Specialty Crisis

[jstargirl17]

Hello, I apologize for the long post in advance! I just wanted to give some background for things. I’m a current MS4 getting toward the end of my rotations and I’m so stressed about choosing a specialty. All of the rotations I’ve had so far (IM, peds, neuro, psych, surg, and I’m currently on OB/GYN) have gone very well. The only rotation that I stuffed with was surgery. I hated the long hours and a lot of the attendings and residents didn’t really teach. I was just there to either hold the camera or

My top two specialities right now are either OB/GYN or IM. I liked my IM rotation because I thought it was sort of a “jack of all trades” (I liked learning about CHF, COPD, GI bleeding, diabetes, CKD). I also like that there are fellowship options. The option that I’m interested in if I were to do a fellowship is medical oncology or cardiology. The only downside is I really enjoy women’s health. Which leads me to talking about my OB/GYN rotation…

The downside to IM is I’m worried about if I will be happy/satisfied long term and if I will get burned out from having to manage all of the conditions for so many patients…

My thoughts on my OB/GYN rotation:
I’ve been really enjoying my OB/GYN rotation so far
I got to deliver 4 placentas and I saw a few C-sections. I was on 1 week of day shifts and 1 week of night shifts. L&D is very busy and can be stressful (at least seeing how the residents were always answering their hospital phones/pagers) and there’s a big learning curve... As time went on, I started to feel a little better as I took a lot of notes on what the resident said, studying some things on my own, and I liked OB triage. There are lots of diverse patients at the level 1 trauma center where I’m at (I’ve seen patients of different races, who speak different languages, teenage patients, etc). I also got to see a code green patient in the ED

I just finished a week of outpatient OB/GYN clinic. While I liked it and have been learning how to do find the fundal height and use the Doppler to listen to baby’s HR/fetal heart tones, it was draining/tiring at times. There’s a lot of routine/repetitive things- Lots of prenatal visits and postpartum visits, some GYN visits. But every patient is still unique and different with their own medical history. I had one half-day of high risk OB patients that had very complex medical issues but that also gave me a headache too since they had soo much going on. It seemed like a mix of IM and OB/GYN- knowing how different chronic conditions affect pregnancy (hypo and hyperthyroidism, rheumatoid arthritis, DiGeorge syndrome, HIV positive, etc)

I have GYN surg next week. I just struggle with studying anatomy… I try so hard to focus but I don’t know if my brain is fried or I’m tired/burned out or just bored?? But I just find it difficult to study anatomy and then am trying to find what things look like laparoscopically
I did find some good videos on YouTube

But I just wonder how I’m going to like GYN surg?

The things I’m worried with OB/GYN are:
1. The hours of L&D in residency
2. If I will struggle with surgery in residency if I apply OB/GYN…
3. How the lifestyle will be as an OB/GYN (I’m 26 and currently single with no kids. I do aspire to be married and have a family one day). There are residents at my home institution who’ve had kids while in residency and one is currently pregnant. Most of the attendings have been very nice and most of the residents have been nice as well and explain/teach things

So while I do like IM, part of my wonders if I’m only choosing it because it’s an “easier” lifestyle than OB/GYN. Another part me wonders if I choose OB/GYN, am I going to have regrets when I’m burnt out from doing 24 hr shifts or struggle with doing surgery?


The other specialties I’ve thought about are psychiatry and neurology. While I enjoyed both of these rotations and think they are interesting, I don’t think I could see myself doing it full time.. I know the lifestyle for psych is great but I also want to do something that’s interesting to me. My most memorable experiences for psych and neuro have been with female patients (I loved helping them through their darkest time when on psych and for neuro I watched a young MS painter get better over her course in the hospital). So I definitely feel more connected to female patients

Derm is interesting and the lifestyle is great… but I’m just not interested in only looking at skin conditions in patients for the rest of my career..

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[dbdnt]

If you’re feeling this way about the OR now, I would give some serious thought to IM. I had a very involved OBGYN rotation and intended to apply, but the fatigue eventually wore me down after several sub-I’s and I am quite glad I did not apply at this point after seeing how those residents work. IM sees all adult patients except OB care, but you still do women’s health. There are many paths from IM as well, even if you don’t do one of the big competitive fellowships.

 

[jstargirl17]

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If you’re feeling this way about the OR now, I would give some serious thought to IM. I had a very involved OBGYN rotation and intended to apply, but the fatigue eventually wore me down after several sub-I’s and I am quite glad I did not apply at this point after seeing how those residents work. IM sees all adult patients except OB care, but you still do women’s health. There are many paths from IM as well, even if you don’t do one of the big competitive fellowships.

How can you do women’s health in IM?

I don’t mind the OR but I know surgery is a lot and it’s challenging in terms of understanding the anatomy…


What specialty did you end up applying instead? You mentioned doing some Sub-Is. I was interested in doing an OB Sub-I but I still have [emoji[emoji[emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6]]]][emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6][emoji6]]]] weeks left of my OB/GYN rotation. So I don’t want to make any final decisions until I am done with the rotation

 

[Smurfette]

Hello, I apologize for the long post in advance! I just wanted to give some background for things. I’m a current MS4 getting toward the end of my rotations and I’m so stressed about choosing a specialty. All of the rotations I’ve had so far (IM, peds, neuro, psych, surg, and I’m currently on OB/GYN) have gone very well. The only rotation that I stuffed with was surgery. I hated the long hours and a lot of the attendings and residents didn’t really teach. I was just there to either hold the camera or

My top two specialities right now are either OB/GYN or IM. I liked my IM rotation because I thought it was sort of a “jack of all trades” (I liked learning about CHF, COPD, GI bleeding, diabetes, CKD). I also like that there are fellowship options. The option that I’m interested in if I were to do a fellowship is medical oncology or cardiology. The only downside is I really enjoy women’s health. Which leads me to talking about my OB/GYN rotation…

The downside to IM is I’m worried about if I will be happy/satisfied long term and if I will get burned out from having to manage all of the conditions for so many patients…

My thoughts on my OB/GYN rotation:
I’ve been really enjoying my OB/GYN rotation so far
I got to deliver 4 placentas and I saw a few C-sections. I was on 1 week of day shifts and 1 week of night shifts. L&D is very busy and can be stressful (at least seeing how the residents were always answering their hospital phones/pagers) and there’s a big learning curve... As time went on, I started to feel a little better as I took a lot of notes on what the resident said, studying some things on my own, and I liked OB triage. There are lots of diverse patients at the level 1 trauma center where I’m at (I’ve seen patients of different races, who speak different languages, teenage patients, etc). I also got to see a code green patient in the ED

I just finished a week of outpatient OB/GYN clinic. While I liked it and have been learning how to do find the fundal height and use the Doppler to listen to baby’s HR/fetal heart tones, it was draining/tiring at times. There’s a lot of routine/repetitive things- Lots of prenatal visits and postpartum visits, some GYN visits. But every patient is still unique and different with their own medical history. I had one half-day of high risk OB patients that had very complex medical issues but that also gave me a headache too since they had soo much going on. It seemed like a mix of IM and OB/GYN- knowing how different chronic conditions affect pregnancy (hypo and hyperthyroidism, rheumatoid arthritis, DiGeorge syndrome, HIV positive, etc)

I have GYN surg next week. I just struggle with studying anatomy… I try so hard to focus but I don’t know if my brain is fried or I’m tired/burned out or just bored?? But I just find it difficult to study anatomy and then am trying to find what things look like laparoscopically
I did find some good videos on YouTube

But I just wonder how I’m going to like GYN surg?

The things I’m worried with OB/GYN are:
1. The hours of L&D in residency
2. If I will struggle with surgery in residency if I apply OB/GYN…
3. How the lifestyle will be as an OB/GYN (I’m 26 and currently single with no kids. I do aspire to be married and have a family one day). There are residents at my home institution who’ve had kids while in residency and one is currently pregnant. Most of the attendings have been very nice and most of the residents have been nice as well and explain/teach things

So while I do like IM, part of my wonders if I’m only choosing it because it’s an “easier” lifestyle than OB/GYN. Another part me wonders if I choose OB/GYN, am I going to have regrets when I’m burnt out from doing 24 hr shifts or struggle with doing surgery?


The other specialties I’ve thought about are psychiatry and neurology. While I enjoyed both of these rotations and think they are interesting, I don’t think I could see myself doing it full time.. I know the lifestyle for psych is great but I also want to do something that’s interesting to me. My most memorable experiences for psych and neuro have been with female patients (I loved helping them through their darkest time when on psych and for neuro I watched a young MS painter get better over her course in the hospital). So I definitely feel more connected to female patients

Derm is interesting and the lifestyle is great… but I’m just not interested in only looking at skin conditions in patients for the rest of my career..

If you're at the end of your MS-4 year, shouldn't you be finalizing your rank list? Are you a third year?

Surgery in OB is not like other surgical fields. Other than gyn-onc (which is a fellowship), there is a limited amount of surgeries they do, and the anatomy involves tubes/ovaries/uterus and avoiding injuring the bladder, rectum and ureters. It's not like GS where you might operate on anything in the belly. Also, the OBs here are mostly clinic based but a few tend to do most of the operative gyn. And of course, those still doing OB (a lot of OBs give this up and just do gyn after a while) have deliveries.

Hours on OB can be long but places are increasingly going to laborist models. That being said, there are various practice models out there for when you are no longer a trainee.

Residency sucks for EVERYBODY. Some are more notoriously tough, but those in tough residencies like their specialties. People who like surgery would typically rather do a long surgery shift than a short day in IM.

As far as women's health, any primary care field can do this. There are women's health electives, etc. out there. If interested in FP, you could get more OB exposure in residency as well. There are practices out there (mostly rural or semi-rural) where you can do deliveries as an FP. One of my close friends did a year long OB fellowship after FP residency and does c-sections in her rural town (there are a few other FPs who also do c-sections, as well as the general surgeons, as there are no OBs in her town. Some of the FPs do deliveries only and those with extra training alternate c-section call). She had no trouble finding hospitals looking for that skill set and paying her more for this.

 

[jstargirl17]

Hello,

Thank you for the response and insight

I’m currently a MS3! I’m on my OB/GYN rotation and I’ve had 2 weeks of L&D and 1 week of outpatient OB clinic with some GYN patients

I have heard that surgeries in OB/GYN are not the same as in Gen Surg or other surgical fields except for GYN Onc and Urogyn.

I will just try as much as I can to keep an open mind when on GYN Surg

Thus far I have enjoyed the patient population of OB/GYN and am glad I’ve gotten some hands on experiences doing things (delivering placentas, measuring fundal height, listening to fetal heart tones using the Doppler, and I got to do one pelvic exam- resident helped as needed)

 

[Entadus]

you didn't deliver a baby? ask your attending to deliver a baby. 4 placentas, wtf?
I loved deliveries and c-sections, but thank God I didn't end up in OB-GYN, the lifestyle is way too rough for me.
Yes you will see a lot of pt's in IM. Lots of paths (inpt/outpt/fellowship)
I'm in palliative care which is not for everyone, but it does have a great QOL/lifestyle (I don't work weekends/holidays/nights. No call).

 

[jstargirl17]

Med students can’t deliver babies since we’re not trained at that level and there’s liability issues..

 

[dbdnt]

I delivered a baby on my second day of OB and about a dozen total including c-sections, but your mileage may vary. My core rotation was also working with a high-volume gyn surgeon. I went into IM and I’m glad I did so.

I felt a lot of passion for OBGYN, but at the end of the day, I think it’s important to consider what you want the rest of your life to look like too. I’m glad there are people that are willing to sacrifice so much to go into various surgical and interventional fields, but eventually I realized that life didn’t suit me. To the med student torn between a variety of specialties, I’d recommend trying to detach your sense of identity from your specialty choice and ask yourself what your overarching goals in life are. Then the answer should be more clear.

 

[LucidSplash]

In these situations, in addition to the other good advice you’ve been given, I recommend consider what you dislike about each of these specialties. Then rank these dislikes as best you can from least annoying to most egregious.

Most of us liked at least something in each specialty we rotated on 3rd year, even if that thing was how little time we spent at the hospital on that rotation. So sometimes what you liked most isn’t the best indicator of what you might like to do longterm. Consider what you disliked, and which of those things you think you could tolerate best on a longterm basis. Every specialty has its crappy parts and it’s almost as important to consider what crappy things you’d rather deal with the rest of your life as it is what you like.

 

[LucidSplash]

Med students can’t deliver babies since we’re not trained at that level and there’s liability issues..

Probably era and location dependent. Circa 2009 on my OB rotation it was required for a med student to “catch” at least one baby and scrub at least one C-section. Of course we were NOT alone in the room or doing it independently. I caught my requisite one and delivered several placentas, enough for me to know OB wasn’t my jam.

But plenty of current med students participate in deliveries. Are you a US medical student? Your timeline is a little off, as previously noted, that as an M4 you would have already submitted a match list by now, as the Match is in a couple of weeks. So it doesn’t quite make sense that you are finishing M4 and still undecided on a specialty, unless you are training outside the US. Or, maybe it was just a typo and you meant M3.

 

[jstargirl17]

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Probably era and location dependent. Circa [emoji[emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6]]]][emoji[emoji[emoji6]][emoji[emoji6]]][emoji[emoji[emoji6]][emoji[emoji6]]][emoji[emoji[emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6]]]][emoji[emoji[emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6]]]][emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6][emoji6]]]][emoji[emoji6][emoji6]][emoji[emoji[emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6]]]][emoji[emoji[emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6]]]][emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6][emoji6]]]][emoji[emoji6][emoji6]][emoji[emoji[emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6]]]][emoji[emoji[emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6]]]][emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6][emoji6]]]][emoji[emoji6][emoji6]][emoji[emoji[emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6]]]][emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6][emoji6]]]]]]] on my OB rotation it was required for a med student to “catch” at least one baby and scrub at least one C-section. Of course we were NOT alone in the room or doing it independently. I caught my requisite one and delivered several placentas, enough for me to know OB wasn’t my jam.

But plenty of current med students participate in deliveries. Are you a US medical student? Your timeline is a little off, as previously noted, that as an M[emoji[emoji[emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6]]]][emoji[emoji[emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6]]]][emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6][emoji6]]]][emoji[emoji6][emoji6]][emoji[emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6]]]]] you would have already submitted a match list by now, as the Match is in a couple of weeks. So it doesn’t quite make sense that you are finishing M[emoji[emoji[emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6]]]][emoji[emoji[emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6]]]][emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6][emoji6]]]][emoji[emoji6][emoji6]][emoji[emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6]]]]] and still undecided on a specialty, unless you are training outside the US. Or, maybe it was just a typo and you meant M[emoji[emoji[emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6]]]][emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6][emoji6]]]].

Hey I meant to say that I’m a MS[emoji[emoji[emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6]]]][emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6][emoji6]]]]

 

[HemeOncHopeful19]

OBGYN falls into the “only do it if you can’t be talked out of it” category along with Gen Surg, Peds IMO

If you happen to be a super gunner / AOA type and want to shoot for REI I guess I’d consider it but then I’d prob just do Dermatology instead

 

[LucidSplash]

Hey I meant to say that I’m a MS[emoji[emoji[emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6]]]][emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6][emoji6]]]]

Are you using the app to post? Your posts are coming across with all this crazy text. I’ve seen this before when people are using the app and it needs to be updated. Try updating your app. Failing that, delete and reinstall. Can barely read your posts will all the insane text.

 

[jstargirl17]

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Are you using the app to post? Your posts are coming across with all this crazy text. I’ve seen this before when people are using the app and it needs to be updated. Try updating your app. Failing that, delete and reinstall. Can barely read your posts will all the insane text.

Hey just deleted and re-installed the app on my phone

Do you need to rewrite any posts?

 

[LucidSplash]

@WildWing Another poster with the Emoji explosion issue. Did y’all ever figure out what was causing CDI’s posts to do this?

 

[anonperson]

Hello, I apologize for the long post in advance! I just wanted to give some background for things. I’m a current MS4 getting toward the end of my rotations and I’m so stressed about choosing a specialty. All of the rotations I’ve had so far (IM, peds, neuro, psych, surg, and I’m currently on OB/GYN) have gone very well. The only rotation that I stuffed with was surgery. I hated the long hours and a lot of the attendings and residents didn’t really teach. I was just there to either hold the camera or

My top two specialities right now are either OB/GYN or IM. I liked my IM rotation because I thought it was sort of a “jack of all trades” (I liked learning about CHF, COPD, GI bleeding, diabetes, CKD). I also like that there are fellowship options. The option that I’m interested in if I were to do a fellowship is medical oncology or cardiology. The only downside is I really enjoy women’s health. Which leads me to talking about my OB/GYN rotation…

The downside to IM is I’m worried about if I will be happy/satisfied long term and if I will get burned out from having to manage all of the conditions for so many patients…

My thoughts on my OB/GYN rotation:
I’ve been really enjoying my OB/GYN rotation so far
I got to deliver 4 placentas and I saw a few C-sections. I was on 1 week of day shifts and 1 week of night shifts. L&D is very busy and can be stressful (at least seeing how the residents were always answering their hospital phones/pagers) and there’s a big learning curve... As time went on, I started to feel a little better as I took a lot of notes on what the resident said, studying some things on my own, and I liked OB triage. There are lots of diverse patients at the level 1 trauma center where I’m at (I’ve seen patients of different races, who speak different languages, teenage patients, etc). I also got to see a code green patient in the ED

I just finished a week of outpatient OB/GYN clinic. While I liked it and have been learning how to do find the fundal height and use the Doppler to listen to baby’s HR/fetal heart tones, it was draining/tiring at times. There’s a lot of routine/repetitive things- Lots of prenatal visits and postpartum visits, some GYN visits. But every patient is still unique and different with their own medical history. I had one half-day of high risk OB patients that had very complex medical issues but that also gave me a headache too since they had soo much going on. It seemed like a mix of IM and OB/GYN- knowing how different chronic conditions affect pregnancy (hypo and hyperthyroidism, rheumatoid arthritis, DiGeorge syndrome, HIV positive, etc)

I have GYN surg next week. I just struggle with studying anatomy… I try so hard to focus but I don’t know if my brain is fried or I’m tired/burned out or just bored?? But I just find it difficult to study anatomy and then am trying to find what things look like laparoscopically
I did find some good videos on YouTube

But I just wonder how I’m going to like GYN surg?

The things I’m worried with OB/GYN are:
1. The hours of L&D in residency
2. If I will struggle with surgery in residency if I apply OB/GYN…
3. How the lifestyle will be as an OB/GYN (I’m 26 and currently single with no kids. I do aspire to be married and have a family one day). There are residents at my home institution who’ve had kids while in residency and one is currently pregnant. Most of the attendings have been very nice and most of the residents have been nice as well and explain/teach things

So while I do like IM, part of my wonders if I’m only choosing it because it’s an “easier” lifestyle than OB/GYN. Another part me wonders if I choose OB/GYN, am I going to have regrets when I’m burnt out from doing 24 hr shifts or struggle with doing surgery?


The other specialties I’ve thought about are psychiatry and neurology. While I enjoyed both of these rotations and think they are interesting, I don’t think I could see myself doing it full time.. I know the lifestyle for psych is great but I also want to do something that’s interesting to me. My most memorable experiences for psych and neuro have been with female patients (I loved helping them through their darkest time when on psych and for neuro I watched a young MS painter get better over her course in the hospital). So I definitely feel more connected to female patients

Derm is interesting and the lifestyle is great… but I’m just not interested in only looking at skin conditions in patients for the rest of my career..

I say this as someone who is an OBGYN and did a urogynecology fellowship. I also do some general OBGYN as well. My first few years out I did everything including labor and delivery call several times a month for several years.

I no longer do call except maybe 4 times a year to maintain my OB privileges as I'm not ready to give them up.

General OBGYN is a flawed field.

Most practices are heavily OB because that pays the bills.
The problem with OB is that unless you have a boutique practice, you will see a wide variety of high risk patients (obesity, HTN, DM) which aren't difficult to manage during the pregnancy. The main issue comes delivery time where reach of these factors usually makes the delivery more challenging and increases your liability and chance for a bad outcome.

You will get sued at least once.

Malpractice insurance is high.

Tail coverage can run easily over $100,000 and can hand cuff you to a bad private practice.

The laborist model isn't great either. Companies tout only working 6 to 8 shifts a month. These are 24 hour shifts which significantly impact one's personal life.

Night shift work is a independent risk factor for cancer, heart attack and stroke.

Salaries are fine but not even comparable to your typical urologist, ENT etc. We are significantly underpaid.

The job market is great in general because demand is high and people burn out and leave jobs.

 

[jstargirl17]

UPDATE:

I have been on nearly one week of gynecological surgery.

I have 3 robotic-assisted hysterectomies, multiples hysteroscopes and D&Cs, a conization, a cystoscopy and SNS removal. I see about 2-3 surgeries/procedures a day. The longest one has been the hysterectomies (2-2.5 hrs). The only hands on things I have done are uterus manipulation on one of the hysterectomies and I got to close one of the port sites. Other than that, I have just been observing since the resident and attending do everything... I do not hate the OR but at the same time I do not love it. When I am just observing in the OR I sometimes just feel bored...

I really like the field of OB/GYN. I have liked and enjoyed outpatient OB and GYN clinic and L&D service.. I also enjoyed seeing C-sections and I could envision myself doing a C-section. I am just not sure about the GYN surg part and if I would be able to survive through a 4-year OB/GYN residency because of the GYN surg part... I know that all specialties have rigorous training and surgery is more challenging since you are learning the regular anatomy, the steps of a surgery, what instruments to use, and then anticipating challenges you could see when you get to the actual surgery (bleeding, adhesions, etc.)

Just the thought of knowing that learning/training for surgery is hard/challenging and that while I do not hate being in the OR, it is not my "favorite" place in the world.. I just wonder if I will make it through residency.. just watching surgery, I feel so detached from the patient and not connected... at least with L&D and c-sections and outpatient clinic, I feel more personable and connected with patients... I do not know if it is because I am not doing the surgery myself/participating and doing hands on things or because I feel so inadequate since I am not a trained/skilled resident.. but it is just hard

If I applied OB/GYN, as an attending, if I wanted to do general OB/GYN, would be interested in doing group private practice and seeing outpatient OB and GYN patients and doing women's well visits. I would like to do L&D service but do not want to be on call 24/7 (so maybe once a month?) If I did a fellowship, then I would be interested in either REI or MFM (an attending I talked to who is an MFM specialist said that MFM is a combination of internal medicine and OB, she has a good lifelstyle and a family,).

 

[smq123]

UPDATE:

I have been on nearly one week of gynecological surgery.

I have 3 robotic-assisted hysterectomies, multiples hysteroscopes and D&Cs, a conization, a cystoscopy and SNS removal. I see about 2-3 surgeries/procedures a day. The longest one has been the hysterectomies (2-2.5 hrs). The only hands on things I have done are uterus manipulation on one of the hysterectomies and I got to close one of the port sites. Other than that, I have just been observing since the resident and attending do everything... I do not hate the OR but at the same time I do not love it. When I am just observing in the OR I sometimes just feel bored...

I really like the field of OB/GYN. I have liked and enjoyed outpatient OB and GYN clinic and L&D service.. I also enjoyed seeing C-sections and I could envision myself doing a C-section. I am just not sure about the GYN surg part and if I would be able to survive through a 4-year OB/GYN residency because of the GYN surg part... I know that all specialties have rigorous training and surgery is more challenging since you are learning the regular anatomy, the steps of a surgery, what instruments to use, and then anticipating challenges you could see when you get to the actual surgery (bleeding, adhesions, etc.)

Just the thought of knowing that learning/training for surgery is hard/challenging and that while I do not hate being in the OR, it is not my "favorite" place in the world.. I just wonder if I will make it through residency.. just watching surgery, I feel so detached from the patient and not connected... at least with L&D and c-sections and outpatient clinic, I feel more personable and connected with patients... I do not know if it is because I am not doing the surgery myself/participating and doing hands on things or because I feel so inadequate since I am not a trained/skilled resident.. but it is just hard

If I applied OB/GYN, as an attending, if I wanted to do general OB/GYN, would be interested in doing group private practice and seeing outpatient OB and GYN patients and doing women's well visits. I would like to do L&D service but do not want to be on call 24/7 (so maybe once a month?) If I did a fellowship, then I would be interested in either REI or MFM (an attending I talked to who is an MFM specialist said that MFM is a combination of internal medicine and OB, she has a good lifelstyle and a family,).

Have you considered doing FM-OB? It would allow you to do outpatient OB, outpatient GYN, well women visits, contraception, family planning, etc. You could also spend some time on L&D, but you wouldn't have to do surgery and you could potentially not do C-sections if you didn't want to. FM-OB has its rigors, although it's not quite as intense a training pathway as straight OB/gyn. Plus, if you ever got burnt out on OB, then you could fall back on just regular FM/primary care.

 

[WildWing]

It may not be what you want to do, but some of the FM residencies that are focused on training up rural docs include more significant L&D since they want to create docs who can handle as much as possible locally.

 

[dbdnt]

FM-OB is going to be more relegated to rural areas FYI. I think FM would be a good choice though if you want a taste of some OB training in residency even if you don’t do it long term. Personally, I think if you’re already not feeling the OR, I wouldn’t bother with OBGYN. It’s not going to get better and you’re going to face more pressure when you’re expected to become competent and operate. I think it’s easy to imagine yourself in a variety of attending jobs because you can’t really imagine the grind it takes to get there. IMO save yourself the pain and choose a more medically oriented specialty like FM or IM then guide your career as your interests develop. If you go IM, ask about women’s health training in your interviews. Despite what people say, not all IM people are inept at women’s health, especially programs that put more effort into their primary care training.

 

[jstargirl17]

Yeah the thing I don’t like about FM is that if you do OB then it’s limited more to rural areas… I do not want to work in a rural area but rather in a suburban or urban area
Also I do not like the compensation of FM and feeling like I’d be a generalist at a wide breath/variety… also do not like that there’s not a lot of fellowship options…

Also I feel that if I do women’s health, then I want to get in-depth training/the best training, which would be OB/GYN

I feel like I’m very wishy washy about the OR… I do not know if it’s because I’m so tired from rotations, stressing about choosing a specialty on top of being tired, and that I do not do a whole lot in the OR other than sometimes help with uterus manipulation, put in Foley catheters, and I got to help with a Pap smear

It’s also very hard to image myself as a surgeon/think of myself as a surgeon… I heard that the training of a surgical specialty is a grind..

I do really like C-sections but I’m not sure about GYN surg..,

My ideal career aspirations is to be in a specialty that makes at least 300K, is something that I have interest in/enjoy, and can have a good work/life balance

 

[WildWing]

SDN has a "How to Choose a Medical Specialty" tool that might highlight something you haven't thought of: Medical Specialty Selector

Also, you might be interested in this interview with an Internal Medicine resident - one of the things he mentions is that you have a lot of options to do fellowships:

 

[LucidSplash]

Yeah the thing I don’t like about FM is that if you do OB then it’s limited more to rural areas… I do not want to work in a rural area but rather in a suburban or urban area
Also I do not like the compensation of FM and feeling like I’d be a generalist at a wide breath/variety… also do not like that there’s not a lot of fellowship options…

Also I feel that if I do women’s health, then I want to get in-depth training/the best training, which would be OB/GYN

I feel like I’m very wishy washy about the OR… I do not know if it’s because I’m so tired from rotations, stressing about choosing a specialty on top of being tired, and that I do not do a whole lot in the OR other than sometimes help with uterus manipulation, put in Foley catheters, and I got to help with a Pap smear

It’s also very hard to image myself as a surgeon/think of myself as a surgeon… I heard that the training of a surgical specialty is a grind..

I do really like C-sections but I’m not sure about GYN surg..,

My ideal career aspirations is to be in a specialty that makes at least 300K, is something that I have interest in/enjoy, and can have a good work/life balance

Based on this post I would not encourage you to pursue most surgical specialties. You are correct in that the training is a grind and you get through that only if you really love it, even when you’re tired. Which it sounds like you don’t.

As far as OB, you should talk to some OB attendings about the different practice options. While I’m not OB, I’m pretty sure there are those who focus their practices on pregnancies/deliveries and don’t do gyn surgery. You would have to do the requisite training during residency of course but if there was a practice option available where you didn’t have to do gyn surgery after training, other than C-sections, would this be of interest to you?

You need to think more about practice options beyond training than the residency years themselves.

 

[jstargirl17]

SDN has a "How to Choose a Medical Specialty" tool that might highlight something you haven't thought of: Medical Specialty Selector

Also, you might be interested in this interview with an Internal Medicine resident - one of the things he mentions is that you have a lot of options to do fellowships:

Yes I did a similar tests on AAMC Specialty Quiz

OB/GYN was #1
IM was #2

 

[VA Hopeful Dr]

Yes I did a similar tests on AAMC Specialty Quiz

OB/GYN was #1
IM was #2

Do IM. You can easily break 300k with that.

Outpatient you'll work regular hours. Hospitalist you'll have 50% of the month off of work.

 

[gutonc]

Do IM. You can easily break 300k with that.

Outpatient you'll work regular hours. Hospitalist you'll have 50% of the month off of work.

Agree. And there are numerous programs that offer concentrations/tracks in Women's Health as well as lots of other fellowship options if you change your mind in the future.

I will also say that there are a lot of "flavors" of rural out there if you decide to go down the FM-OB pathway. It's not all barren wastelands with 100s of miles of flat prairie, desert or forests surrounding you. There are a lot of vacation destination type places (at least in the mountain West, SW and West coast) that qualify as rural but don't feel like it when you're there. The example I always like to give is that Jackson Hole, WY is considered rural for Census Bureau purposes but doesn't at all feel that way. I live and work in a similar place and it feels the same, and I'm only 50 minutes from the international airport (which is the same distance that some people living in the suburbs on the opposite side of that town drive to get there). That may not be your jam, which is fine, but don't just completely dismiss it.

 

[jstargirl17]

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Agree. And there are numerous programs that offer concentrations/tracks in Women's Health as well as lots of other fellowship options if you change your mind in the future.

I will also say that there are a lot of "flavors" of rural out there if you decide to go down the FM-OB pathway. It's not all barren wastelands with [emoji[emoji[emoji6]][emoji[emoji6][emoji6]]][emoji[emoji[emoji6]][emoji[emoji6]]][emoji[emoji[emoji6]][emoji[emoji6]]]s of miles of flat prairie, desert or forests surrounding you. There are a lot of vacation destination type places (at least in the mountain West, SW and West coast) that qualify as rural but don't feel like it when you're there. The example I always like to give is that Jackson Hole, WY is considered rural for Census Bureau purposes but doesn't at all feel that way. I live and work in a similar place and it feels the same, and I'm only [emoji[emoji[emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6]]]][emoji[emoji[emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6]]]][emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6][emoji6]]]][emoji[emoji6][emoji6]][emoji[emoji[emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6]]]][emoji[emoji6][emoji6]][emoji[emoji[emoji6]][emoji[emoji6][emoji6]]]]][emoji[emoji[emoji6]][emoji[emoji6]]] minutes from the international airport (which is the same distance that some people living in the suburbs on the opposite side of that town drive to get there). That may not be your jam, which is fine, but don't just completely dismiss it.

I’ve never heard of any women’s health tracks via IM… am I missing something? A physician mentor of mine whose an IM hospitalist said that IM doesn’t do women’s health
I also know an IM intern resident who also said that IM doesn’t do a lot of women’s health…

I feel that if I want women’s health training OB/GYN would be the best way to go…

If I did IM I would want to do a fellowship in medical oncology since you can still treat breast cancer and other gynecological cancers

 

[gutonc]

I’ve never heard of any women’s health tracks via IM… am I missing something? A physician mentor of mine whose an IM hospitalist said that IM doesn’t do women’s health
I also know an IM intern resident who also said that IM doesn’t do a lot of women’s health…

You are missing something. Just the first page of Google results for "internal medicine women's health track" pulled up programs at Pitt, Mayo, Brown, NW, UWash, UAB, and Kentucky. The 2nd page gets you 4 or 5 more...you get the idea.

And asking a hospitalist (or an IM intern) about women's health management in IM is like asking a neurosurgeon about dialysis parameters (or to name all of their kids without looking at their phone).

I feel that if I want women’s health training OB/GYN would be the best way to go…

I don't think anyone is arguing that point with you. But if you don't love the OR, OB/Gyn is going to be a miserable few years.

If I did IM I would want to do a fellowship in medical oncology since you can still treat breast cancer and other gynecological cancers

Then do that. And do it coming from a Women's Health track program in IM. It will give you a unique story during your fellowship application.

 

[jstargirl17]

You are missing something. Just the first page of Google results for "internal medicine women's health track" pulled up programs at Pitt, Mayo, Brown, NW, UWash, UAB, and Kentucky. The 2nd page gets you 4 or 5 more...you get the idea.

And asking a hospitalist (or an IM intern) about women's health management in IM is like asking a neurosurgeon about dialysis parameters (or to name all of their kids without looking at their phone).

I don't think anyone is arguing that point with you. But if you don't love the OR, OB/Gyn is going to be a miserable few years.

Then do that. And do it coming from a Women's Health track program in IM. It will give you a unique story during your fellowship application.

I did look up women's health tracks in IM residency programs. It appears that Pitt, NW and UWash have very good and well-established programs. Pitt seems to be the oldest and most well-known (established in 1994).

I do not mind the OR on the OB side since I like C-sections. The OR on the Gyn side of things (Gyn surg) has not been my favorite since I have not been able to do a lot... I also feel like I have not seen a lot other than hysteroscopes, D&Cs, a couple of robotic-assisted hysterectomies, and laparoscopic bilateral salpingectomies

I do know OB/GYN attendings who focus only on the OB side of things and another OB/GYN attending who didn't like OB but does Urogyn.

Should I dual apply to OB/GYN and IM programs with women's health tracks (I was interested in Pitt, UWash, Northwestern, Brown,)?
I also thought about reaching out to the program directors of these schools to see about career options post-residency..

 

[anonperson]

I also feel like I have not seen a lot other than hysteroscopes, D&Cs, a couple of robotic-assisted hysterectomies, and laparoscopic bilateral salpingectomies

That's basically 95% of the surgical procedures a general gynecologist does.

 

[LucidSplash]

I don’t think you should dual apply. I think you should pick one and apply. You’ve already been advised of what career options there are for OB without the gyn component. They are called laborists. You can try to email the PDs at the IM-Women’s Health tracks but they might not be the director of the track so you might want to check the websites for a director instead. Also the websites might list what fellowships and careers the former track participants have gone on to. I googled for 0.5 sec and found the following: Women's Health Track

 

[jstargirl17]

That's basically 95% of the surgical procedures a general gynecologist does.

Yes, I have seen a few hysterectomies (robotic and laparoscopic) and BSOs
BSOs are pretty quick/more straightforward. But hysterectomies are more challenging and take a lot longer (2-3 hours) since I understand that it is a major surgery

From what I can tell, it seems that the intern and second year residents do not lead on the hysterectomies (might just assist/do uterine manipulation). But the third and fourth year residents lead more on the hysterectomies

Regardless, still trying to figure out if surgery is for me/do I have what it takes to be a surgeon :/ (will, interest, motivation, etc) I will say I also just feel burnt out (I'm at the end of third year and I'm on my 6th clinical rotation right now)... the last couple of months I have been so stressed about not having a final specialty choice decision (I have been reaching out to people in both OB/GYN and IM- residents and attendings) So right now I also have been thinking a lot about lifestyle... OB/GYN seems so hard and mentally draining and so does IM...

I know that FM is an option, but I just do not like the compensation, limited ability to provide OB care in urban/suburban areas (which is where I want to work), and I am not sure if I will got the same in depth type of training in women's health compared to a OB/GYN program...

 

[jstargirl17]

I just hate feeling at baseline a very anxious person/worrier... I know that I also worry a lot about the future/am anxious...

I do talk a lot to a few physician mentors about my worries, fears, etc. and I have a therapist. I also talk to my aunt who is an orthopedic surgeon

 

[RangerBob]

My opinion is the anxious/worrier types have a tougher time in surgery. When you run into a difficult moment in surgery, you really need to have your stuff together, make a decision quickly, and stick with it. Unless things go south again, in which case you need to again be present in the moment, make a new quick decision, and stick with that new decision. And so on.

I watched an anxious/worrier type (I'm one too for what it's worth) operate in the OR. Super nice Canadian transplant surgeon. You couldn't ask for a nicer surgeon. But it was painful to watch him keep questioning what he should do when things were not going well for the donor he was harvesting the kidney from.

I think anxious/worrier types do better in specialties where you're looking at the long run. Think psych, FM, PM&R, etc. Ones where you have time to get to know your patient, think, adjust course, etc.

Some people worry about how FM doesn't get paid much. Done right, they get paid quite well. But more important to is consider your lifelong earnings. If you go into a specialty and burn out, and shift to half-time or quit, then you lose a lot of future earnings. Psych, for example, provides the ability to easily work into your 70's if you'd like--even later if your mind is still sharp. You could practice it in a wheelchair. FM docs can typically practice to a much older age than surgeons.

The two most solid/reliable retirement plans out there are 1) have lots of kids who love you, and 2) find a job you can do until you die.

As someone who also worried a lot about specialty choice in med school (your specialty is the rest of your life!), was I eventually just focused on taking the next best step. I was too caught up in my head about income of specialty y, or QOL in specialty z. So I just brought it back to the basics and asked myself which rotation I thought I smiled the most. Which few weeks did I seem the happiest. Where did I feel at home. And I chose that specialty.

Sometimes for over-thinkers, it can help to ignore your brain and just do what feels right, as much as that might go against your normal analytical mind.

 

[anonperson]

I know that FM is an option, but I just do not like the compensation, limited ability to provide OB care in urban/suburban areas (which is where I want to work), and I am not sure if I will got the same in depth type of training in women's health compared to a OB/GYN program.

Who says OB income is any better? For the amount of hours worked, it is worse. If you have the grades etc, you're much better off doing something like urology, ENT, ophtho.

FM can pay well depending on practice location.. And it is completely feasible to run your own practice in a lot of locations and be your own boss. Private OBGYN practices are closing because it is not financially or physically sustainable at current reimbursement rates.

It you want to do pap smear, manage AUB medically, put in IUDs, you can do that from primary care.

just hate feeling at baseline a very anxious person/worrier... I know that I also worry a lot about the future/am anxious...

I do talk a lot to a few physician mentors about my worries, fears, etc. and I have a therapist. I also talk to my aunt who is an orthopedic surgeon

We had an extremely anxious newish OB join the hospital practice. Constantly second guessed themselves in front of nurses and even patients.

Couldn't operate well.
Nurses hated her. Anesthesia disliked her because basic cases would take forever. A decent number of other OBs disliked her because constantly needing help/reassurance for straightforward things.

She is not cut out for the specialty. Would do better in a different specialty.

So if being anxious/worrier is you, probably consider a different specialty.

---------------------------------------------------------------

Look, at the end of the day, do what you want but OBGYN is a flawed field which won't get fixed any time soon, specifically being on CALL. I've clearly laid out the cons in my several posts.

And this is coming from someone who actually practices every day and still takes occasional L and D call.

I'm good with my job at this point. The day to day clinical management is typically straightforward and the OR is reasonably enjoyable .If I was forced to be on call constantly, I would have a more negative view though.

 

[jstargirl17]

I think I felt the most at home during IM and OB/GYN.

I smiled a lot during both, had good relationships with both the residents and attendings. I probably felt most connected to the patients I saw in the OB/GYN clinic and in OB triage. Saw lots of teenage patients and patients of diverse backgrounds

Being in the OR for GYN surg, I have seen a lot. Surgery just seems stressful… today I saw some complex cases (I saw two total laparoscopic hysterectomies- one surgery resulted in a minor bladder injury since patient had a hx of C-sections and there was a lot of adhesions/scar tissue. She also had some endometriosis. She also had a chocolate cyst endometrioma. Urogyn had to be called to help out). For the second TLH case, I saw a uterus with large fibroids. For the third case, I saw a bilateral oophorectomy (uterus and fallopian tubes were already removed). That also took some time since patient had a lot of adhesions/scar tissue from her previous surgeries (primarily hysterectomy)

They were interesting, but at the same time I wasn’t doing much except just standing there watching… I did some uterus manipulation and helped put in the Foley catheter. I know that surgery requires taking your time, being thorough, not panicking when a case ends up being more complex/complicated than intended

While they are interesting, I just don’t know if I want to be doing complex surgeries throughout my career (other than C-sections) I saw the attendings teaching the R2 and R4 residents and saw the struggling with some things… I know surgery training is hard/can be a grind

I feel like I will have regrets about not applying OB/GYN… but then if I do OB/GYN and am miserable, I’ll have fears that I should’ve just applied IM..

 

[LucidSplash]

I think I felt the most at home during IM and OB/GYN.

I smiled a lot during both, had good relationships with both the residents and attendings. I probably felt most connected to the patients I saw in the OB/GYN clinic and in OB triage. Saw lots of teenage patients and patients of diverse backgrounds

Being in the OR for GYN surg, I have seen a lot. Surgery just seems stressful… today I saw some complex cases (I saw two total laparoscopic hysterectomies- one surgery resulted in a minor bladder injury since patient had a hx of C-sections and there was a lot of adhesions/scar tissue. She also had some endometriosis. She also had a chocolate cyst endometrioma. Urogyn had to be called to help out). For the second TLH case, I saw a uterus with large fibroids. For the third case, I saw a bilateral oophorectomy (uterus and fallopian tubes were already removed). That also took some time since patient had a lot of adhesions/scar tissue from her previous surgeries (primarily hysterectomy)

They were interesting, but at the same time I wasn’t doing much except just standing there watching… I did some uterus manipulation and helped put in the Foley catheter. I know that surgery requires taking your time, being thorough, not panicking when a case ends up being more complex/complicated than intended

While they are interesting, I just don’t know if I want to be doing complex surgeries throughout my career (other than C-sections) I saw the attendings teaching the R2 and R4 residents and saw the struggling with some things… I know surgery training is hard/can be a grind

I feel like I will have regrets about not applying OB/GYN… but then if I do OB/GYN and am miserable, I’ll have fears that I should’ve just applied IM..

Nothing you just posted does anything but suggest that you should absolutely NOT apply ObGyn. Go into IM.

 

[jstargirl17]

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Nothing you just posted does anything but suggest that you should absolutely NOT apply ObGyn. Go into IM.

But I really like women’s health though… and I feel like I’m going to regret NOT applying OB/GYN

And I feel like I’m talking myself out of OB/GYN because of the surgical aspect and long hours…

I know that becoming a surgeon takes years of experience/training…

I just don’t know how I’m supposed to feel when I’m just wanting the attendings and resents do the whole case and I’m just there myself? I do admit that when I’m more hands on/involved in the case (like suturing, doing the catheter, etc ) I do feel a little better
The anatomy isn’t too hard to understand other than finding the ureters (which even the attending struggles with)

With IM, I feel like it’s more of a “safety” option/back up option rather than dealing with the intensity of OB/GYN… which I enjoy the subject/content matter of OB/GYN but I seem to be daunted by the idea of actually doing the work…

 

[dbdnt]

Your dilemma is a common one, and unfortunately you can’t ruminate or analyze your way out of it. Do what you feel in your bones, and you will either be happy or unhappy, but you must make a choice and then correct later if needed. Make the right choice or make the choice right.

 

[LucidSplash]

But I really like women’s health though… and I feel like I’m going to regret NOT applying OB/GYN

And I feel like I’m talking myself out of OB/GYN because of the surgical aspect and long hours…

I know that becoming a surgeon takes years of experience/training…

I just don’t know how I’m supposed to feel when I’m just wanting the attendings and resents do the whole case and I’m just there myself? I do admit that when I’m more hands on/involved in the case (like suturing, doing the catheter, etc ) I do feel a little better
The anatomy isn’t too hard to understand other than finding the ureters (which even the attending struggles with)

With IM, I feel like it’s more of a “safety” option/back up option rather than dealing with the intensity of OB/GYN… which I enjoy the subject/content matter of OB/GYN but I seem to be daunted by the idea of actually doing the work…

From everything you’ve posted, I get the impression that you like the IDEA of being an ObGyn more than you actually like what an ObGyn is, and more than you like the IDEA of being an internist or IM subspecialist. Women’s health is about more than babies and uteri. Every time you listen to a woman patient and treat her, you are engaging in Women’s health. That’s anything from a UTI to hypertension, to breast cancer. Women are too frequently dismissed and/or under treated or under diagnosed. You can do “Women’s health” from almost any specialty and definitely from IM. I suspect that’s what is emphasized in those IM programs with women’s health tracks.

Just about everyone likes suturing and doing small procedures as a med student. It feels more like what many thought “being a doctor” was before they came to med school and it often is more exciting that discussing the 12th thing on the differential. But you have to like the actual work of being an ObGyn and the fact that you are talking yourself out of it because surgery is a solid portion of ObGyn work, to me would mean you should not pursue ObGyn. I have already suggested you look into what a Laborist position is and discuss with the ObGyn attendings at your school whether that would be a viable option for you. That’s the only path I see being viable for you in ObGyn.

But as a surgeon, I don’t think you should pursue a career as anything in surgery. Please note I am NOT saying I don’t think you’re CAPABLE of doing something surgical. I don’t know you enough to make that assessment. But I think it will be a constant source of anxiety and misery for you, rather than a source of professional fulfillment.

There’s no way to know if you’d regret applying to ObGyn. But based on your posts I think you’d only regret applying. I don’t think you’d actually regret not being an ObGyn because all your posts suggest you don’t want to be what an ObGyn is.

 

[jstargirl17]

Hi,

Thank you for your input and insight. I know you’ve offered a lot of feedback to my many posts (you probably can tell the amount of stress/anxiety this subject of choosing a specialty has been giving me)
It is nice to be able to talk to a medical professional with experience in this area

At the end of the day I know I have to make a decision. I have been keeping track of things I am not crazy about (which is mainly GYN surg).

I will try to talk to another OB/GYN attending I work with prior to the end of my rotation and get their insight and perspective on things

I really take seriously my specialty choice and I have readily liked the majority of my time on OB/GYN. Yes it’s true that I’ve enjoyed more of the OB side of things and outpatient OB and GYN clinic. I guess what I have to decide is if I have the heart/will to be able to do GYN surg which is the other key aspect of OB/GYN

I also really appreciate your perspective on women’s health being more than just OB/GYN. I really want to engage in some form of women’s health in my practice ac a resident and doctor, be competent, and be good at it
And fill a sense of connection and fulfillment with my patients. These are the things I really want and all I could ask for

There are some days when I feel like I will burst into tears

I just want to make the right decision for me and not have any regrets/second thoughts

 

[jstargirl17]

Hello!

Sorry for the late response

If there was practice option where I didn’t have to do GYN surgery after residency other than C-sections, then I think I would be interested in this option

 

[gutonc]

There are lots of OB/Gyns out there that, once they are in practice, primarily do primary care for women only. You can absolutely tailor your practice post-fellowship to to minimal/no surgery other than C-sections, but of course you will have to survive the surgery parts of residency.

I will once again recommend at least considering FM+OB fellowship to get the same place you want to be in the same amount of time. You will get more primary care and less surgery during your training and will be able to craft a similar type of practice in women's healthcare, after training. You will of course have to survive the peds and other gen med parts of FM residency if you go that route.

 

[wysdoc]

Hello!

Sorry for the late response

If there was practice option where I didn’t have to do GYN surgery after residency other than C-sections, then I think I would be interested in this option

Hey @jstargirl17 please try posting without quoting the prior post to eliminate the long strings of nonsense characters in your posts

 

[DocWinter]

Yeah you shouldn't go into OBGYN.

No offense, but I concur with the above poster noting if you have anxiety or worry regarding decisions, which it is apparent you do, do not put yourself in a position to make those worrisome decisions on not one but two patients in a stressful environment.

I find that students such as yourself who are debating between OB and another career choice, typically end up with the other career choice.

Money is better in OB and rivals surgery, however we work very hard and often annoying, dog-tired hours for that money.

Source: am OBGYN.

 

[dozitgetchahi]

Yeah you shouldn't go into OBGYN.

No offense, but I concur with the above poster noting if you have anxiety or worry regarding decisions, which it is apparent you do, do not put yourself in a position to make those worrisome decisions on not one but two patients in a stressful environment.

I find that students such as yourself who are debating between OB and another career choice, typically end up with the other career choice.

Money is better in OB and rivals surgery, however we work very hard and often annoying, dog-tired hours for that money.

Source: am OBGYN.

I would agree with this (I am IM => rheumatology).

One thing I remember being told on my surgery rotation by residents was not to choose surgery unless you LOVE it, and basically can’t see yourself doing anything else…because the training is grueling, and that passion might be the only thing that really gets you through all of it. And I’d imagine this line of thinking applies to any other surgical subspecialty.

I also did rheumatology specifically because I like the clinic and I like having the ability to sit back and think about my patients at a slower, more easygoing pace. There’s nothing wrong with this. If you have a high stakes surgical issue, you want a doctor who can confidently make good split second decisions. On the other hand, if you have a high stakes complex medical issue (say, severe SLE, or an unusual cancer situation, etc etc), you want a doctor who can size up the situation, discuss options with you, and who will maybe open pubmed and take a deep dive of the literature before committing to the next step of treatment. We need all sorts of doctors in medicine. You’re not “losing out” by choosing to avoid something that doesn’t suit you (and your personality) well.

As an aside - I liked some of my time on OB/GYN too, but I primarily liked MFM and REI…in other words, the aspects of OB that were clinic oriented *medicine*. I hadn’t really enjoyed any surgical rotation by that point, and that’s when I realized I was someone who leaned in the *medicine* direction.

 

[LucidSplash]

I would agree with this (I am IM => rheumatology).

One thing I remember being told on my surgery rotation by residents was not to choose surgery unless you LOVE it, and basically can’t see yourself doing anything else…because the training is grueling, and that passion might be the only thing that really gets you through all of it. And I’d imagine this line of thinking applies to any other surgical subspecialty.

I also did rheumatology specifically because I like the clinic and I like having the ability to sit back and think about my patients at a slower, more easygoing pace. There’s nothing wrong with this. If you have a high stakes surgical issue, you want a doctor who can confidently make good split second decisions. On the other hand, if you have a high stakes complex medical issue (say, severe SLE, or an unusual cancer situation, etc etc), you want a doctor who can size up the situation, discuss options with you, and who will maybe open pubmed and take a deep dive of the literature before committing to the next step of treatment. We need all sorts of doctors in medicine. You’re not “losing out” by choosing to avoid something that doesn’t suit you (and your personality) well.

As an aside - I liked some of my time on OB/GYN too, but I primarily liked MFM and REI…in other words, the aspects of OB that were clinic oriented *medicine*. I hadn’t really enjoyed any surgical rotation by that point, and that’s when I realized I was someone who leaned in the *medicine* direction.

Also heaven bless rheumatologists. That is definitely a much needed field and they are hard to come by. As close to Dr. House as it gets IMHO. And thank the ones who take the referrals I send them with what amounts to “skin looks weird, please eval and treat.” Not really but almost. The last one was a dialysis patient and I sent them with a referral that basically said “um, scleroderma maybe?”

 

[DocWinter]

Also heaven bless rheumatologists. That is definitely a much needed field and they are hard to come by. As close to Dr. House as it gets IMHO. And thank the ones who take the referrals I send them with what amounts to “skin looks weird, please eval and treat.” Not really but almost. The last one was a dialysis patient and I sent them with a referral that basically said “um, scleroderma maybe?”

Amen.

I refer to medicine as" the smart people". Surgery and medicine not have much different in brains but it's that patience and intrigue they've accumulated in areas I've not been trained in that I appreciate.

We all get very good in our narrow corner. 95% of my physician colleagues don't want to do what I do, and I don't want to do 95% of what they do.

Figuring out that branch between medicine and surgery early on is one of the most important things a medical student can do.

 

[jstargirl17]

Hi all!

I have reached out to a few of the program directors for IM residency programs with either women's health tracks or primary care tracks. I will be meeting with Ohio State's IM residency primary care program director about women's health training next week.

I have also been talking to OB/GYN attendings that I have worked with.

My gut is saying to do OB/GYN but my logical side/brain is saying do I really want to do GYN surg?

My dream job is to have a women's health clinic that does OB care, GYN care, primary care, and mental health. I have truly enjoyed the patient population I have worked with

I am still exploring all of my options (OB/GYN, IM, even FM)?

I have heard of OB anesthesia since people have told me that anesthesia has great money and a great lifestyle and something I should look more into.

Trying to have faith that everything will work out and be okay

 

[dozitgetchahi]

Hi all!

I have reached out to a few of the program directors for IM residency programs with either women's health tracks or primary care tracks. I will be meeting with Ohio State's IM residency primary care program director about women's health training next week.

I have also been talking to OB/GYN attendings that I have worked with.

My gut is saying to do OB/GYN but my logical side/brain is saying do I really want to do GYN surg?

My dream job is to have a women's health clinic that does OB care, GYN care, primary care, and mental health. I have truly enjoyed the patient population I have worked with

I am still exploring all of my options (OB/GYN, IM, even FM)?

I have heard of OB anesthesia since people have told me that anesthesia has great money and a great lifestyle and something I should look more into.

Trying to have faith that everything will work out and be okay

Sounds like you should do FM (possibly with a women’s health fellowship). This is the one specialty that would let you check the boxes above to one extent or another.