pt management vs surgical skills

[obdoc13]

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Hi there, any of you residents out there have any suggestions about which is more beneficial: learning pre op, post op pt management or tons of surgical experience?
My top 2 programs are definitely different as one is a great community program that lacks some autonomy in the patient management issue as 50% of patients are private but has excellent surgical numbers...and then my other choice is a large academic center with great management but much lower surgical experience (that they are working on improving, but can't compete with the first program)
Also-if i was to go to the less surgical orientated program and do a MIS fellowship afterwards...what do you think of that?
thanks for any advice
ps-most likely doing general obgyn

 

[pruritis_ani]

Hi there, any of you residents out there have any suggestions about which is more beneficial: learning pre op, post op pt management or tons of surgical experience?
My top 2 programs are definitely different as one is a great community program that lacks some autonomy in the patient management issue as 50% of patients are private but has excellent surgical numbers...and then my other choice is a large academic center with great management but much lower surgical experience (that they are working on improving, but can't compete with the first program)
Also-if i was to go to the less surgical orientated program and do a MIS fellowship afterwards...what do you think of that?
thanks for any advice
ps-most likely doing general obgyn

Always go with the surgical numbers. Post op, pre op is great to have, but you will sufficient exposure with a lower number of cases. The key is getting comfortable with doing the cases.

Some things to be aware of, however....great numbers does NOT mean the residents are doing the case. Be sure that when they do cases with privates, they DO them, and are not a glorified first assist. Some hospitals utilize privates and have a very good relationship with them, and they let residents operate. Other facilities have privates who use the residents for first assists. The difference may not be clear on the case lists, talk to the residents.

Be careful with big programs, or programs with fellows. Many places will have enough cases to go around, but some do not. It sucks to be getting all of your OR experience as a chief. Especially if you are going to do general ob/gyn, I would strongly consider avoiding programs with competing fellows, and be sure to go to a program with good exposure to all subspecialities. As a generalist, you need to know how to do many different types of cases, and you need all 4 years of training to expose you to everything. As for the MIS training...hopefully, if you pick a good program, that extra training will be redundant. I think it is a tough sell to be going into a residency and already thinking about extending the residency for a year to do a fellowship that really should be included in your training.

Good luck