critical care/complex patients

[ucsfer]

How much critical care is there in OB - General and MFM? Also in MFM, do you really deal with patients with lots of comorbidities and have to manage all of those or is reality a little different than that?

Also I've seen in some places that critical care is a subspecialty of OB/gyn. is that true? It doesn't seem to show up in the main lists at ACOG and the others.

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[VentdependenT]

Critical care and OBGYN don't really go hand in hand. Patient population and type of surgical intervention do not tend to put many women into the SICU. If it did then it'd be a good idea to have an intensivist there to manage the patient.

 

[Global Disrobal]

We do get critical care training during residency in the form of a SICU rotation. As for the specialty, you generally see OB-GYN patients end up in the hands of a critical care specialist when they are Gyn-Onc patients with very advanced disease or a large number of co-morbidities.

 

[ucsfer]

Okay, that makes sense for the normal OB population. How about MFM patients? We're told in med school that the great thing about MFM is that you get to manage all their comorbidities during their pregnancy.. is that true?
Also, do OBs do critical care fellowships?

 

[NYC Girl]

This thread is actually pretty timely for me - I just finished a SICU/CTICU rotation, where one of our critical care fellows was an OB/Gyn! There had also been a recent run of eclamptics in the ICU's here as well.

The fellow said that critical care Ob/Gyn is an extremely specialized field, but it does exist - however, most Ob/Gyns in daily practice will never be responsible for critical care management of pts (pressors, invasive PA monitoring, etc).

 

[NYC Girl]

Also, in terms of MFM, pts may have medical comorbidities, but usually nothing involving intensive care. Their management is more along the lines of glycemic control for diabetics, etc. rather than the type of interventions and hemodynamic monitoring that is expected of an intensivist.

 

[Global Disrobal]

NYC Girl,

I concur with your post. Just one question (out of curosity), what is he planning on doing after the fellowship? Is he going to do OB-GYN? Critical Care? I don't see making a living as a OB-GYN Critical Care specialist, unless he plans on doing regular OB-GYN w/Critical Care on the side (as a consult)

Thanks for the info!