Urology versus ObGyn

[trigirl]

I'm almost finished with 3rd year and I'm having trouble deciding my residency choice. The dilema is that I love surgery. Being in the OR even briefly makes the whole day seem somewhat brighter I'm currently on out-patient peds and can't wait for it to end, ughh, the thought of out-patient medicine for the rest of my life or rounding on inpatients for 4 hours a day makes me shudder, I'd rather wake up at 4am on surgery than work at the clinic 9-5. I digress...

I did enjoy my Ob-Gyn rotation, even out-patient, and overall I thought the mix of patients (range of ages, high-risk MFM versus routine OB, office gyn procedures coupled with complicated Gyn-Onc) and the the ability to do research (I have a graduate degree in basic science) were all great. It all seemed like a good fit, especially since I have a toddler (and would like more children) and thought that Ob-Gyn would provide the opportunity to tailor my practice to a more family friendly lifestyle. But then I did surgery, and I liked surgery more. In particular, the reconstructive work in peds urology was absolutely stunning!

So, to make it short, I have a few questions that I would love some insight on: 1) am I fooling myself to think that Ob-Gyn will provide a better lifestyle during residency and beyond? (maybe I'll ask this in the Ob-Gyn forum as well, 2) the surgeons I've talked to have all encouraged me and told me that you can tailor your practice to whatever you want after residency, is this really true? 3) How brutal is urology residency with young children at home? (ie. I think sometimes the very fact that I question the combination of motherhood and surgical residency means it is not the right choice....)

Well, if anyone has any comments I'd be glad to hear them. Thanks!

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[napoleondynamite]

I don't know what planet you did your OB/GYN rotation on, but at most institutions OB/GYN is considered one of the WORST in terms of lifestyle (and malignancy I might add), ESPECIALLY during residency. If lifestyle is a significant consideration for you, and it sounds like it is given your situation, I don't think OB/GYN would be a good fit for you. Unless 5:30am-7pm 6 days a week with q3-4 call sounds good to you.

I am not going into Urology, but it sounds to me like you should take a look at it if you love surgery and want to have a nicer lifestyle. Your first year will likely suck, but from what everyone tells me it gets much better after that. I think you will also have MUCH, MUCH, MUCH, MUCH better luck "tailoring" your post-residency lifestyle in Urology than in ob/gyn..unless you do a fellowship in uro-gyn or REI or something like that..which would be 4 more years each. Anyway, given your values, I think you would be NUTS to go into ob/gyn personally..but that's just me.

 

[StickMe]

I just recently finished my OB/GYN rotation where I was on 24 hour call q4. Compare that to home call for urology and who's the clear winner on lifestyle during residency? Also, when I was on my surgery rotation, I would see the urology residents heading home around 5 or even earlier sometimes. Post residency you should be able to tailor your job to the lifestyle you want, but I think urology comes out the clear winner during residency.

 

[trigirl]

I appreciate your comments. I guess you can tell I'm leaning towards Urology I'm not sure the desire to operate is the best reason to go into ObGyn. Maybe a few sub-Is will help me decide for sure. Anyone else have any thoughts?

 

[toxic-megacolon]

Three other considerations

1. Urology is very competitive and you'll have much less control about where you end up geographically for residency.

2. There are plenty of Urology programs (like at my institution) where the residents work 90-100 hours per week consistently. There is a lot of variability in Urology programs. As far as lifestyle post-residency, OBGYN+fellowship (ie. REI, Adolecent, Urogyn) probably has equal or better lifestyle than general Urology.

3. Many Urology programs are 5-6 years, while OBGYN is only 4. So you have to wait longer to tailor your practice.

 

[paean]

If you love surgery, you should look hard at the schedule of residency training for OB vs urology (or any other surgical specialty, for that matter). The number of cases the average OB resident does by the time they complete residency is far, far less than that of other surgical fields. They have to spend a lot of time devoted to other areas of their field, and as a consequence, their OR time is limited.

My personal opservation (as a medical student) is that the level of surgical finesse is higher Urology than GenSurg, and that both are far better than gynecology.

As far as lifestyle, both fields have plenty of programs where you will be expected to work long hours, but also many programs that value residents personal time, and will get you home to see your family. If you think you want to do a fellowship, the surgical ones that follow gyn tend to be longer than urology fellowhips (to give you a chance to try to catch up on your OR time), so the total residency+fellowhip time may be the same for either field.

If you want to do community practice, the extra year or two of urology residency probably more than makes up for the lack of midnight emergency/delivery calls you will have as a general OBgyn for the rest of your career.

Disclaimer: I applied in urology this year, so all this is of course my personal bias.