query about ob/gyn residencies

[jane2]

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Hi,
i'm from the UK so please forgive my lack of familiarity with the way you guys do things.
I'm interested in training in obs/gyn and am wondering a few things...

- Which programs (if any) are generally thought to be the best?

- Are all the residencies of similar length, generally? I've looked at details for a couple, they were 4 years, are they all this length?

- What happens after your residency? Would you probbaly have to do some sort of sub-speciality training, or is this not really necessary? I've not managed to glean what exactly sub-specialty training is - I gather that if, for example, you wanted to be a cardiac surgeon you'd do your residency in internal medicine and then sub-s training in cardiac surgery, but I am not sure if all doctors eventually have to do sub-specialty training, or not.

Thank you!

 

[doc05]

on this side of the atlantic, there is a malpractice crisis that is driving obgyn's out of practice every single day. think twice before you move here if you want obgyn, or before choosing a specialty if you want to come to the US.

 

[jvarga]

And now for a post that actually answers the original questions.
1. After graduating medschool you are required to complete a four year ob/gyn residency. After residency, you have the option of practicing general ob/gyn, continuing your education in a fellowship (sub-specialty training), or retiring and becoming a beer truck driver. All "official" fellowships last 3 years after residency.
2. As far as becoming a cardio-thoracic surgeon, you would have to complete a residency in general surgery (not internal medicine) and then complete a cardio-thoracic surgery fellowship...a very long road!
3. Not all doctors have to complete a fellowship...only those that seek to prolong their misery need apply!
4. As we all know, making generalizations is highly dangerous and inaccurate. As such, it is a grave error to include all of the states when addressing the malpractice issue "this side of the atlantic". This is highly variable depending on the state in which you choose to reside. There are a couple of states that are in the aforementioned crisis, but many states have not been affected. So, it goes without saying, the business of Ob/gyn in the US remains strong and secure! Hopefully, changes will soon be on their way for the affected states.

 

[jane2]

thank you guys. I have heard about the malpractice issue but to be honest it doesn't hugely put me off. Maybe this is just because i'm english so am totally unaware of how awful it might be. I appreciate that it's a consideration though, thanks. Is it just that the insurance is expensive, or is there a significant possibility that obstetricians might get struck off the register?

The states I would be interested in living in are probably Oregon, Washington, Boston, Rhode Island or New York State. Which of those is worst / best?

Thanks so much.

 

[doc05]

forget about Boston (Massacusetts) and New York. Don't know about the others. Never intended to disparage a career choice, but given that things are vastly different in Europe, I thought you should know. For the record, I've met a few obgyns forced out of practice because of ever-increasing premiums. Good luck.

 

[jane2]

OK. well, I'm still at an early stage of enquiry but am keen to know my options well in advance. However, I don't think the way that the different states are now will necessarily be the way that they are a few years down teh line, when I come to apply.

There must be obgyns practising in Massachussetts (sorry, I do k now that Boston isn't its own state...!) and New York, but I take your point.

 

[ny skindoc]

thank you guys. I have heard about the malpractice issue but to be honest it doesn't hugely put me off. Maybe this is just because i'm english so am totally unaware of how awful it might be. I appreciate that it's a consideration though, thanks. Is it just that the insurance is expensive, or is there a significant possibility that obstetricians might get struck off the register?

The states I would be interested in living in are probably Oregon, Washington, Boston, Rhode Island or New York State. Which of those is worst / best?

Thanks so much.

I would suggest visiting these places and doing some first hand research before considering living in any of them,as there is no such thing as worst or best.Each has its own particular positives and negatives.Even within a state like NY there is much variation in lifestyle from large cities,to suburbs and rural areas.Very different types of places to live and practice.I would not worry too much about malpractice,there is always the option of working for a large group or HMO setting and it would not be as much of an issue as in a smaller private practice.

 

[jane2]

Thanks. Yeah, that's why I'm trying to get it figured out now - I'm goign to spending a year in Canada from June so at that point will be able to visit America more easily than I can from the UK. I'm just trying to narrow my options down as to where to see!

 

[sjkpark]

Thanks. Yeah, that's why I'm trying to get it figured out now - I'm goign to spending a year in Canada from June so at that point will be able to visit America more easily than I can from the UK. I'm just trying to narrow my options down as to where to see!

What year are you at medical school? I ask this question because I'm from Commonwealth system and I was interested in O&G because I enjoyed reproduction physiology courses during my pre-clinical years. After O&G run, it is the specialty that I'll consider leaving medicine if it was my ONLY option. I HATE IT!

I don't know what it is like in America, but here midwives do the deliveries. They all have huge chip on their shoulders and their mission in life seems to be to eat all the medical professionals alive.

 

[abski]

I was sort of sad to hear all the nay-saying. OB/Gyn is a rewarding field, and New York and Boston have some of the best training around... Training in OB/Gyn in an urban environment, especially in states with large malpractice premiums is hard, but in my opinion, still worth it!!

So to answer the original question, the best programs in NY and Boston:
NY: Columbia, Albert Einstein Montefiore, Cornell, NYU
Boston: Brigham and Women's, Beth Israel

Good luck!

 

[norbel]

although some of the names are impressive...they are not necessarily the better programs from an overall perspective...so be cautious of what you hear...big names do not always equal great experience...good luck

 

[doprogressive]

For your west coast states (washington and oregon), they both have 1 residency program each (ACGME not including military). They both are mild-medium competitiveness as OBGYN residencies go. They tend to be very popular because of location and strong reputation. As an IMG you ought to know that all residency programs here in the US that are accreditied by the ACGME must meet standard requirements. So if you go to any of these you will be adequately trained. There are some places that are "better" but you really need to choose the place that you fit in the best and that teaches you the things YOU want to know...ie some programs are stronger in infertility/reproductive endocrinology, some programs are stronger in minimally invasive surgery, some programs are a majority of high risk obstetrics, some programs teach forceps, some really don't. This is all information you can request from the programs (average #s for the graduates). Dont be disuaded by negativity. Women will continue to need care and it may take sometime and some scary scenarios to convince legislators. But, in america everyone ought to know about the stock market and values: buy low, sell high. Good Luck