Rei

[everly]

I just finished my OB rotation and found myself considering this field for the first time...
I am really worried about the lifestyle/malpractice, and I have heard REI is a much better lifestyle. Anyone here know if this true? Also, just HOW selective is it really?

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[LIDO]

First you need to make it through residency. Residency is difficult for most fields. OBGYN is not an exception. REI can have a better lifestyle, but I know of plenty physicians who still work a ton. I also know plenty of general OBGYN physicians who work 4 days / week. Do what you enjoy.

 

[everly]

Thanks for your reply. Certainly, I agree with your advice, but I have been discouraged from OB by many OBs I come across, all citing terrible working hours and malpractice. I am not afraid of hard work, but I am concerned by the frequency and uniformity of the advice I have gotten. One of the OBs I shadowed said REI was very rewarding personally and had relatively little call, so I was trying to find out more about it, but I have been struggling. I'm not sure I'm a 'glitz-and-glamour' person, but helping a couple conceive seems one of the most emotionally satisfying acts one could do.

 

[Textbookversion]

Thanks for your reply. Certainly, I agree with your advice, but I have been discouraged from OB by many OBs I come across, all citing terrible working hours and malpractice. I am not afraid of hard work, but I am concerned by the frequency and uniformity of the advice I have gotten. One of the OBs I shadowed said REI was very rewarding personally and had relatively little call, so I was trying to find out more about it, but I have been struggling. I'm not sure I'm a 'glitz-and-glamour' person, but helping a couple conceive seems one of the most emotionally satisfying acts one could do.

Patient population is very very different too between OB and REI. REI is basically the derm of OBGYN.

 

[everly]

oh, I guess I see that. Obviously, I am still exploring, but I always pictured myself as an advocate and aide for low-income women as well as more wealthy patients. I'm interested in learning more about various specialties of OB, including urogynecology. If you go to a good residency, how likely is it that you'll match SOMEWHERE for fellowship?

 

[anonperson]

I just finished my OB rotation and found myself considering this field for the first time...
I am really worried about the lifestyle/malpractice, and I have heard REI is a much better lifestyle. Anyone here know if this true? Also, just HOW selective is it really?

Malpractice is minimal.

Lifestyle is generally pretty good, especially if you're in a bigger group. No in house call. No real emergencies. You may have to come in on weekends for inseminations etc on the weekend if the patient's are ovulating but in a larger group this is spread out.

Pay is generally solid. It's largely a cash business in most areas and people are desperate for kids and will pay whatever. This is an outlier but for Columbia University, the second and third highest faculty were both REIs pulling in $~2 million a year. Average salaries are in the $300K-400K range.

Patient's are high maintenance and want your time which is a reasonable desire based on the money they are paying.

As far as being an advocate for low income women. Good luck with that. You can offer most services but not likely IVF, too much money at stake. There may be a few university programs that buck that trend but I'm not certain.

Matching is tough. There's ~40 or so fellowships. The exact number is at the ABOG website. You need to go to a top tier residency, preferably with a fellowship of its own to have a decent shot at matching.

 

[Textbookversion]

Thank you for that informative response. Do you happen to know the malpractice status of the other fellowships? In particular, I am also interested in Urogyn. (My father is an attorney, and VERY aware of malpractice issues).

You really shouldn't be picking a specialty based on malpractice. Everyone gets sued, it's part of life. Mostly it's going to be based on luck and how much your patients like you. That's why everyone has malpractice insurance.

If you are scared of malpractice you shouldn't be doing OBGYN period. There is a good chance you'll get named in a suit before you even finish residency lawl. Plus 18 years of liability for every baby you deliver instead of 2 years or w/e it is for every other medical procedure.

Personally I think you should pick a specialty you'd be happy doing the base residency specialty in but that's just me.

 

[anonperson]

Thank you for that informative response. Do you happen to know the malpractice status of the other fellowships? In particular, I am also interested in Urogyn. (My father is an attorney, and VERY aware of malpractice issues).

REI has less malpractice issues than other specialties in OB GYN. But again, no one is immune to being named in a lawsuit.

As far as urogyn, it depends. I know a well respected urogyn who has been practicing for 15 years and has never been named in a suit. He documents well and counsels his patients thoroughly.

This is all location dependent and luck of the draw to a certain extent. The malpractice environment is vastly different in Philadelphia versus a more rural area just 1.5 hours outside of Philadelphia.

 

[LIDO]

The legal environment is always changing. There are numerous physicians that are sued more frequently than OBGYN. Also, not all OBGYN physicians are liable for 18 years. Check with your local state laws.

Let's avoid broad swooping generalizations that further deter bright students.

You really shouldn't be picking a specialty based on malpractice. Everyone gets sued, it's part of life. Mostly it's going to be based on luck and how much your patients like you. That's why everyone has malpractice insurance.

If you are scared of malpractice you shouldn't be doing OBGYN period. There is a good chance you'll get named in a suit before you even finish residency lawl. Plus 18 years of liability for every baby you deliver instead of 2 years or w/e it is for every other medical procedure.

Personally I think you should pick a specialty you'd be happy doing the base residency specialty in but that's just me.

 

[anonperson]

Thanks for the responses! Can anyone give me any more information re: the different OB specialties? Any websites or books that I can read? There doesn't seem to be much out there for Urogyn or REI (really, there isn't much about the subspecialties anywhere that I can find, including MFM. What is the malpractice situation like for MFMs?)
I'm sorry if I seem like I am indiscriminately asking about various subspecialties, I just can't seem to find more information about them anywhere else, and if I am thinking of going into OB I would like to be knowledgeable about all of the future options.

Geez, this is annoying. First, why not figure out if you can even tolerate being a general OB GYN and an OB GYN residency? The vast majority of OB residents, even from high powered academic programs go on to being generalists. It's a bit dangerous going into residency thinking the fellowship is a sure bet when this may not be the case.