Male Ob/Gyn Residents, Please be honest.

[Leukocyte]

I am a male MS-3 who is considering Ob/Gyn for the 2006 match. I like Ob/Gyn because:

1) It is focused on dealing with specific problems, unlike GS.
2) The Patient population is generally healthier, unlike GS.
3) Outcomes are usually good.
4) Involves medical and surgical management of problems.

Now, to all of you male Ob/Gyns,
1) Do you ever feel that you are "out of place"?
2) Have you ever been rejected by patients because you are a male?
3) Are you having a harder time getting your work done in the clinic because, unlike female ob/gyns, you are running around trying to find a chaperone to be with you in the room?
4) Do patients treat you well, and talk to you freely about their medical problems just as well as they do with female ob/gyns?

Please be honest. I have read in the book titled "Choosing a medical speciality" that 60% of patients prefer a female Ob/Gyn. This leaves us males with only 40% of the patients. So would you seriously encourage male students to enter ob/gyn despite this bias against males in this profession?

By the way, inputs from female ob/gyns and honest patients are also welcome.

Thank You.

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[PTOSIS]

ms2 here,
i and 3 of my friends that have told me whom they go to go to males. i never had a preference before i went, but my fav has been a man. he is much more gentle, especially b/c i am a wuss, he never makes me feel bad, and takes a really long time. never told me to suck it up. out of 5 pple that know who had baby's recentl;y, all had men. the way i see it, 50% pf the popuilation will need an ob, so there will be plenty of patients for u.

 

[Global Disrobal]

Well Leukocyte, I am a male Ob/Gyn resident almost about to enter the 2nd year of residency. I did a post-sophomore fellowship in pathology and applied to both specialties, but finally settled on Ob-Gyn b/c of pt contact and many of the reasons you stated above. As for your questions, here are the answers one by one:

1. I do feel out of place some times (not majority though) solely because I am in a program with 18 women and myself. Alot of their social discussions is hard to get in on, but on the same token our class is very close and I am we are all best friends regardless of gender. Being a male has its perks though, since I get preferential treatment from the nursing staff (hate to say it but its true) and get along much better with the male attendings that many of my counterparts.

2. I have NEVER been rejected by a patient. There have been occassions on L&D when I have been on the board at night and there has been a patient requesting a male because of various reasons (religion, pref, etc). I have taken time after sign out to go into those rooms and reviewed the strips and the history. I tell them right off the bat that I respect their wishes and will follow it unless there is an emergency (decel, etc). I can honestly tell you that in all those times (10 or so this year) I ended up doing the delivery and following the patient since the preference was later waived by the patient. It all ultimately comes down to bedside mannerism and how you approach the patient. Show the patient and her wishes the respect it deserves, and you'll be surprised. I haven't been refused at all in clinic for whatever reason it maybe.

3. This is true. There are times (peak patient times at clinic) when its harder for me to complete a visit because I have to get a nurse. Its more logistics than anything.

4. Answer to this is yes and goes back to my reply above. It is how you approach the patient.

Overall, let me give you one piece of advice. I had the same thoughts when choosing between pathology and Ob-Gyn. Granted life style, malpractice, and income potential (in case of derm path, GI path, etc) is great in path, it shouldn't be the sole reason behind your decision. Being a male with you get you more interviews in OB, a chance to match at a higher caliber program (comparatively speaking), and don't let the "male" talk discourage you. I would recommend that you do electives in Path (Surg Path, Autopsy, HemePath) and OB/Gyn (MFM, Gyn Onc, Gyn Surg) and see what feel you get. Then just sit back and ask yourself with all other factors removed, which trade/specialty will you enjoy more 20 years down the road.

Regardless of your choice, good luck with the match (sorry if I came across OB biased).

GD

 

[brotherbloat]

Hi there,

I'm 28, pre-med, and female and for the first time I went to a male gyn yesterday for my annual, he was 65 years old. However, I would be way too embarassed to go to a male gyne who was under the age of 45. I just couldn't bring myself to be naked in front of a relatively young guy. That would be too weird. I have only been to women before, but I didn't like my last gyn and decided to try an old man for a change. I felt totally comfortable talking to him, as I would with a woman, but this guy did not ask if I'd like a chaperone nor did he get one, which I thought was odd, but ultimately it didn't bother me. I guess the fewer audience members, the better.

Anyhow, overall, if I had a choice, I'd choose a woman. In general, I've found the male doctors I've been to (derms, internists) to be very intimidating, unapproachable, and condescending, whereas I find I relate to the women far better. I find the women to be more compassionate in general. But if an older man was known to be excellent, I'd go with the man. It's not that I think women are better gyns or doctors than men have the capability to be--it's just that it makes me generally uncomfortable to get undressed in front of any young male doctor--regardless of whether it's a family practice or a gyn.

In general, I've been very disappointed with the quality of my gyne care. I've yet to find a gyn of either gender who I think is truly excellent. Generally I feel that they don't take enough time to go over my history and answer questions; that they run out of the room at the earliest opportunity, and that the exam is not as thorough as I think it should be (i.e. this gyn didn't feel my thyroid or listen to my heart and lungs, even though I told him I hadn't had a physical in years.) I think that is poor doctoring.

Thanks,

BB

 

[jeffsleepy]

the exam is not as thorough as I think it should be (i.e. this gyn didn't feel my thyroid or listen to my heart and lungs, even though I told him I hadn't had a physical in years.) I think that is poor doctoring.
BB

As another silly premed, forgive me if the answer to this is obvious, but is it really the OBGYN's job to be checking for all that other stuff? If a physical is needed, maybe a family practitioner should be seen. I wouldn't expect my dermatologist to check my BP very often. Maybe these things are commonly done at gynecological exams. If that's the case, then nm .

 

[Global Disrobal]

Its not a stupid question to ask by any means. If you look at the stats (or even if you just watch your population in residency) you'll see that there is a great number of females that use an OB-GYN for primary care needs, or in many cases the OB-GYN is the only doctor they see during the year. I often order life style (cholestrol, diabetes) screens, and colonoscopy referrals.

Getting back to the Bloat's post, an issue I see with your Gyn experience is that you've limited your care to either women or "old" guy, therefore its cery plausible that you've skipped over "good" care by a younger male Ob-Gyn. Regardless, I think a thorough exam should include a pelvic, rectal, and breast. Many of us usually don't go for the HEENT, Lung, Heart unless they are approaching their 40's (higher risk category), have certain complaints, or are getting pre-opped.

Anyhow, its great seeing premeds involved in the forum. Good luck the rest of the way.

 

[brotherbloat]

I just thought since I told him I hadn't had a physical in years--and wrote it on my form--that he should have at least done the lung, heart, thyroid thing--as all my other gyns have done. He didn't do a very thorough breast exam either--didn't even look at them, only felt them in one position (lying down) with arms down at sides, etc. He did a good pelvic and rectal, though. I think the lack of consistency among gyns for these things is odd. I also felt that he didn't really get much into my history, as other gyns have also not done (as a new patient with a gyn, I kind of expect an initial consultation that's longer than two minutes.)

Yes, I would not consider seeing a younger male gyne. I just wouldn't feel comfortable, I don't know, just my preference. Just as I feel highly uncomfortable when I go to my derm (located at a teaching hosp.) and there are male med students/ residents there while he does the whole exam (which includes a vulva exam b/c I have some moles there.) The first time this happened I was livid, as my opinion to have them there was not asked for. I did not expect when I made the appt. that male med students/ residents would be staring at my naked crotch during the skin exam. However, I decided to stick with my derm only because he is truly excellent (and over 60 as well.)

Also, as an unrelated point, I feel more comfortable going to doctors over 45 anyway, regardless of gender, because I feel they do a better job in general and are more knowledgable. The times I've seen younger women doctors I've felt they had no idea what my problem was, whereas when I went for a second opinion to an older doctor, they knew right away. Thus, in general, though I know that younger doctors may be easier to relate to, since I'm 28, I feel fare more secure when my health is in the hands of an experienced oldtimer. Thus, unless necessary, I will not be going to any newbies any time soon.

 

[LADoc00]

Yes, I would not consider seeing a younger male gyne.

What if he was insanely hot?

 

[Teufelhunden]

Also, as an unrelated point, I feel more comfortable going to doctors over 45 anyway, regardless of gender, because I feel they do a better job in general and are more knowledgable.

You may want to re-think that. Read the links below:

link
link

 

[minime]

During my clinical rotations I was amazed at how out of touch/date a lot of older physicians are-not saying they all are-just my experience.

I also thought that older physicians seemed to know what they were doing more before I went to medical school, but now I know different and would never go to an older doc.

 

[tigershark]

I just thought since I told him I hadn't had a physical in years--and wrote it on my form--that he should have at least done the lung, heart, thyroid thing--as all my other gyns have done. He didn't do a very thorough breast exam either--didn't even look at them, only felt them in one position (lying down) with arms down at sides, etc. He did a good pelvic and rectal, though. I think the lack of consistency among gyns for these things is odd. I also felt that he didn't really get much into my history, as other gyns have also not done (as a new patient with a gyn, I kind of expect an initial consultation that's longer than two minutes.)

Listening to the heart and lungs in an asymptomatic 28 year old is a waste of time, what exactly do you think that would discover? He has enough experience to look at you and quickly decide what exam is necessary.

 

[Ikazi27]

Hi, I have had two annual exams by a gyn (I am 19) and the first was performed by a female doctor, the second one a year later by a male.
The first pelvic exam was very fast and I only felt a moment's discomfort.
The second exam by the male doctor was an extremely traumatizing experience.
The doctor has got to be at least in his 70s. My sister recommended him, and he is very nice and concerned when it comes to your history, and answering questions...but
The exam was awful!
It must have lasted ten minutes and it hurt a lot. He messed up the first Pap smear and had to repeat it a second time. I did not say anything because I just wanted it to be over with, but there was a tremendous disparity of pain and discomfort between the exam with him, and the exam with the female doctor.

In my opinion, I would not go to another male gyn again, unless there was an emergency. Even though my view is biased because my male doctor was much older than my female one, I still feel that I would be very uncomfortable with a male doctor. Plus, call me crazy, but I would not really feel respected by a male gyn because I would feel like he sees me as a "female" that he has to treat while a female doctor would sympathize more directly with me since she can relate personally to my health.

However, a lot of my friends and family members prefer male obgyns, so I think males certainly shouldn't rule out the speciality.

Peace,
Irina

 

[brotherbloat]

I didn't think it would be a waste of time since under the heart section on my info sheet I wrote "frequent palpations" which is true, I get them all the time and often feel like my heart skips a beat, that alone I would think would prompt at least a brief listen, plus all my other gyns have done that.

Anyhow, to respond to the poster above, interestingly, my family (parents that is) feels exactly opposite to me with regard to male doctors in general. My parents are sort of old school and they will only go to male doctors. They have always said that women doctors are "distracted" by their kids and they don't think they're as competent. Interesting, since I prefer females. And I, myself am pre-med (and a woman.) But my parents are also 100% against my career move to medicine.

 

[Global Disrobal]

Great posts. Thanks for sharing your experiences as it truely does give great insight to the ones of us in the clinical practice.

As for your exam question, you are right. If I look at the patient questionnaire and there is anything about "palpitations," an auscultation is at the least warranted if not a more thorough history.

As for Ikazi27's post, thats exactly the truth out there. I don't think its gender related, but the actual physical exam (pelvic) can vary from doctor to doctor regardless of how nice, good, bad, or knowledgable they are. I think as a patient, unfortunately, you often just have to go to a few until you settle down with the one you like. The only problem in today's setting is that many docs constantly move because of money/malpractice/etc and many patients don't get the luxury of having the same doc following them for an extended time.

 

[minime]

I hope that tigershark is kidding about auscultating the heart in an asymptomatic 28 yo. Mitral valve prolapse has to be diagnosed early on because if you wait to fix it until you are symptomatic then it is too late and left ventricular function will not return. There are many other reasons (including idiopathic left ventricular hypertrophy ie the asymptomatic athlete who falls over dead) and if you have forgotten them maybe you need to read up.
Besides in most of these young women obgyns are the only physician they ever see.

 

[Doctobee]

I preffer male Ob/Gyn just becuase of my past experiences. Two (out of 4) were in their 30s to 40s, very nice, professsional and knowledgeable. The third was older, like 60s, and I didn't like him becuase he was somewhat impersonal. And finally, the last was a lady (I switched b/c I didn't like the older guy), who was also nice and thorough... But either way, if Ob/Gyn is your passion, just go for it. Im sure you'll have plenty of patients. It's like Global said above - it all really depends on your bedside manners and your professionalism.

 

[mustangsally65]

I think males are needed in OB/GYN, and even if most women preferred females, there are always going to be some women who prefer going to male physicians. It seems silly to limit the profession to females only, because the ability to provide necessary care isn't gender-specific, and the higher prevalance of females is mostly caused by women who feel embarrassed to be seen by a male doctor. Men are just as capable of providing wonderful care and compassion, just as women can be rough and condescending. The idea that men can't be "as good as women" in OB/GYN is a stereotype, and patients need to realize that men don't go into the profession to get to see nude women. If you wanted to see that, all you'd have to do was go online, so why endure 4 years undergrad, 4 of med school, and 3+ years of a residency?

I've seen both men and women, and I don't really have a preference, except that the person performing the exam is gentle, willing to listen to me, and understanding. Compassion is much more important than gender. I've been asked several times if I'd allow med students to watch my physician do the exam, and even participate themselves. While it's not all that great to have a med student do your pap smear, or have two breast exams (one by your doctor to demonstrate, then one by the med student), I have no problem with this either because I know that one day I'll be at the mercy of patients to be allowed to witness procedures. It's not much fun, but you have to realize that you might just as well be another textbook, at least as I see it. People don't look at you like you think they look at you. You think that you are being exposed in front of these people, but they are just seeing you as a learning experience, and a case of whatever disease you might have.

I'm a pre-med, and this is just my opinion. I think we need to get past our own insecurities (which I'll admit is very hard to do!) and realize that everyone has these same fears, and it is part of what makes us human. We're probably going to have to examine each other in our clinical medicine classes, and this is going to be very awkward at first. But in the end, your doctor doesn't see you the same way a layman on the street would see you unclothed. And if your problem is serious enough, you're not going to care who examines you, as long as you get the care you need.

I think it's really sad that males might not go into OB/GYN because of these reasons. Men have the capacity to care just as much as females do, and many of them might be missing their true calling because of discrimination. I always make a point to allow all med students to observe if they happen to be there when I see any kind of physician. Such a small act can make such a difference. It's kind of like donating blood: it might be kind of annoying for a small amount of time, but when you get done you feel so much better for having done the right thing.

 

[v-tach]

Anyhow, to respond to the poster above, interestingly, my family (parents that is) feels exactly opposite to me with regard to male doctors in general. My parents are sort of old school and they will only go to male doctors. They have always said that women doctors are "distracted" by their kids and they don't think they're as competent. Interesting, since I prefer females. And I, myself am pre-med (and a woman.) But my parents are also 100% against my career move to medicine.

Any idea why they have that attitude? Maybe they're just more used to the style of male doctors and therefore might perceive the women as "less competent" (even though that's not true) because they communicate a little differently. I know that some people are just the opposite--they feel that women are better doctors (not saying that's necessarily true either--lots of individual differences regardless of gender) because sometimes they listen more and involve the patient more in making decisions. And as for being "distracted by their kids", that's not a fair statement. After all, there are certainly women doctors who are single and don't have kids--talk about not having "distractions" (I will more than likely be in that category)! I have to say, it's pretty sad that these attitudes still exist. There are good and not-so-good doctors of both genders. Anyway, enough of my rant.

 

[v-tach]

I hope that tigershark is kidding about auscultating the heart in an asymptomatic 28 yo. Mitral valve prolapse has to be diagnosed early on because if you wait to fix it until you are symptomatic then it is too late and left ventricular function will not return. There are many other reasons (including idiopathic left ventricular hypertrophy ie the asymptomatic athlete who falls over dead) and if you have forgotten them maybe you need to read up.
Besides in most of these young women obgyns are the only physician they ever see.

That is true. And especially if someone wrote down that she gets frequent palpitations. When I mentioned something similar at my last physical, I got sent for a Holter monitor and an echo, even though I didn't think it was anything serious (and it wasn't--just the occasional few PVC's, and the echo did show mild mitral valve prolapse with "trace" regurgitation, but that's pretty common from what I understand). My opinion is that it's not the best idea to have your ob/gyn as your primary care doctor; a better choice would be an internist or FP.

 

[ellehcim]

I didn't think it would be a waste of time since under the heart section on my info sheet I wrote "frequent palpations" which is true, I get them all the time and often feel like my heart skips a beat, that alone I would think would prompt at least a brief listen, plus all my other gyns have done that.

Why are you seeing an Ob/Gyn as your primary care when you have these symptoms which you know warrant investigation, and that an internist would be the one to do them? Just curious.

 

[AzMichelle]

By the way, inputs from female ob/gyns and honest patients are also welcome.

I am female, a nurse, and I've been to both male and female. It's less humiliating to go to a female however without a doubt, men are far more gentle. They care more about the little things and they are overall.. just nicer than women. They are easier to talk to, easier to joke around with, and they are better at lightening the mood.

As for the person that didn't understand the value of an OB/GYN listening to heart and lungs... you have a GREAT deal to learn! Many women ... you almost have to drag them to a doctor every 4-5 years. When you have the opportunity to look them over, you do it. You don't whine about it you just do it. What kind of medical malpractice would you be looking at if you did an annual physical and missed something huge and obvious but you were too busy to do the basics in an exam?

If you go into OB/GYN and someone comes in for an annual, it is only fair to let them know you only plan on doing half the job. Maybe you could put a sign in your waiting room saying that you don't do anything above the breasts.

 

[timtye78]

I am sure if there was something 'huge and obvious', the patient would express a complaint, such, short of breath, coughing up blood. If the OB/Gyn offered primary care services or charted normal lung sounds or regular heart rhythm and there was a tumor, even listening to the lungs doesn't r/o Ca.

Obviously, you have made public your level of education, and for some reason apparently lay people AND even healthcare professionals still expect their MD/DO to have 'xray' vision and diagnose disease without even having symptoms. And, as aside I have heard many disgruntled patients gripe about coming into the clinic, let alone, hospital, with twenty-thousand more diagnoses than they had when they entered.

I would expect an Obgyn to be an expert in his/her area, and leave primary care screening to the FP or IM-unless the physician and patient have agreed to making the ob her PCP.

 

[AzMichelle]

I am sure if there was something 'huge and obvious', the patient would express a complaint, such, short of breath, coughing up blood. If the OB/Gyn offered primary care services or charted normal lung sounds or regular heart rhythm and there was a tumor, even listening to the lungs doesn't r/o Ca.

Obviously, you have made public your level of education, and for some reason apparently lay people AND even healthcare professionals still expect their MD/DO to have 'xray' vision and diagnose disease without even having symptoms. And, as aside I have heard many disgruntled patients gripe about coming into the clinic, let alone, hospital, with twenty-thousand more diagnoses than they had when they entered.

I would expect an Obgyn to be an expert in his/her area, and leave primary care screening to the FP or IM-unless the physician and patient have agreed to making the ob her PCP.

We disagree. My doc asked questions about fatigue, dry hair, dry skin. I said no, no, and no. I'm ... I used to be 39, changes are subtle and I really hadn't noticed. Had my GYN not felt my thyroid I wouldn't have had a clue my thyroid was enlarged and later I discovered my TSH was 12+. I didn't know how bad I felt until I felt great again on Levothyroxine. I am a nurse, I KNOW what to look for, I'm the best nurse you'll ever meet but just like most women I blow off the little stuff and chalk it up to age.

Woman just don't go for a Pap from their OB/GYN and a physical from their PCP. That isn't how it works. They get a physical when they get one. They don't go to multi-docs for multi-physicals. Besides, insurance wouldn't likely pay for a routine px from every specialty.

When you have a women there for a physical, do it.

Something cool about nursing. You get to see lots of docs doing their thing and you soon learn who is good and who fakes it. You learn who is careful about everything and who just gets by. Tell me who you would choose, someone careful and does a good solid px or someone who will only do a limited exam?

And btw, "huge and obvious" are not always huge and obvious to a patient. You are supposed to be the expert ... so be one.

 

[criminallyinane]

Why are you seeing an Ob/Gyn as your primary care when you have these symptoms which you know warrant investigation, and that an internist would be the one to do them? Just curious.

Exactly. I understand wanting more complete care, but how can you fault a busy OB/GYN in this managed care day and age, for not doing a heart/lung/thyroid exam on a 28-yr old presenting for a yearly pap/GYN exam? If he advised you to get a full physical with an internist or FM doc, then that, to me, is sufficient. It is not fair for patients to expect that ANY doc they see is going to act as their primary care doc; that is not what specialists are for. I personally don't blame Ob/gyn docs who dont' want to do a lot of primary care because I think that the old school way of thinking (that women need only see an ob/gyn for their health needs) should be replaced by an understanding that patients need to take responsibility for their healthcare by going to an internist and specialists as necessary.

In any case, my internist does my gyn work, so I don't have this problem. I would never go to a male ob/gyn, but I know my mother and aunts would never go to a female (they feel weird having a woman touch their lady-parts because they are silly.) Men who are passionate about ob/gyn should go into it.

 

[timtye78]

We disagree. My doc asked questions about fatigue, dry hair, dry skin. I said no, no, and no. I'm ... I used to be 39, changes are subtle and I really hadn't noticed. Had my GYN not felt my thyroid I wouldn't have had a clue my thyroid was enlarged and later I discovered my TSH was 12+. I didn't know how bad I felt until I felt great again on Levothyroxine.
I am a nurse, I KNOW what to look for, I'm the best nurse you'll ever meet but just like most women I blow off the little stuff and chalk it up to age.
Something cool about nursing. You get to see lots of docs doing their thing and you soon learn who is good and who fakes it. You learn who is careful about everything and who just gets by. Tell me who you would choose, someone careful and does a good solid px or someone who will only do a limited exam?
And btw, "huge and obvious" are not always huge and obvious to a patient. You are supposed to be the expert ... so be one.

Thanks for that fascinating story about your thyroid disorder...
Darn...I missed the boat..I should have become a nurse for the above reasons.
Wow, why should you even go to an MD? You apparently know what to look for right? Then why did you 'miss' the thyroid?