Thinking of switching from medicine to obgyn

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

futureidoc

Full Member
10+ Year Member
15+ Year Member
Joined
Jan 22, 2007
Messages
22
Reaction score
0
hi all,
i am new here to sdn forums so first off, a big hello to everyone... i really think that this is a great community here... well as the topic states, i am currently a first year internal medicine resident and unfortunately did not match into my first choice of residency - ophthalmology... as much as i told myself that i would not mind going into internal medicine as a backup, it is just too painful to keep in it... i just do not feel the excitement for it... i have always loved ob/gyn ever since med school... everyone keeps telling me that i am crazy to enter a field that is so demanding, time wise, - especially my wife - but i dont mind all the work if i love it... anyways, i have a couple questions about the residency and the field in general since i do not know anything about it:

1 - so what are the hours really like in residency... i know that it would depend on the program, but what are the general trends and all?

2 - money is not everything to me (otherwise i would have chosen a different profession) but of course it is important... we all have families to support... what are the average salaries for ob/gyn in private practice? what are the highest that they can go?

3 - everyone keeps telling me the same thing.. malpractice, malpractice, malpractice... i know that there is a big stereotype, so where does it exactly stand? how much does one have to pay for malpractice insurance on average? is there a high rate of malpractice lawsuits? do people join groups who take care of their malpractice insurance?

4 - what are the fellowship opportunities like? which ones are available and how competitive are they? i am interested in an infertility fellowship and was wondering how competitive they were? what can one do to get it?

i know that these are alot of questions, i would really apprecite all the input i can get... thanks...

Members don't see this ad.
 
hello
i switched from medicine to ob/gyn last year. i am now finishing my intern year in ob/gyn. very happy i switched.
the hours are basically the same. actually, my program is a lot better at sticking to the hours regulations than my medicine program was. the difference is that the time you are on is much more demanding. i remember being on call on medicine and getting a few hours of sleep, even in the ICU. this does not happen on ob.
malpractice is a real issue, but it is becoming such a problem in all specialties. i decided that it would not be the determining factor for me in which field i chose.
i think the salary issue depends a lot on what you decide to go into in the end, private/academic/fellowship. you certainly can make a good living in ob/gyn.
i would google salaries in ob/gyn to get a sense of the exact numbers and also for the malpractice rates.
i am not that interested in rei so dont know the exact numbers. i think there are 30 fellowships offered yearly and i know it is the one of the most competitive of the fellowships.
optho and ob/gyn are quite different! interesting that you are making that switch.
hope this answers most of your questions
ac
 
I believe that the match rate for REI Fellowship is 30%, and that for MFM is 50%.
 
Members don't see this ad :)
Competitiveness: According to the NRMP match data for 2006, OB (along with Peds, Med-Peds, Emergency medicine, and Anesthesia) is EASIER to match into than Internal Medicine. IM has a higher average Step 1 than all of these specialties, and a higher %AOA and #publications than most of them as well.

Hours: OB is generally worse than medical subspecialties. Cardiology is the lone exception. Of course, if midwives or hospitalists deliver all urgent patients, OBs will lose that revenue.

Malpractice: OB is higher than all IM subspecialties. Depends on which state you live in - $125,000 per year to $280,000 per year. We're talking $10,000-20,000 pretax MONTHLY that used to go into OB's pockets in previous years.
 
Malpractice: OB is higher than all IM subspecialties. Depends on which state you live in - $125,000 per year to $280,000 per year. We're talking $10,000-20,000 pretax MONTHLY that used to go into OB's pockets in previous years.

Wow... does the average OB actually spend $125-280,000 per year paying out malpractice lawsuits? It seems like at these astronomical numbers it would actually be CHEAPER to just pay out of pocket...
 
Depends on the state - I think the avg in TX is lower than that - maybe 50K per year???? Heard that at a meeting, I'm positive it's not over 100K for insurance premiums.
 
Nationally, 76.3% of ob/gyns have had claims filed against them

During a survey from January 1999 through December 2002, 61% had a claim filed; 21% had two or more

Asked how they have changed practices purely due to liability issues, over 2,000 respondents responded this way: Nationally, 22% have decreased the number of high-risk OB patients, and 14% have stopped practicing obstetrics completely. 3% have stopped practicing.

In 2004, the average Florida annual malpractice premium was $195,000. In Dade County, it was $277,000 (that's over $20,000 per month). Some states had much lower rates; 3.8% have relocated out of the state in which they lived and 3.2% have relocated within their state.

A survey of 226 medical students at a New York state university found that while "almost 63% of the students had considered an ob/gyn specialty," only 5% "actually planned to do it."

In 2003, U.S. graduates filled just over two-thirds of available ob-gyn slots--the lowest percentage ever--while graduates of foreign medical schools filled 23 percent and 9 percent of slots went unfilled."

43% of the cost of delivering a baby goes to cover the obstetrician's malpractice insurance - one reason why so many doctors are leaving the field
 
I'm told that malpractice premiums in California are in the $50k range.

The statistics that Meltyman posted above is courtesy of the ACOG, and updated on an semi-annual basis to reflect "crisis" in the OB/GYN field. Personally, I dug through the statistics when they were last published last month... and I didn't see anything worthy of hysterics, at least over the past 5 years. (I'm not going to compare with the state of medicine 20 years ago; that's history.)

Anecdotal stories aside, statistics in the ACOG survey shows very few doctors have actually stopped delivery due to malpractice concerns. Very few doctors have left the field due to malpractice concerns. Many have been forced to "change the way they practice"... but really, is that necessarily a bad thing? The truth is malpractice lawsuits play a role as negative feedback in getting rid of procedures that many believe are higher (financial) risk.

The growth of C-sections is one concern that many point to as a possible negative... I don't know. I believe in the market effect. If C-sections in general had a medical/financial cost associated with them, I'd assume eventually the insurance/maplractice industry would push back against their growth as well.

I for one am neutral (tending towards optimistic) about the future of OB/GYN.
 
In 2003, U.S. graduates filled just over two-thirds of available ob-gyn slots--the lowest percentage ever--while graduates of foreign medical schools filled 23 percent and 9 percent of slots went unfilled." QUOTE]

But the numbers are a bit different for this year... I think it was 78% filled with US seniors, several US seniors went unmatched, and it filled 99.5%. Most fields have peaks and valleys, ob/gyn is on the upswing from one of the deeper valleys it's seen in a long time. I'm pretty encouraged by it. Yes, I know I'll probably be sued at some point in my life - the latest numbers from the ACOG survey from this past year said avg of 2.6 lawsuits lifetime, but more than 70% of lawsuits are dropped before trial, and more than 50% of those left are found in favor of the doctor. I can modulate my lawsuit risk by working hard at being a nice person to be around and documenting my rear off. There are courses (which I'm excited to take) about the evidenced based practices that lower lawsuits - things like talking to the patients and families after a bad outcome - seems logical but everyone goes into protection/CYA mode and that's what really leaves the families hanging out to dry, then angry. And, our medico-legal professor said that ob is the 3rd most frequently sued specialty - (in terms of numbers of lawsuits) - he said its FP then IM then OB... yes, there's a lot more FP/IM than ob, but you get the picture, right?
 

In 2003, U.S. graduates filled just over two-thirds of available ob-gyn slots--the lowest percentage ever--while graduates of foreign medical schools filled 23 percent and 9 percent of slots went unfilled."


This is no longer the case...The field is definitely on the upswing. This latest match there were only like 4 slots unfilled(+2 prelims i think). There were US seniors going unmatched!!!(people with excellent stats at personalities at that!) OB/Gyn used to be a field where for sure EVERY US senior matched. This year(2007 match), that was not the case...while I don't think OB is going to be as competitive as Rad Onc anytime soon, it is certainly no longer a slam dunk by merely being a US senior.
 
Top