Specialties that provide the most obvious benefits to patients

[LoveandHate]

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So I like fields of medicine where the patient leaves very happy that something positive was accomplished. I like fields where the benefit of treatment is very tangible to the patient

As an example, I would imagine that in trauma surgery when the outcome is positive, the patient is satisfied that the doctor was able to provide care with very obvious and tangible benefits.

What fields of medicine best fit this criteria? Right now I'm thinking the surgical fields and dermatology.

 

[Druggernaut]

So I like fields of medicine where the patient leaves very happy that something positive was accomplished. I like fields where the benefit of treatment is very tangible to the patient

As an example, I would imagine that in trauma surgery when the outcome is positive, the patient is satisfied that the doctor was able to provide care with very obvious and tangible benefits.

What fields of medicine best fit this criteria? Right now I'm thinking the surgical fields and dermatology.

Trauma's patient population tends to be ungrateful. Sure, you saved them from that bullet wound they received when the robbery went bad, but did you see the bill you sent them?! And you called the cops. The same goes for EM. You'll get some patients who you've snatched from the jaws of death who will be very thankful, but so many of them have made so many poor life decisions and been handed so many freebies that they feel entitled.

I'd expect the elective fee-for-service things, such as plastics and derm, would have pretty satisfied patients. Urology, ortho, and maybe opthalmology would probably be up there too. Cardiology and most other surgeons not listed above would probably rank slightly lower.

FM and IM, despite forming long-term relationships with patients, get the short end of the stick. You love the guy who cuts you open and puts in a new heart, not the guy who kept yours trudging along years after it would've otherwise thrown in the towel.

 

[isoquin]

I hate to stereotype, but I don't think dermatology quite applies in that category. Many skin conditions take years of trying different treatments. Some people like ophthalmology because patients can be given back failing vision. There are also a lot of subspecialized areas such as headache medicine where patients come in with something bad and leave with a great game plan as to how to fix it.

I'm guessing you're an MS1. I would recommend waiting till you experience some of the different fields in third year before narrowing your focus. We all came to med school to help people (hopefully). We find those great altruistic feelings in unexpected places sometimes.

 

[HumbleMD]

I'm guessing you're an MS1. I would recommend waiting till you experience some of the different fields in third year before narrowing your focus. We all came to med school to help people (hopefully). We find those great altruistic feelings in unexpected places sometimes.

Agreed. Every field can have a huge impact on patients. Dermatology included. You'll experience this on the wards. Give it time.

 

[Jack is Back]

So I like fields of medicine where the patient leaves very happy that something positive was accomplished. I like fields where the benefit of treatment is very tangible to the patient

As an example, I would imagine that in trauma surgery when the outcome is positive, the patient is satisfied that the doctor was able to provide care with very obvious and tangible benefits.

What fields of medicine best fit this criteria? Right now I'm thinking the surgical fields and dermatology.

Lol @ Derm.

Five Most Frequently Encountered Illnesses/Conditions:
1. Acne
2. Eczema
3. Skin cancer
4. Psoriasis
5. Warts

I have a dream where dermatologists make as much as FM and work just as long. Then alloapthic students flee from the specialty, siting "I don't think it's interesting." Come on guys, just say you want $/lifestyle.

 

[Bartelby]

Optho has a reputation for happy patients.

 

[Jack is Back]

Agreed. Every field can have a huge impact on patients. Dermatology included. You'll experience this on the wards. Give it time.

This is obviously a true statement, but some will do "more good" or have more of an affect on patient's lives than others.

I don't think you could say a derm changes lives like neurosurg, oncology, or pediatric surgeon. Derm gets our best and brightest because of lifestyle / money.

 

[ucsfstudents]

I think every specialty has the potential to make a significant difference in the of patients. When its all said and done, the true heroes are teachers and parents.

 

[HumbleMD]

This is obviously a true statement, but some will do "more good" or have more of an affect on patient's lives than others.

I don't think you could say a derm changes lives like neurosurg, oncology, or pediatric surgeon. Derm gets our best and brightest because of lifestyle / money.

It does attract many for money and hours, but to write it off as popping zits probably means you had a very limited clinical exposure. Have you talked to kids with epidermolysis bullosa, or adults with disfiguring cutaneous T-cell lymphoma?

You're talking to someone going into the trenches of OB-GYN, which I view as a societal AND patient "high impact" field. But to write off fields as high or low impact, important or not, is as myopic as it is naive. OP, you'll come to see what kinds of outcomes and patients you value with time.

 

[Isoprop]

So I like fields of medicine where the patient leaves very happy that something positive was accomplished. I like fields where the benefit of treatment is very tangible to the patient

As an example, I would imagine that in trauma surgery when the outcome is positive, the patient is satisfied that the doctor was able to provide care with very obvious and tangible benefits.

What fields of medicine best fit this criteria? Right now I'm thinking the surgical fields and dermatology.

Gas. Patients are very happy to see you. All the benefits are immediate and tangible.

 

[rmaj79]

Palliative medicine would be my guess. Maybe geriatrics along the same lines

 

[Siverhideo1985]

Well, it's definitely NOT neuro.

 

[loveoforganic]

I would think ped onc. Gotta be willing to have the big downs too though obviously.

 

[kitsunepixie]

Today I feel like it's my specialty, neurosurgery. We operated on a patient who was going blind from a tuberculum sella meningioma that was compressing his optic chiasm and his vision was back to normal immediately after surgery. Tomorrow I'm sure I'll feel the opposite when I get the ungrateful trauma victim who just wants to get back home to his cocaine and gin.

 

[LoveandHate]

Today I feel like it's my specialty, neurosurgery. We operated on a patient who was going blind from a tuberculum sella meningioma that was compressing his optic chiasm and his vision was back to normal immediately after surgery. Tomorrow I'm sure I'll feel the opposite when I get the ungrateful trauma victim who just wants to get back home to his cocaine and gin.

Yup the bolded part is what i'm looking for out of a career in medicine. Dramatic obvious improvement/cure. But I only want that part not the other part lol

 

[UVAbme2009]

Obstetrics

 

[KinasePro]

I would think ped onc. Gotta be willing to have the big downs too though obviously.

Seems paradoxical to some extent, but the ped onc docs are by far the most satisfied/happy ones that I've come across so far. When you win in ped onc, it's gotta feel pretty damn good.

 

[Jack is Back]

It does attract many for money and hours, but to write it off as popping zits probably means you had a very limited clinical exposure. Have you talked to kids with epidermolysis bullosa, or adults with disfiguring cutaneous T-cell lymphoma?

You're talking to someone going into the trenches of OB-GYN, which I view as a societal AND patient "high impact" field. But to write off fields as high or low impact, important or not, is as myopic as it is naive. OP, you'll come to see what kinds of outcomes and patients you value with time.

You just made my point exactly.

They do deal mostly with acne patients. It's the most frequent task they do. You can't look at the minority of cases and determine that's what the specialty is about. You look @ what is done 80% of the time. 4 of the 5 most frequently dealt with conditions are cosmetic, source AAMC.

 

[2012mdc]

You just made my point exactly.

They do deal mostly with acne patients. It's the most frequent task they do. You can't look at the minority of cases and determine that's what the specialty is about. You look @ what is done 80% of the time. 4 of the 5 most frequently dealt with conditions are cosmetic, source AAMC.

In our society cosmetic appearance is very important to people. I think that field is a great fit for what the OP was looking for - happy patients and very obvious/tangible benefits.

 

[HumbleMD]

You just made my point exactly.

They do deal mostly with acne patients. It's the most frequent task they do. You can't look at the minority of cases and determine that's what the specialty is about. You look @ what is done 80% of the time. 4 of the 5 most frequently dealt with conditions are cosmetic, source AAMC.

Doctors don't practice on a population basis. Yes, on the whole 80% of Derm visits are likely for cosmetic issues. A Moh's surgeon sees 0% of acne. A derm oncologist sees 0% of acne. An inpatient peds dermatologist sees 1-10% acne. Many outpatient docs see 99% of acne. There's your 80%, but note that few docs see exactly 80%. It becomes dangerous planning your life on population-based statistics.

Additionally, a kiddo with awful nodular acne is likely going to see their dermatologist as making their life bearable in high school and having a huge "impact". I make the same argument for a man with ED, a person with chronis sinusitis, or an incontinent woman - all issues many could dismissive as minimally morbid problems, but are important to the patient at the time.

Patient "impact" can be judged by one person only - the patient.

 

[phenylacetone]

Today I feel like it's my specialty, neurosurgery. We operated on a patient who was going blind from a tuberculum sella meningioma that was compressing his optic chiasm and his vision was back to normal immediately after surgery. Tomorrow I'm sure I'll feel the opposite when I get the ungrateful trauma victim who just wants to get back home to his cocaine and gin.

Was that patient anosmic pre- or post-op? It's interesting how patients respond to disease, and how gladly patients will give up their sense of smell when the world starts to go dark.

 

[badasshairday]

Plastic Surgery. Burn victims, breast reconstruction after cancer, ect. Also the cosmetic stuff provides obvious benefits as well. 😉

 

[mave]

Urogynecology. I have never seen happier patients - some of those little old ladies love their pessaries more than their children.

 

[LoveandHate]

In our society cosmetic appearance is very important to people. I think that field is a great fit for what the OP was looking for - happy patients and very obvious/tangible benefits.

Yup, that's why I mentioned derm in the first place.

 

[LoveandHate]

I would think ped onc. Gotta be willing to have the big downs too though obviously.

I like this idea too. Oncology is an awesome field. I think I saw they were 3rd most satisfied in medicine in that recent medscape survey (behind dermatologists and radiologists)

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There have got to be more surgeons out there who can comment on this. Of all the fields that utilize dramatic interventions for dramatic improvement I would think surgery tops the list.

 

[surftheiop]

as far as quick tangible fixes, isnt optho the king of that? My grandparents were so pumped when they got cataracts fixed.

 

[Valadi]

Immediate immediate gratification - Neurosurg, ophtho
Sub-immediate gratification - plastics/ortho (stuffs gotta heal before they can use it)
Long-term gratification - medicine specialties. by then, the surgeon has forgotten who you are.

 

[Geekchick921]

Lots of good answers here. My first thought was ortho, especially joint replacement specialists.

I'm going to throw one out that hasn't been mentioned, though someone did mention obstetrics. Reproductive endocrinology. Helping someone get or stay pregnant is huge to them.

 

[NeuroChris]

Neurosurg, Plastics and Derm

 

[nitemagi]

Psychiatry with ECT in the elderly. You'd be F😱😱ing astounded.

 

[officedepot]

So I like fields of medicine where the patient leaves very happy that something positive was accomplished. I like fields where the benefit of treatment is very tangible to the patient

As an example, I would imagine that in trauma surgery when the outcome is positive, the patient is satisfied that the doctor was able to provide care with very obvious and tangible benefits.

What fields of medicine best fit this criteria? Right now I'm thinking the surgical fields and dermatology.

Do you want a field that makes you feel good? or the patient? because it sounds like the former to me. There is no way you will only have good outcomes with happy patients in any surgical field... or any medical field. There will be lots of patients who just don't like you and will not appreciate what you have done for them no matter what it is. Surgery work is also fairly grueling hours wise, repetitive, and boring that at times can feel rewarding but honestly I never saw that in any resident I worked with as most were too tired and cynical. Attendings just stopped caring at a certain point for the most part.

Maybe you're different though so think of stuff like surg onc, rad onc, oncology. Yes those fields generally have poor outcomes in the end but the treatments for some things are very effective and patients will generally be happy. It'll also make you feel good. Could also consider thoracic surgery (lots of lung cancers that are curable... though you have your lung transplants which suck).

I will also plug peds. Not sure if you like kids but that stuff is always fun and parents are usually grateful depending on your work environment (inner city vs suburbs...).

OBGYN can get rewarding with delivering children, following patients most of their lives, doing definitive surgical managements, successfully helping a patient get pregnant and doing the US to see the look on her face, etc.

But as others have discussed neurosurgery can have what you're looking for, gen surg, EM, dermatology, psychiatry, and others.


So yeah dude just wait till you start doing more rotations, if you haven't already, to see what floats your boat. I think you can garner satisfaction out of most any field depending on how you look at. But DO NOT choose a field you do not enjoy over one you do because of the former's perceived benifit to the patient, as if it is some sort of calling. That is the recipe for a bad life.

 

[HumbleMD]

Urogynecology. I have never seen happier patients - some of those little old ladies love their pessaries more than their children.

👍👍👍
The point I was trying to make earlier. OBGYN is one of the most rewarding ever, with Urogyn just one of it's life-altering fields.

 

[Jack is Back]

Doctors don't practice on a population basis. Yes, on the whole 80% of Derm visits are likely for cosmetic issues. A Moh's surgeon sees 0% of acne. A derm oncologist sees 0% of acne. An inpatient peds dermatologist sees 1-10% acne. Many outpatient docs see 99% of acne. There's your 80%, but note that few docs see exactly 80%. It becomes dangerous planning your life on population-based statistics.

Additionally, a kiddo with awful nodular acne is likely going to see their dermatologist as making their life bearable in high school and having a huge "impact". I make the same argument for a man with ED, a person with chronis sinusitis, or an incontinent woman - all issues many could dismissive as minimally morbid problems, but are important to the patient at the time.

Patient "impact" can be judged by one person only - the patient.

😕

Makes no sense.

I didn't realize this was fantasy land, lets say a double boarded plastic surgeon and dermatologist who works 1/8 time in each field doing botox and breast implants. All cash practice and likely could earn 150k working 2-3 months a year.

 

[coldleg]

I've never seen more grateful patients than on Urology.

Patients can quickly get over the fact that you reperfused their legs, or took out their appendix... but man alive, you should see the thank you's after grandpa can finally get it up again, or empty his bladder in under 10 minutes.

 

[Jack is Back]

In our society cosmetic appearance is very important to people. I think that field is a great fit for what the OP was looking for - happy patients and very obvious/tangible benefits.

I guess if you are willing to say that cosmetic appearance is making a difference, then you are there with derm. If that actually fulfills the goal of "most obvious benefit to patients" then I would agree.

I guess when I think, "most obvious benefit", I think of things that would allow people to do things they couldn't do before your care. Like staying alive instead of dying. This seems like a more obvious benefit than clearing up skin or making a 50 year old look like they are 30.

But maybe I was looking at this wrong and superficial benefits are the most obvious. Which is why I recommend part time plastic surgery or derm moh's where they can make half a million part time with happy patients. Go get'em tiger!

 

[drctother]

Lol @ Derm.

I have a dream where dermatologists make as much as FM and work just as long. Then alloapthic students flee from the specialty, siting "I don't think it's interesting." Come on guys, just say you want $/lifestyle.

What are you talking about?! Warts are fascinating!

You will never get most derm prospects to admit that, although we all know it😛

 

[HumbleMD]

😕

Makes no sense.

I didn't realize this was fantasy land, lets say a double boarded plastic surgeon and dermatologist who works 1/8 time in each field doing botox and breast implants. All cash practice and likely could earn 150k working 2-3 months a year.

Makes sense if you look at the way physicians practice. Maybe your hospital is drastically different than mine (didn't realize I train in a fantasy land, but hey, I'll take it), but there are plenty of dermatologists who don't do acne.

I don't know why we're arguing. I'm with you, most derm is for sellouts doing acne, but it's not for us to judge what someone's practice will look like, and what a patient sees as "high impact." What I'm trying to clarify is that general/population stats will only get you so far, and instead the OP should think more granularly. For instance, taking it way back to, say medical school admissions, you wouldn't look at the number of scholarships a school gives out. At some point, you only focus on the ones they did or did not give to YOU.

Another example. I'm going into obstetrics and gynecology. Somewhere under half of OBGYNs do obstetrics. I plan to do none, and many others do the same and stay in pure gynecology or a sub-specialty.

And to drive it home, a clinical example. On the whole, if a treatment improves survival by 1 month in a trial of 12 people, it may seem useless. But it might actually be improving the survival of 1 select patient by 1 year, which is much more meaningful to that one patient.

PS - Mohs surgeons aren't plastics or double board-certified, they're much more commonly Derm Surg (1 year fellowship).

 

[2012mdc]

I guess if you are willing to say that cosmetic appearance is making a difference, then you are there with derm. If that actually fulfills the goal of "most obvious benefit to patients" then I would agree.

I guess when I think, "most obvious benefit", I think of things that would allow people to do things they couldn't do before your care. Like staying alive instead of dying. This seems like a more obvious benefit than clearing up skin or making a 50 year old look like they are 30.

But maybe I was looking at this wrong and superficial benefits are the most obvious. Which is why I recommend part time plastic surgery or derm moh's where they can make half a million part time with happy patients. Go get'em tiger!

OP - "So I like fields of medicine where the patient leaves very happy that something positive was accomplished. I like fields where the benefit of treatment is very tangible to the patient"

Clearing up a teenage's girl skin just in time for prom will make her very happy and is a very tangible result. OP didn't ask for fields where the most significant results occur (which is very subjective BTW).

I have no dog in this fight but you seem to harbor some animosity towards derm

 

[LoveandHate]

OP - "So I like fields of medicine where the patient leaves very happy that something positive was accomplished. I like fields where the benefit of treatment is very tangible to the patient"

Clearing up a teenage's girl skin just in time for prom will make her very happy and is a very tangible result. OP didn't ask for fields where the most significant results occur (which is very subjective BTW).

I have no dog in this fight but you seem to harbor some animosity towards derm

Really what I should have written was: What field of medicine would best allow me to, more often than not, provide cures or near cure. A cure to me generally means minimal effect to quality of life and no complex longterm medical management. This is why I talked about surgery in the beginning. I also mentioned Derm because the cure rate for skin cancers are often very high... for example if I went into Mohs.

I simply assumed that cure = patient notes very tangible benefit which isn't always the case. Nevertheless, I'm sure others on this forum can understand where I'm coming from. It's gratifying to provide patients with a tangible solution to their problems. They're happy and healed, your happy. Everyone wins. I think it's silly to deny that atleast part of the reason I've pursued this profession is because I think helping people is gratifying (ie. because it makes ME feel good).

 

[Jack is Back]

OP - "So I like fields of medicine where the patient leaves very happy that something positive was accomplished. I like fields where the benefit of treatment is very tangible to the patient"

Clearing up a teenage's girl skin just in time for prom will make her very happy and is a very tangible result. OP didn't ask for fields where the most significant results occur (which is very subjective BTW).

I have no dog in this fight but you seem to harbor some animosity towards derm

I do.

It's probably just the gunners I know who talk about derm who seem to have no interest in the field other than $/lifestyle.

Just like I don't like athletes that say they just "show up for their paycheck and don't love the game." Some part of me wants people to enjoy what they do (interest/passion). I know there are people who really derm in its purity but I've just been around all the grade hungry (*anal*) / political brown nosing pre-clinical students that talk about derm, who are my least favorite individuals. So unfortunately I have animosity towards some of the aspiring derm'ies more than I do the actual practicing physicians or the field.

 

[Jack is Back]

Makes sense if you look at the way physicians practice. Maybe your hospital is drastically different than mine (didn't realize I train in a fantasy land, but hey, I'll take it), but there are plenty of dermatologists who don't do acne.

I don't know why we're arguing. I'm with you, most derm is for sellouts doing acne, but it's not for us to judge what someone's practice will look like, and what a patient sees as "high impact." What I'm trying to clarify is that general/population stats will only get you so far, and instead the OP should think more granularly. For instance, taking it way back to, say medical school admissions, you wouldn't look at the number of scholarships a school gives out. At some point, you only focus on the ones they did or did not give to YOU.

Another example. I'm going into obstetrics and gynecology. Somewhere under half of OBGYNs do obstetrics. I plan to do none, and many others do the same and stay in pure gynecology or a sub-specialty.

And to drive it home, a clinical example. On the whole, if a treatment improves survival by 1 month in a trial of 12 people, it may seem useless. But it might actually be improving the survival of 1 select patient by 1 year, which is much more meaningful to that one patient.

PS - Mohs surgeons aren't plastics or double board-certified, they're much more commonly Derm Surg (1 year fellowship).

lol, my double board was derm/plastics - double residency double board...

anyway, I will agree with you and I have no reason to begin an argument on this site.

I like people to like what they do. That was my only point. Some of the students I run into seem like they are greedy and overly concerned with $/lifestyle when they talk about the field rather than the actual MEDICINE.

You have made good points.

 

[2012mdc]

I do.

It's probably just the gunners I know who talk about derm who seem to have no interest in the field other than $/lifestyle.

Just like I don't like athletes that say they just "show up for their paycheck and don't love the game." Some part of me wants people to enjoy what they do (interest/passion). I know there are people who really derm in its purity but I've just been around all the grade hungry (*anal*) / political brown nosing pre-clinical students that talk about derm, who are my least favorite individuals. So unfortunately I have animosity towards some of the aspiring derm'ies more than I do the actual practicing physicians or the field.

Fair enough. Preclinical students who are dead set on a prestigious/ROAD specialty w/o much exposure to it can be annoying.

There are physicians in every field who just show up for a paycheck. There are many with that mentality who don't have the numbers for derm. EM was popular in my class in the preclinical years just because of the shift work and most interested ppl hadn't had much exposure to it at that point in time

I'm curious to know if you feel the same way about preclinical students who are dead set on specialties like neurosurg or pediatric cardiothoracic surg because they carry a lot of prestige.

 

[dr zaius]

Pediatric urology.

 

[kitsunepixie]

Was that patient anosmic pre- or post-op? It's interesting how patients respond to disease, and how gladly patients will give up their sense of smell when the world starts to go dark.

The patient's sense of smell was intact both before and after surgery. We saw the olfactory tracts, but they were far from harm's way with his tumor. Olfactory groove meningiomas are another story.

 

[BigRedBeta]

Although peds heme/onc was mentioned, there are other peds fields that also have many tangible rewards - although it's the parent feeling overwhelmed and the child just going back to be a normal kid (which is actually the best part).

Neonatology, peds critical care (unlike adult ICU's, most PICU's have mortality rates of <4%), Peds surgery, and Peds cardiology are all very high on the list of patients having clearly tangible benefits. I think I'd actually say that Peds Cards - in my experience - has the overall highest % of grateful patients/parents I've seen in any field. The cardiologists and the CT surgeons really do get to fix broken hearts that would otherwise ended poorly, and they get to see them back for years (sometimes even into adulthood because adult cardiologists won't touch them).

 

[HumbleMD]

Pediatric urology.

No way. Those kids will need multiple surgeries, and at the end of the day, they end up on a transplant list regardless of what interventions were or were not performed.

OP, it sounds like you want a field of medicine in which you perform an intervention and have instant results, almost 100% of the time. That almost never happens in medicine - we exist in a world of liminality, with unsatisfied patients, unclear diagnoses, and interventions that are 80% effective, 80% of the time, for 80% of the patients you give it to. Just give it time and you'll figure out what you find the most rewarding after trying things out.

Almost every field has their chronic pelvic pain, their IBS, their fibromyalgia, their refractory eczema, or their noncompliant patient in a hell of their own making.

The one practice model I can think of with a super low complication rate and super high success rate is cataract surgery. But if you talk to an ophtho running a cataract clinic where they have their patients lined up like an auto assembly plant, you'll find they don't exactly find it as the most rewarding experience.

In short, wait until you get to the clinics, then carefully select electives in order to sort it out.

 

[Socrates25]

Although peds heme/onc was mentioned, there are other peds fields that also have many tangible rewards - although it's the parent feeling overwhelmed and the child just going back to be a normal kid (which is actually the best part).

Neonatology, peds critical care (unlike adult ICU's, most PICU's have mortality rates of <4%), Peds surgery, and Peds cardiology are all very high on the list of patients having clearly tangible benefits. I think I'd actually say that Peds Cards - in my experience - has the overall highest % of grateful patients/parents I've seen in any field. The cardiologists and the CT surgeons really do get to fix broken hearts that would otherwise ended poorly, and they get to see them back for years (sometimes even into adulthood because adult cardiologists won't touch them).

Let me put in a plug for peds cardiology. Even on a simple referral for an innocent murmur, the parents are always ecstatic when you can tell them after auscultating that its just a Stills murmur. Even if you dont get an echo to confirm they are very satisfied that you put their mind at ease.

 

[45408]

Obstetrics

Yeah, handing a new human to your patient is pretty obvious and pretty tangible.

 

[startswithb]

Urogynecology. I have never seen happier patients - some of those little old ladies love their pessaries more than their children.

As an aside, can anyone explain the difference between female urology and urogynecology? I don't want to deliver babies.

 

[HumbleMD]

As an aside, can anyone explain the difference between female urology and urogynecology? I don't want to deliver babies.

It's a double-pathway, board-certified specialty now. You can enter "urogynecology and pelvic surgery" from obstetrics and gynecology, or "female urology" through urology. Fellowships have their own flavor.

OB-GYN is a 4 year residency, followed by the 2-3 year urogyn fellowship. Yes, you will be delivering babies. Urogology is a 5 year residency with a 1 year gen surg internship included. Yes, you will be sticking your finger up a lot of men's recta for prostate exams, and get called in to place difficult urinary catheters. Urology is a much more competitive residency.

The OBGYN fellowships are more about prolapse than anything else, and also do a lot of TVTs, etc. Urology tends to do more bladder work, e-stims, and also its fair share of TVTs, etc.

You'll be doing something you don't like, at some point in residency (just like in medical school) no matter what career you choose.