What's the truth behind the Ob/Gyn stereotype?

[Leukocyte]

So why do I keep hearing that Ob/Gyns are not surgeons? Was it an Ob/Gyn who did the first lap appy?

Please be honest.

Thanks.

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[johnny_blaze]

Obs/Gyne is a surgical specialty. In the U.K, Attaining membership to the royal college of obs/gyne grants you the special title of “Mr” before your name in exchange for the previously held “Dr.” title… like all surgeons here do.

I think this is just a matter of poor perspective on behalf of some people. Obs/Gyne is one of those specialties that some people consider to be a hybrid of medicine and surgery and therefore not “pure” surgery. I was once with a general surgeon who told me that he doesn’t consider orthopaedic surgeons to be “real” surgeons… Go figure

 

[Pir8DeacDoc]

I'll let ya know in the next little bit. Today is Ob-Gyn orientation for me. Welcome to two months of baby catching

 

[Khirurg]

Ob?Gyn is a surgical specialty also. they only have three procedures, though...
1. Cut right ureter
2. Cut left ureter
3. Cut both ureters

 

[iliketocut]

They have two more:

1. create adhesions
2. cause permanent nerve damage secondary to incorrect use of Bookwalter

They are doctors who don't do a surgical residency, but are trying to do surgery. Figure that one out.

 

[mddo2b]

So why do I keep hearing that Ob/Gyns are not surgeons? Was it an Ob/Gyn who did the first lap appy?

Please be honest.

Thanks.

Heres my 2 cents....they say they are surgeons but when they get into trouble or have complications drop the pt on the surgeons.
They say they specialize in womens medicine, but all they do is refer their pts to real medical doctors
I guess the problem I have is they they know alot about a few things but act like they are experts in everything. There is a reason why IM is 3 years and Surgery is 5 years...you cant combine the 2 into a 4 year residency and act as if you are an expert.

 

[Tenesma]

OB/GYNS are great obstetricians (ie: they know how to deliver a baby) and great gynecologists (ie: they understand disease of the female pelvis/vulva).... nobody ever said they were general surgeons or cardiologists or internists....

my only beef is with those OB/GYNS who think because they know how to cut open a uterus (to be honest i think a med student can figure that one out too) that they are all of a sudden accomplished abdominal surgeons....

but for the most part the OB/GYNs I have worked with know their job, do it well and also know when and who to call for help.... and that right there is a sign of confidence and strength!!!

for the original poster: it looks like you are still very confused about what you want to do with your life!!!! neuro/ob/psych or anesthesia??? phewwww.... that is quite the dilemma

 

[doc05]

So why do I keep hearing that Ob/Gyns are not surgeons? Was it an Ob/Gyn who did the first lap appy?

Please be honest.

Thanks.

based on your question, I can only assume you haven't done your obgyn rotation yet. once you've worked among them you'll understand why:

they do operate, or at least try to. but they're technically very sloppy. not a surprise, since they learn not from accomplished surgeons, but from obgyns.

they're scope of practice in the OR is very limited. and their time in the OR is also a minor component of a 4-yr residency.

not a bad specialty if it's what you like, but a poor choice if you really want to be a surgeon.

 

[Leukocyte]

Thank you all for sharing your thoughts.

But there is one thing that puzzles me. There are many fields out there that are analogous to Ob/Gyn in that they:
1) have a medical/surgical scope,
2) are not trained by general surgeons,
3) have a limited scope in the OR.
Such fields include Urology, Opthalmology, ENT....Why is it that I never hear jokes about Urologists, Opthalmologists, ect...not being surgeons, while Ob/Gyns always get hammered with all the bad rap?

The other question is.....What if (AND THAT IS A BIG IF) a general surgeon nicks a fallopian tube during a difficult lap appy, would he/she call an Ob/Gyn to help him/her in the OR?

Thanks Again.

 

[Bo Hurley]

Blah, blah, blah...it seems like every "surgeon" has a gripe about other specialties. Some don't consider ob/gyns as "real" surgeons, others don't consider opthalmologists as "real" surgeons, etc. Who really cares if some overworked, walking cliche of a "surgeon" or whoever thinks another specialist in not a "real" surgeon.

That being said, some doctors still don't think of surgeons as "real" doctors/physicians. Why do you think they still call surgeons in England "Mr." instead of "Dr."? But again, who really cares. Just do your job, take care of your patients, get your $$$, and just be thankful for everyday you're not named in a malpractice suit.

 

[pikachu]

urology does 2 years of general surgery before continuing into the specialized urology training. ENT does one year of GS. Then both of them spend the majority of their time operating during the remainder of their residency. Ob-Gyns divide their time between the clinic, delivery room and OR and do far less operating during the course of their residency. This may not be a problem as they are trained to do just a few procedures and do them adequately (e.g., C-section or hysterectomy). However, as a few people mentioned, in the case of complications or unexpected events, I would much rather be in the hands of an experienced general surgeon. I also take issue with the gyn-oncologists who, after a three year fellowship, not only do some of the riskiest surgical procedures (pelvic exenteration, anyone?) on their patients but also give chemo. talk about overstepping your bounds. i was once told by one of these guys that a 65 year old overweight lady s/p radical hysterectomy and pelvic lymph node dissection for uterine cancer was "not hypercoagulable."

 

[VentdependenT]

Gynonc fella I worked with in Detroit was one of the most wicked surgeons I've met.

 

[Leukocyte]

I also take issue with the gyn-oncologists who, after a three year fellowship, not only do some of the riskiest surgical procedures (pelvic exenteration, anyone?) on their patients but also give chemo. talk about overstepping your bounds. "

I respect your opinion, but, come-on guys, please,...... give me a break. Who else is best qualified to take care of females with gyn cancer. And 3 years of intensive fellowship training is not enough?!!! That is 7 years in total focusing on only one region of the body!!!!

Please do not tell me that any other surgeon in his/her right mind would even RISK attempting to operate on a female with gyn cancer. You know, there is a whole pack of lawyers out there waiting for us to make the smallest error.

Patient: Now I have urinary incontinence
Lawyer: Who did your surgery
Patient: A surgeon
Lawyer: A GynOnc
Patient: No, but a famous surgeon
Lawyer: BINGO $$$$$$$$$$$$$$$$

 

[pikachu]

1) to Vent - some of the Gyn Onc surgeons, especially the older ones, are GS (not Ob-Gyn) trained. I'm not saying that Ob-Gyn residency excludes you from being a great surgeon at all, however I tend to think that gynecologic surgery (oncologic and otherwise) should be a subspecialty in itself, and an offshoot of general surgery (more like urology), rather than an offshoot of ob-gyn.

2) to Leukocyte - Gyn cancer is best treated like many other cancers - by a multidisciplinary team with specialists in medical, surgical, and radiation oncology. I definitely think that the surgeon in question should specialize in gynecologic malignancies; however, i don't think that this same surgeon should be managing an intensive chemo regimen as well.

 

[LuckyMD2b]

...That being said, some doctors still don't think of surgeons as "real" doctors/physicians. Why do you think they still call surgeons in England "Mr." instead of "Dr."? ...

Acutally the use of the term Mr. to address surgeons in Britain has historical significance and has nothing to do with them not being real doctors. Furthermore we should distinguish between a docotor (MD, PhD, DMD, EdD), and a physician (MD or DO).

"In the UK and some other places, male surgeons are distinguished from physicians by being referred to as Mister. This tradition has its origins in the 18th century, when surgeons were barber-surgeons and did not have a degree (or indeed any formal qualification), unlike physicians, who were doctors with a university medical degree. By the beginning of the 19th century, surgeons had obtained high status, and in 1800, the Royal College of Surgeons (RCS) in London began to offer surgeons a formal status via RCS membership. The title Mister became a badge of honour, and today only surgeons who hold the Fellowship of one of the Royal Colleges of Surgery are entitled to call themselves Mister, Miss, Mrs or Ms."

In contrast, American physicians and surgeons are always addressed as "Doctor."

 

[Winged Scapula]

Moving to Ob-Gyn forum...

 

[MeowMix]

I heard a great talk on pelvic surgery recently by a gyn/onc. After the talk, she said that she thought it would be better to split the residency into different programs for those who wanted to deliver babies, and those who wanted to primarily do non-obstetric surgery. She had a lot to say about the problems inherent in trying to teach people everything during 4 years. She was quite clear that she will never deliver a baby again because she's out of practice and not good at it, but she loves doing gyn surgery. She did a long fellowship after residency and has done many, many surgical procedures.

If I needed a gyn surgeon, I would go to someone like this every time over any other kind of surgeon.

it was also a great learning opportunity for me about being very clear with your patients (and yourself) about what you are good at and what you like to do, and sending them to someone else when you don't have the skills to do what they need.

 

[Apollyon]

1) to Vent - some of the Gyn Onc surgeons, especially the older ones, are GS (not Ob-Gyn) trained. I'm not saying that Ob-Gyn residency excludes you from being a great surgeon at all, however I tend to think that gynecologic surgery (oncologic and otherwise) should be a subspecialty in itself, and an offshoot of general surgery (more like urology), rather than an offshoot of ob-gyn.

Back when I was a student (all those years ago), the Ob/Gyn program where I was doing my rotation had just gotten a new PD, who was a stellar gyn onc surgeon (after having been a commando in the Israeli army - really!). This guy was a master. However, the residents didn't operate with him until they were 3rd years, so their crappy surgical skills were now habit. I did Ob/Gyn before surgery, and was amazed at seeing how much more graceful and skillful the general surgeons were. There were (thankfully only) a few Ob/Gyn's that I would certifiably call butchers.

 

[fourthyearmed]

Ob?Gyn is a surgical specialty also. they only have three procedures, though...
1. Cut right ureter
2. Cut left ureter
3. Cut both ureters

What about -
Puncturing the aorta with a varies (sp?) needle while trying to do a tubal? Fortunately the surgeons came to the rescue.

 

[daisygirl]

Back when I was a student (all those years ago), the Ob/Gyn program where I was doing my rotation had just gotten a new PD, who was a stellar gyn onc surgeon (after having been a commando in the Israeli army - really!). This guy was a master. However, the residents didn't operate with him until they were 3rd years, so their crappy surgical skills were now habit.

This is so true. The gyn onc surgeons at my school are incredible.

The residents at my school also don't operate with the gyn onc surgeons until they are at least R3, and even they rarely go into the OR with the gyn onc surgeons. It is usually the R4s that operate with the gyn onc surgeons.

Let's just say that the residents where I am abhor their time on gyn onc since they are eaten alive in the OR. It is ashame though- you cannot really fault the residents for the fact that their surgical skills are so poor.

 

[Global Disrobal]

Leukocyte:

Do Ob-Gyn if you want a good variety of primary care and surgery to balance out your practice.

Surgeons are better than Ob-Gyn's technically because all they do is operate (for the most part, except for the office visits here and there), have better skills handed down from their seniors, and this should be the option for you if you rather cut out the primary care and operate all the time, which can be great for certain people.

As for the myriad of lovely comments regarding ureters, aorta's, etc., it appears that the surgeons will always be surgeons. Yes, some OB-GYN's have complications, namely because they are stupid enough to not take their time, ask for help, or keep their skills update. However I also think that its naive for the poster to think that Gyn Onc should be a subset of GS. I would love to see the GS resident come into Colpo clinic as a fellow and see his first cervix, do his first pap, and etc. Gyn Onc is not just being in the operating room cutting, as many surgeons like to do.

Lastly, should I start my stories or tales regarding general surgeons? The genius surg onc who decided to go after a pelvic leiomyosarc, or the overworked GS who bovied through the bowel because he was sleep, etc.

 

[juddson]

Great!!! I have this kind of bull$hit to look forward to.

judd

 

[Leukocyte]

Leukocyte:

Do Ob-Gyn if you want a good variety of primary care and surgery to balance out your practice.

Surgeons are better than Ob-Gyn's technically because all they do is operate (for the most part, except for the office visits here and there), have better skills handed down from their seniors, and this should be the option for you if you rather cut out the primary care and operate all the time, which can be great for certain people.

As for the myriad of lovely comments regarding ureters, aorta's, etc., it appears that the surgeons will always be surgeons. Yes, some OB-GYN's have complications, namely because they are stupid enough to not take their time, ask for help, or keep their skills update. However I also think that its naive for the poster to think that Gyn Onc should be a subset of GS. I would love to see the GS resident come into Colpo clinic as a fellow and see his first cervix, do his first pap, and etc. Gyn Onc is not just being in the operating room cutting, as many surgeons like to do.

Lastly, should I start my stories or tales regarding general surgeons? The genius surg onc who decided to go after a pelvic leiomyosarc, or the overworked GS who bovied through the bowel because he was sleep, etc.

Thanks for the encouraging words Global Disrobal!!!

 

[Jamier2]

Was it an Ob/Gyn who did the first lap appy?

Please be honest.

Thanks.

You're thinking of Ephraim McDowell, who did the first successful laparotomy (to remove a very large ovarian cyst - in his living room - the woman lived something like 20 years after the operation). This happened here in Kentucky, and the woman was from the county next to mine.