Not matched OB again. Advice.

[lodeofdarkness]

Hi, I have scoured the boards for advice on transitioning or switching somehow b/w residencies. Basically, I am a re-applicant unfortunately after having my application fudged the first time around who's been wanting and working toward obgyn for >10years and was in a transitional spot this year after not matching. This year, I re-vamped my app (board scores are >230, 10+ pubs, leadership, etc) and had better luck this year with 11+ interviews and stil did not match ob....Is there a sliver of hope for this FMer now?

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[Piebaldi]

Hi, I have scoured the boards for advice on transitioning or switching somehow b/w residencies. Basically, I am a re-applicant unfortunately after having my application fudged the first time around who's been wanting and working toward obgyn for >10years and was in a transitional spot this year after not matching. This year, I re-vamped my app (board scores are >230, 10+ pubs, leadership, etc) and had better luck this year with 11+ interviews and stil did not match ob....Is there a sliver of hope for this FMer now?

Count your blessings. I would do FM over Ob any day. 11+ interviews and your profile says it's not your app, likely IV skills or lack thereof

 

[lodeofdarkness]

Count your blessings. I would do FM over Ob any day. 11+ interviews and your profile says it's not your app, likely IV skills or lack thereof

Sorry but as someone whos wanted OB for over a decade, worked hard at it for the same time frame, it is not what i'm looking for. looking for advice on how people can switch. thanks.

 

[Piebaldi]

Sorry but as someone whos wanted OB for over a decade, worked hard at it for the same time frame, it is not what i'm looking for. looking for advice on how people can switch. thanks.

Same advice applies really. If you got 11 interviews in OB, that should be plenty to match. It's not your app, it's likely your IV skills. I would suggest mock interviews to practice your interviewing skills.

 

[Dr G Oogle]

Can you talk with the program where Yih did FM or do an OB fellowship and then reapply? What exactly is it that draws you to OB? the gyn surgery? The OB part or the women’s health part?

If it’s the last 2 just stick with FM if it’s the first, you’ll not only have to do obgyn residency you’ll have to do a fellowship if you want to do anything resembling meaningful surgery

 

[lodeofdarkness]

Same advice applies really. If you got 11 interviews in OB, that should be plenty to match. It's not your app, it's likely your IV skills. I would suggest mock interviews to practice your interviewing skills.

I guess I could say as much. All the FM interviewers basically told me they liked what I was throwing down and wanted to pursue me on the spot. OB- crickets. Thank you.

 

[lodeofdarkness]

Can you talk with the program where Yih did FM or do an OB fellowship and then reapply? What exactly is it that draws you to OB? the gyn surgery? The OB part or the women’s health part?

If it’s the last 2 just stick with FM if it’s the first, you’ll not only have to do obgyn residency you’ll have to do a fellowship if you want to do anything resembling meaningful surgery

The last 2. I havent done FM yet. How do I tell a PD "Hey i know you wanted me to come but I really only pursued this as a backup since last year was so ****ty and my real passion is X"

 

[lodeofdarkness]

The last 2. I havent done FM yet. How do I tell a PD "Hey i know you wanted me to come but I really only pursued this as a backup since last year was so ****ty and my real passion is X"

Sorry i meant first 2, the surgeries, the breadth, etc. everything.

 

[lodeofdarkness]

Sorry i meant first 2, the surgeries, the breadth, etc. everything.

I cannot muster an iota of interest in anything else, least of all the one field I need to know something about everything.

 

[lodeofdarkness]

I cannot muster an iota of interest in anything else, least of all the one field I need to know something about everything.

I can't even get credit for the prelim year I already did.... which makes it double awful. Any advice for a hopeful?

 

[Piebaldi]

I can't even get credit for the prelim year I already did.... which makes it double awful. Any advice for a hopeful?

Whhy can't you get credit for the prelim year?

 

[Dr G Oogle]

I would go to the FM program and after reapply and then if you still don’t get in do an OB fellowship. The only thing worse than doing a specialty you don’t like is not matching at all. MDs without residency training have few options and lots of debt; unless you are independently wealthy or have an in with an investment bank

 

[Jecave]

Can you talk with the program where Yih did FM or do an OB fellowship and then reapply? What exactly is it that draws you to OB? the gyn surgery? The OB part or the women’s health part?

If it’s the last 2 just stick with FM if it’s the first, you’ll not only have to do obgyn residency you’ll have to do a fellowship if you want to do anything resembling meaningful surgery

Why do you suggest needing to do a fellowship in order to to perform meaningful surgeries? What kind of cases are generalist doing?

 

[Dr G Oogle]

It depends on where you are; rural areas generalists may still be doing the gamut of gyn like hysts and even some pelvic floor repairs; in urban areas there is a shift to have the majority of big surgeries done by fellowship trained surgeons. This is due to several things dropping surgical volumes in residency (you need 150 cesareans, 200 svds, and fewer than 100 hysts with all modalities now being counted together), low volume of procedures out in practice to be considered “high volume” the cut off is 12 hysts annually, about 1 a month. Only 20% percent of generalists meet this criteria nationwide. Places like CCF and Mayo have all but stopped having generalists do any majors and most academic and urban hospitals are moving in that direction. When I started residency 7 years ago all of the generalists were doing majors with many doing less than one case per month, now only 2 out of a department of 40 do majors. The last part is the advent of MIGS which is basically a fellowship in surgical gynecology, technically MIGS shouldn’t teach you anything that a gyn residency doesn’t; but in reality MIGS trained surgeons do a ton more cases in those 2 years of fellowship than gyn residents and under the guidance of other fellowship trained surgeons. MIGS has also filed for its own board specialization through ABMS this year, its only a matter of time before it is approved, which in all likelihood be a blow to generalists doing majors, at least in all metropolitan and semi metropolitan areas.

Likely, rural areas will still see General gyns doing a variety of cases just like gen surgeons out there doing thoracic and oncology cases and diagnostic radiologists doing IR procedures etc. leadership are discussing ways to change residency, either splitting up OB and Gyn, or having tracking, including a rural track or making residency longer.

In places where generalists aren’t doing majors they may still do hysteroscopies, laparoscopic adnexal procedures (usually TL and ectopics; with cystectomies and oophorectomies being done by MIGS) and OB related procedures. Some go and do office only (a very lifestyle friendly and lucrative part) or become laborists (also pretty lucrative).