Male and interested in OB/Gyn: Experiences

[THP]

Banned. That's a shame.

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[Global Disrobal]

Banned. That's a shame.

So is using multiple accounts simultaneously!

 

[spotted owl]

I once encountered a male obgyn that had female patients waiting in a line at his office at six in the morning waiting to see him because he was so awesome and blah blah blah blah. Spare us your anecdotes. They are meaningless because they are the exception, not the rule.
You're calling me prejudiced? You're saying I'm prejudiced against men because I don't believe that they should work in a profession where they exclusively deal with female health issues and routinely perform exams on female sexual and reproductive organs?

I am a forth year medical student. I am a man. I have interviewed at some of the best academic Ob/Gyn programs in the nation. My interviewers have mostly been female attendings, residents, and program directors. I have felt highly recruited to the field in general and to their specific programs. I am interested to know why these top programs, which are almost universally lead by women, are so interested in me as a potential resident? Do they not care for women's modesty? Are they trying to disrespect their patients? I care about patient preference, and I understand that not all patients will want me involved in their care. Still I think there is a legitimate reason for me to go into the field, and so do the program directors of Harvard and Hopkins. What could they be thinking?

Perhaps they are not so worried about the future of women's ability to choose a female provider, since the overwhelming majority of medical students choosing Ob/Gyn are women.

Perhaps they are concerned that if all male medical students discount Ob/Gyn the over all effect on the field will be a negative one. After all, if Ob/Gyn appeals to only half of graduating medical students, the field will attract half as many top students as they would appealing to both genders. The same result would be obtained, of course, by a specialty which attracted only male applicants (that isn't meant to be a knock on ortho).

Recruiting weaker applicants will result in an intellectually inferior specialty and hurt our ability to make badly needed scientific advances in women's health. You don't want men and women working together on advancing ovarian cancer screening? No men helping to invent newer better contraceptives? Should we stop male-female collaboration in discovering the etiology of pelvic organ prolapse? I understand you are concerned about women bearing their junk to men doctors, but how far are you willing to go to prevent that? And how desirable is that?

Also, I don't think there is any data, but it seems to me that in subspecialty care the patient preference for female doctors might be less pronounced. Is it smart/fair to keep men out of REI and Onc, because some women want their screening pap smears from women?

My last point, and I don't mean to be rude. I think your conception of the whole relationship between genitals, gender, and sex lacks nuance. Sex is about more then nudity and gender preference. It is a complicated and contextual activity. In my own experience as a practitioner of both heterosexual sex and pelvic exams, I couldn't think of two less related activities. People, not medical people, often ask me weather doing Ob/Gyn has affected my sex life, and I always say no without reservation. Since you've brought it up, I must say the reverse is also true: being a man and a heterosexual doesn't influence how I practice Ob/Gyn. If anything it has made be very sensitive to the kind of language I use with my patients, in order to avoid any ambiguity.

I respect you for voicing what is, at least among Ob/Gyns, an unpopular opinion. Yet I am not sure where you concern really lies. There will be enough women to see all the women who have that preference. So why are you so passionate about excluding the minority of men still interested in the field?

 

[wholeheartedly]

I think the above post has to be the most articulate and awesome ever first post by poster on SDN....

 

[deleted432032]

I'll second that. Very well put.

 

[dmuryan]

For the sake of clarification: I am a 4th-year ObGyn heterosexual male resident. I have been kicked out of a room zero times, and approximately five times in four years did a patient discover my male sex and request a female resident.

This field needs more male physicians. Our program embraces male residents, and it is currently comprised of 33% males. Many of our male and female interviewees explain that they targeted our program because of higher-than-average male:female ratio.

Statistically speaking, females have shorter career spans and are much more likely to reduce their workload to part-time volumes. As a result of our field becoming predominantly female in recent times, I anticipate an ObGyn shortage in the next 10-15 years.

I had zero difficulty landing excellent post-residency employment. In fact, my job position opened up because one of the two females in the large group is transitioning to part time. Females are fine; males encouraged to apply.

 

[Chuck's Right Foot]

Just a follow up: LOVED my OB rotation. Didn't get kicked out during GynOnc or L&D service. Only had a few problems with being a male at a local school's primary care clinic. Otherwise my favorite rotation. I'll be applying OB/Gyn next fall. Also I missed all the troll-tastic awesomeness til tonight while I'm working on my 4th year schedule.

 

[DrMattOglesby]

That's great news 'CRF'!
I admittedly won't add much to the discussion; just wanted a place to blab about my appreciation of Ob/Gyn...
Anyhow, I loved my Ob/Gyn rotation all the same. Crazy hard work...but I got a great experience rotating in a residency program here at Penn State. Despite being worked to the bone, I was happy. If I had to choose what residency I would enter as a career based on what I have done so far--I'd pick Ob/Gyn.
But I do have reservations as I have yet to participate in my elective rotation of Physical Med & Rehab (which was my #1 choice prior to clinical rotations). And I still have to finish off my Psychiatry and Surgery rotations. I'll definitely update on how things turn out; it's nice seeing how people from the C/O 2013 turned out =)

 

[OddInsight]

That's an interesting theory you've got there: Practices not wanting to hire women out of concerns that they'll end up going part time because of maternity leave. And I suppose you think these women all decide to stay part-time for the remainder of their careers, right? Your argument is ridiculous, sweetie. And the change in trends you seem to think is taking place (because of your anecdotal experiences finding a job as well as what you perceive as difficulty for your female co-residents in finding jobs) is not taking place. There are practices aplenty advertising themselves as all-female, seeking out female obgyns. They do this because female obgyns attract more patients (and often better-paying patients as well), period. But dont take my word for it. Why don't you do a little field research yourself and call even 10 male/female practices and see which gender of doctor has openings in their schedule. Matenity leave....dream on, bub!

There's another angle here that I think you ALL are missing and stands in defense of Tara. Most women still experience OB GYN through Well Woman exams. As the Well Woman industry is increasingly subjected to scientific scrutiny and found wanting (e.g. pelvic exams contraindicated in asymptomatic, no value for CBEs in the mammogram population, annual pap smears despite huge lifetime false positive rate), women patients are waking up and wondering what role male sexuality played in the design and execution of this wellness regimen. A high school stats student could tell you annual pap smear regimen was simply mean (life time false positive risk north of 60%). Palpation-based diagnostics just don't work and are a rich source of false positives (but this is celebrated as a success by the field). Women never told that normal pelvic exam really meant the doctor couldn't palpate ovaries, etc. Married women swabbed for STDs without their knowledge when they could self-collect or do a blood draw or refuse? Stirrups aren't necessary but here we are. And cervical cells don't require clinical collection (and acellular HPV DNA screening is already here). Women are starting to view the Well Woman industry as a decades long fraud and why wouldn't they? It looks like a power trip at their expense ex-post. Would it happen if women led the field from the start?

How angry would you be exactly upon learning that you submitted to error prone, sexually humiliating invasive examination year after year by surgeons that self-refer (ie are conflicted by definition) just to obtain oral contraceptives that ACOG now endorses for OTC treatment? And what if you learned how much information about the weaknesses of the medicine was kept from you as you reported for inspection?

There has been a huge abuse of trust. Males OB GYNs will pay the price.

 

[anonperson]

There's another angle here that I think you ALL are missing and stands in defense of Tara. Most women still experience OB GYN through Well Woman exams. As the Well Woman industry is increasingly subjected to scientific scrutiny and found wanting (e.g. pelvic exams contraindicated in asymptomatic, no value for CBEs in the mammogram population, annual pap smears despite huge lifetime false positive rate), women patients are waking up and wondering what role male sexuality played in the design and execution of this wellness regimen. A high school stats student could tell you annual pap smear regimen was simply mean (life time false positive risk north of 60%). Palpation-based diagnostics just don't work and are a rich source of false positives (but this is celebrated as a success by the field). Women never told that normal pelvic exam really meant the doctor couldn't palpate ovaries, etc. Married women swabbed for STDs without their knowledge when they could self-collect or do a blood draw or refuse? Stirrups aren't necessary but here we are. And cervical cells don't require clinical collection (and acellular HPV DNA screening is already here). Women are starting to view the Well Woman industry as a decades long fraud and why wouldn't they? It looks like a power trip at their expense ex-post. Would it happen if women led the field from the start?

How angry would you be exactly upon learning that you submitted to error prone, sexually humiliating invasive examination year after year by surgeons that self-refer (ie are conflicted by definition) just to obtain oral contraceptives that ACOG now endorses for OTC treatment? And what if you learned how much information about the weaknesses of the medicine was kept from you as you reported for inspection?

There has been a huge abuse of trust. Males OB GYNs will pay the price.

Take a few deep breaths. It will be okay. Please stop projecting whatever BS happened in your life to physicians.

The pap smear has been a success as far as I'm concerned. Cervical cancer rates have dropped dramatically and a majority of women diagnosed in this country The initial thought was annual screening was necessary. But *gasp* as better research was done, the field has come to realize that we can be less aggressive with them and space out the screening which has happened. The management of abnormal pap smears in younger patients is much more conservative now. There is no conspiracy in OB GYN. As better research comes out, practice management changes. It's as simple as that.

Regarding STD screening. You must be going off older data but it's nowhere near as aggressive as you make it sound. In the clinic population, we are much more aggressive with screening but that's just because of the increased prevalence of infections, even in our married patients.

Clinical breast exams are an imperfect tool. No one argues that. There is some benefit because mammography itself is not a perfect tool.

I just don't understand where this ridiculous vitriol is coming from. Early practice management was not based on as much evidence because there was none to base it upon. As more information has come about, ACOG, ASCCP etc has made changes to reflect the current understanding of the disease processes we are treating.

So please take your bizarre hang ups to some other website.