this is with a night float system. The night float system is itself pretty brutal and studies show it can take up to 3 or 4 years to recover from its impact if you subsequently have a normal sleep schedule. I dated a GS resident for part of residency and I was the one more consistently late or had to reschedule due my job than her.

Trying to say OB or GS has the better schedule is like saying one way to amputate your leg is better than the other. The both suck and institution dependent.

Agree that both residencies are painful and the adage about "if you can picture yourself doing anything other than surgery, do that" really should have an exception of OB/Gyn as it's really not much better, other than being a year shorter. I remember one of our residents was married to an OB/gyn resident and thought her schedule was worse, and the overall culture was worse in her dept (although this is site specific). Most GS programs do not have PGY 4s and 5s on in-house call as much, especially at bigger programs. As a 5, I only was in-house on trauma and otherwise took home call one weekend a month (which meant I only went in when someone needed surgery and showed up to do the case).
.
As an attending, I will say that as a general surgeon, I take call from home and only come in when someone needs an operation or is super sick. Yes, some nights are busy, but a true all-nighter is pretty rare. My OB colleagues (those who haven't converted over to gyn only practices), however, take in-house call and have much more frequent sleepless call nights. Some have been doing it for 30+ years. And this is community practice.

 

[Styrene]

The process of choosing a specialty involves several steps, one of which is thinking about it before clerkships and another being clerkships. You will have a better idea after clerkships, as many of the questions you have will be answered then. Choose a field you think you will be interested in and try to get involved in research. Find the contact info for a professor or chair in said department.

 

[wildfan220]

I'm late to this post but i'll give another plug for urology. I discovered during clinicals that I loved gynecology and the procedural clinic but didn't like the OB. To me OB was too "similar" day to day, whereas the OR was always new to me because every body is a little different. The thing that really helped me become more interested in Urology though was the huge impact on patients' quality of life. I too want to have a tangible impact on patients and am a bit of a "fixer". I don't enjoy long term management of chronic disease. I do enjoy treating incontinence, ED, sexual dysfunction, sexual health, etc because they have HUGE impacts on quality of life and can be difficult topics for patients to discuss. I like normalizing them and helping treat them. I also want continuity and the ability to treat patients medically, in the clinic, in the OR, etc and Urology is a wonderful field for that. I enjoy developing a rapport with patients and contrary to popular opinion, quickly developing a rapport is critical to surgery. I learned that I much prefer impacting quality of life over saving someone's life in a trauma or emergent situation.

Urology wasn't even on my radar until third year but I quickly learned it had an incredible combination of surgery, procedural clinic, sexual health, fun "toys" and awesome OR cases. I'm a female and urology is still primarily a male dominated field even though that is shifting.

 

[cjmurph14]

I'm late to this post but i'll give another plug for urology. I discovered during clinicals that I loved gynecology and the procedural clinic but didn't like the OB. To me OB was too "similar" day to day, whereas the OR was always new to me because every body is a little different. The thing that really helped me become more interested in Urology though was the huge impact on patients' quality of life. I too want to have a tangible impact on patients and am a bit of a "fixer". I don't enjoy long term management of chronic disease. I do enjoy treating incontinence, ED, sexual dysfunction, sexual health, etc because they have HUGE impacts on quality of life and can be difficult topics for patients to discuss. I like normalizing them and helping treat them. I also want continuity and the ability to treat patients medically, in the clinic, in the OR, etc and Urology is a wonderful field for that. I enjoy developing a rapport with patients and contrary to popular opinion, quickly developing a rapport is critical to surgery. I learned that I much prefer impacting quality of life over saving someone's life in a trauma or emergent situation.

Urology wasn't even on my radar until third year but I quickly learned it had an incredible combination of surgery, procedural clinic, sexual health, fun "toys" and awesome OR cases. I'm a female and urology is still primarily a male dominated field even though that is shifting.

I like what you mentioned about “normalizing” difficult conversations/topics with patients. I worked as a scribe for several urologists in my state’s largest urology group so I had a little bit of exposure, but it was mostly clinic work. I was surprised to see the breadth of conditions they treat. When I asked some of the surgeons why they chose Urology many of them said that using the Da Vinci was one of their main pros. I’ve heard there is some robotics involved in GYN as well, but I doubt it’s to the extent that urology uses it.

You’re absolutely right about how rewarding it can be to improve the quality of life of patients in your field though. It was a daily occurrence to have someone come in with either sexual dysfunction or incontinence that was very distressed about how this affected their life.

Part of me worries that I’m romanticizing medicine a bit when I think about “saving lives” or “bringing new life into the world.” I really do worry that it’s a line of thinking that may be a pitfall for me later. I’ve yet to shadow L&D and I think that will definitely help. It’s just that I hear from a lot of fulfilled physicians that they found their field to be their “passion” when they discovered it. I do hope that the lightbulb moment will come for me, but I’m hoping that I’m not overlooking all of the other great specialties while searching for the “soulmate” one of you get what I mean.

 

[Dr G Oogle]

I’ve heard there is some robotics involved in GYN as well, but I doubt it’s to the extent that urology uses it.

Robotics use in gynecology is unfortunately just as wide spread as it is in urology. A large swath of surgeries and surgeons use robotic assistance for especially in urogyn and oncology, but also for endometriosis, and many, many hysterectomies. At least 50% of minimally invasive surgeries in gyn are performed robotically, I’ve even seen an abdominal cerclage performed robotically.

 

[operaman]

Putting a plug in here for ENT and other surgical subs. Terribly difficult to match but they probably hit most of the things on your list. Despite being limited to a geographically small area of the body, our practice scope is pretty wide and the variety of things we do is remarkable. Great outcomes, and we get to operate on the things that really make us human - hearing, speaking, swallowing, smell, taste, and the list goes on. Definitely worth a look.

 

[Angus Avagadro]

OP, what articles interest you and what do you read casually? This is what guided me toward my specialty. I think you have to like reading the literature in your specialty. I hope that helps your decision process. OB is a blast, usually a great time delivering babies. Having said that, when it goes bad, it's very bad. Keeping a brain dead women's body alive until the baby is mature enough to deliver, ( yes, I have seen this), fetal demise, maternal death from pulm embolism or amniotic fluid embolism, it goes on. Plus, most of the time the patients, quite understandably, aren't happy to see you for their annual exams. It would be a no for me, but infertility might be a rewarding area to explore. Gen surgery might be more interesting overall and less litigious. My $. 02

 

[cjmurph14]

OP, what articles interest you and what do you read casually? This is what guided me toward my specialty. I think you have to like reading the literature in your specialty. I hope that helps your decision process. OB is a blast, usually a great time delivering babies. Having said that, when it goes bad, it's very bad. Keeping a brain dead women's body alive until the baby is mature enough to deliver, ( yes, I have seen this), fetal demise, maternal death from pulm embolism or amniotic fluid embolism, it goes on. Plus, most of the time the patients, quite understandably, aren't happy to see you for their annual exams. It would be a no for me, but infertility might be a rewarding area to explore. Gen surgery might be more interesting overall and less litigious. My $. 02

Casually on the medical side of things, I really enjoyed Mukherjee's Emperor of All Maladies and The Gene. Verghese's Cutting for Stone is actually pretty relevant to this convo since one of the twins goes down the transplant surgery route and another leans OB. That was the first time I heard about maneuvers for babies that aren't positioned favorably in the womb which blew my mind. All of Atul Gawande's books were interesting to me but probably just because of the cool anecdotes. Kalanithi's When Breath Becomes Air was thoughtful. I actually really liked War Doctor by David Nott, a British surgeon that worked with MSF. I would really like to do some mission work in the future as a physician if possible.

Outside of medical books, I'm a huge LOTR fan. Just read Dune which was awesome. I read a lot of non-fiction historical like Alexander Hamilton, 1776, etc.

I haven't looked too much into literature of any of these fields as an M1 first semester finisher yet. I've browsed a little bit on placenta accreta and gestational diabetes, but not enough to count for anything. I think that'll come with time, but I do think there could be a real interest in the OB side for sure. This wasn't in the original post I made, but the "catalyst" to think about OB was a panel of patients that came to speak to our class at the beginning of the year. One woman described the difficulty of delivering her stillborn child following a coma due to cardiac complications prior to labor. I was thinking about how difficult of a conversation that would be to navigate with the patient when she wakes from her coma to discover that her child isn't going to survive. It seemed to me that if I was equipped to handle that conversation gracefully, then it could be an impactful service that I could provide. I'm not sure if that's even a skill I could acquire, but still it was a compelling thought to me.
I thought that maternal fetal medicine would be a good route if I ended up leaning towards OBGYN and OB>GYN, but I don't really know what that lifestyle is like. Part of the pull to OB for me was the variety with clinic, surgery, L&D.

I am a little concerned about the litigation side of it. A podcast I listened to recently had an OBGYN on it that said that she did not have a colleague that had not been at least named in a lawsuit. I've heard that the state I'm in and most likely will practice in has favorable laws for OBs, but I don't know for sure.

 

[Angus Avagadro]

Casually on the medical side of things, I really enjoyed Mukherjee's Emperor of All Maladies and The Gene. Verghese's Cutting for Stone is actually pretty relevant to this convo since one of the twins goes down the transplant surgery route and another leans OB. That was the first time I heard about maneuvers for babies that aren't positioned favorably in the womb which blew my mind. All of Atul Gawande's books were interesting to me but probably just because of the cool anecdotes. Kalanithi's When Breath Becomes Air was thoughtful. I actually really liked War Doctor by David Nott, a British surgeon that worked with MSF. I would really like to do some mission work in the future as a physician if possible.

Outside of medical books, I'm a huge LOTR fan. Just read Dune which was awesome. I read a lot of non-fiction historical like Alexander Hamilton, 1776, etc.

I haven't looked too much into literature of any of these fields as an M1 first semester finisher yet. I've browsed a little bit on placenta accreta and gestational diabetes, but not enough to count for anything. I think that'll come with time, but I do think there could be a real interest in the OB side for sure. This wasn't in the original post I made, but the "catalyst" to think about OB was a panel of patients that came to speak to our class at the beginning of the year. One woman described the difficulty of delivering her stillborn child following a coma due to cardiac complications prior to labor. I was thinking about how difficult of a conversation that would be to navigate with the patient when she wakes from her coma to discover that her child isn't going to survive. It seemed to me that if I was equipped to handle that conversation gracefully, then it could be an impactful service that I could provide. I'm not sure if that's even a skill I could acquire, but still it was a compelling thought to me.
I thought that maternal fetal medicine would be a good route if I ended up leaning towards OBGYN and OB>GYN, but I don't really know what that lifestyle is like. Part of the pull to OB for me was the variety with clinic, surgery, L&D.

I am a little concerned about the litigation side of it. A podcast I listened to recently had an OBGYN on it that said that she did not have a colleague that had not been at least named in a lawsuit. I've heard that the state I'm in and most likely will practice in has favorable laws for OBs, but I don't know for sure.

Good luck and best wishes whatever you choose!

 

[Matthew9Thirtyfive]

Casually on the medical side of things, I really enjoyed Mukherjee's Emperor of All Maladies and The Gene. Verghese's Cutting for Stone is actually pretty relevant to this convo since one of the twins goes down the transplant surgery route and another leans OB. That was the first time I heard about maneuvers for babies that aren't positioned favorably in the womb which blew my mind. All of Atul Gawande's books were interesting to me but probably just because of the cool anecdotes. Kalanithi's When Breath Becomes Air was thoughtful. I actually really liked War Doctor by David Nott, a British surgeon that worked with MSF. I would really like to do some mission work in the future as a physician if possible.

ECV can be cool when it works. It works maybe 50-60% of the time.

OB is awesome. I’m biased since I’m applying OB, but it is an amazing field that really has the best of everything. When it goes bad, it is some of the worst of the worst, but fortunately that isn’t super common.

I also loved Emperor of all Maladies. I loved oncology stuff in preclerkship and third year. Gyn Onc is very cool, but can be very sad much of the time and is a very long training path (7-8 years).

Outside of medical books, I'm a huge LOTR fan. Just read Dune which was awesome. I read a lot of non-fiction historical like Alexander Hamilton, 1776, etc.

I haven't looked too much into literature of any of these fields as an M1 first semester finisher yet. I've browsed a little bit on placenta accreta and gestational diabetes, but not enough to count for anything. I think that'll come with time, but I do think there could be a real interest in the OB side for sure. This wasn't in the original post I made, but the "catalyst" to think about OB was a panel of patients that came to speak to our class at the beginning of the year. One woman described the difficulty of delivering her stillborn child following a coma due to cardiac complications prior to labor. I was thinking about how difficult of a conversation that would be to navigate with the patient when she wakes from her coma to discover that her child isn't going to survive. It seemed to me that if I was equipped to handle that conversation gracefully, then it could be an impactful service that I could provide. I'm not sure if that's even a skill I could acquire, but still it was a compelling thought to me.
I thought that maternal fetal medicine would be a good route if I ended up leaning towards OBGYN and OB>GYN, but I don't really know what that lifestyle is like. Part of the pull to OB for me was the variety with clinic, surgery, L&D.

Yeah I fell in love with general obgyn. Some of the fellowships are cool, but I loved the mix of things. Honestly, the whole “what are you reading casually” question isn’t really useful imo. I enjoy reading literature in cards and endo, but I have zero desire to do either of them. I do enjoy obgyn literature because I love the field, but enjoying lit from a field doesn’t necessarily mean you’ll like it clinically. And many people go into specialties hating research lol.

I am a little concerned about the litigation side of it. A podcast I listened to recently had an OBGYN on it that said that she did not have a colleague that had not been at least named in a lawsuit. I've heard that the state I'm in and most likely will practice in has favorable laws for OBs, but I don't know for sure.

Litigation is present in many fields. It’s def higher in some fields like obgyn, but the fear of lawsuits shouldn’t deter you from a specialty imo. Practice good medicine and take the best care of you patients as you can. You might still get sued, but at least you will be able to sleep at night.

 

[Gilakend]

OP, what articles interest you and what do you read casually?

I must be an awful med student. I have never once in my life read, or considered reading, a medical article casually.

 

[Matthew9Thirtyfive]

I must be an awful med student. I have never once in my life read, or considered reading, a medical article casually.

You’ll never be a good doctor if you don’t read medical journals for fun.

 

[Dr G Oogle]

There’s nonsense in a lot of fields, pick the field in which the nonsense is tolerable to you. I think the risk of litigation is real, but is really quite overblown for OB, also if you’re hospital employed you’re somewhat insulated from the ordeal even if named in a suit. You can also just not do the OB part, lawsuits in gyn aren’t any higher than in other fields. And consent people up the wazoo, I would literally tell people there is a risk of death from a circumcision (albeit so small it could be a rounding error) and document that I told them that.

I also don’t think people are any more unhappy of going in for an annual than for most other things people go to the doctor for. People don’t like going to doctors period.

Most people in PP, and probably most in academics don’t read many published articles out of casual interest, so not a great Metric for selection of specialty. In fact overtime I would guess you’d want to read as little as possible of anything medical, as that will be your whole life. I haven’t read anything other than sci-fi or fantasy since I started med school, and used to read a ton of Mediciny books like those mentioned above. When you have little free time, the last thing you want to do is fill it up with work related things. I love my job, but as i get older I want spend as little time doing it as possible.