Why you chose Obgyn despite stressful Lifestyle. Any regrets?

[elevation1]

I'm an MS3 strongly considering Obgyn
-> The main things holding me back (and making me consider a different medicine/surgical specialty like Ophtho) is the relatively more stressful lifestyle and schedule in Obgyn.

1) Any advice or words of wisdom?
2) For upper year residents, fellows, and staff: any regrets? would you have maybe chosen differently if you could go back?

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[finnasvaret]

I'm an MS2 mostly likely going into Ob/gyn and also interested in how anyone will answer these questions (particularly #2) - I'd be interested in knowing what you would have done differently in medical school before applying for or starting residency.

 

[hypotheticalhifive]

First year resident in OB/GYN: I'm really happy having picked OB. My advice would be to really look at yourself and ask if you'd be happy with OB/GYN. I didn't want to hit 80 hours every week in residency, so I listened really closely to that during interviews. If residents say "it's like this everywhere" they probably work a lot of hours (probably >80). My program is very conscious about that, but its obviously not as little as ophtho. Second, when you tell people you want to do OB/GYN, you'll be met with a lot of scoffs so know that's a possibility.

In terms of medical school, don't bother doing OB/GYN specific things. You'll spend your whole life doing that. Branch out and explore. I did a 4th year rotation in ENT and it has actually proven to be helpful. In terms of applying, I would "play the game" and sweet-talk programs. Rotate and get letters in areas you want to end up geographically. Know that it's hard to match outside your general geographic location (particularly the Midwest) so be prepared for that.

Good luck!

 

[malisa]

This popped up on my Facebook as a thread so I thought I would comment. I'm a new aOB/Gyn attending been in practice 6 months now. I joined a private practice group that shares call with another group for one hospital.

Optho is way different that OB. So I think you need to decide what you like the most and what you would be happy doing all the time. I had no doubt I wanted to do anything besides OB/Gyn once I was finishing up medical school. But if you aren't sure that is exactly what you want to do I would really concentrate on which surgeries, patients, practices you think you like.

Why I liked OB/Gyn before going into it because I thought it would be nice to focus on women's health and not need to know a little bit about everything such as family medicine. I liked surgery but not necessarily incredibly long surgeries. And well delivering babies is amazing and I still think it's amazing (hope this doesn't change). Now I still like my choice I don't regret it. It is stressful but I think any new attending is stressed going from residency to being in charge. Yes some really ****ty things can come into Labor and Delivery that are emergencies so I'm still on edge when on call because you never know what you will be called for but I'm also new so this will hopefully ease up some. There are lots of different practice options for OBs now that have better lifestyles. Most are in larger call groups so you aren't on call every night and some people are OB hospitalist so they work their set shifts and that's it. You can look for whatever style suits you best when you apply for jobs there are tons of jobs out there, they predict that OBs will be very much in need and in shortage in the next 10 years.

Residency I think sucks no matter what for OB. You can try to get a feel for it when you interview but yes you will work long hours. Most everyone has went to night float so you get to work nights for weeks at a time or a few still do traditional call. Also you learn to manage the board on L&D and once in practice you often aren't just sitting on OB all day waiting for triages to come in or waiting for people to deliver. You are seeing patients in office and trying to time when you will leave to go to the hospital.

Anyways PM me if you have more questions. I don't regret my choice because like I said I didn't see myself doing any other specialty I guess it would be different if I had two choices I liked equally.

 

[pimmar]

Hi I hope this helps I am 10 years out of residency and don't regret my decision one bit.i am in a group of 5, love that every day is different it's all a mix between office, l&d and surgeries, and the beauty of it is the continuity of care. You will see these women for many years to come take care of their mothers, sisters, nieces, even grandmothers. Most patients are very loyal and if they trust you and you take good care of them they will be with you for a long time and you build a nice following and reputation in your community. Practicing in a larger group allows plenty of family time and time to enjoy things if you give yourself the time...you have to be able to sometimes say no and that's ok it comes with time. I would not change a thing. Good luck! And finally it's a calling, it chose me. Just listen to your gut. Life outside residency is way better. Residency just prepares you to deal with the unexpected and with the sickest and worst cases you may ever see.

 

[anonperson]

I'm an MS3 strongly considering Obgyn
-> The main things holding me back (and making me consider a different medicine/surgical specialty like Ophtho) is the relatively more stressful lifestyle and schedule in Obgyn.

1) Any advice or words of wisdom?
2) For upper year residents, fellows, and staff: any regrets? would you have maybe chosen differently if you could go back?

I would take these concerns very seriously. You have to think about the situation not just 10 years from now but also when you are in your 50s, 60s etc.

OB GYN has a higher burnout rate than other professions on average. Couple that with calls that can be particularly busy and physician compensation that is unfairly low when compared to other specialties and that can be a recipe for job dissatisfaction.

The usual conventional wisdom has been, suffer early on and then transition into a gyn only practice. I think in certain regions that may be possible but in larger areas where there are more fellowship trained people, that is getting a bit more challenging.

This is coming from someone who has completed residency and is at the tail end of fellowship

 

[Dr G Oogle]

I'm an MS2 mostly likely going into Ob/gyn and also interested in how anyone will answer these questions (particularly #2) - I'd be interested in knowing what you would have done differently in medical school before applying for or starting residency.

I think it depends on your career goals. There are certain things only an obgyn can do, most obviously the OB part. While there are FM people who do that, realistically they cannot offer full spectrum obstetrics including surgical management.

Gyn Onc and REI you can only do as obgyn though there are parallel specialties in surgery and urology. Urogyn can be done through urology or obgyn. And " women's health" like office gyn can be done through IM and FM both of which are less stressful.

I chose obgyn knowing I wanted to be a subspecialist surgeon and do 0% ob, and still do not regret it as I'm going through my fellowship. I think it's a great speciality with a huge amount of flexibility that the other specialties I mentioned just don't have. For instance if as a gyn onc you just wanted to focus on cervical dysplasia (not even cancer) you could do that. You can't really do that in surgical oncology. You really have to decide what kind of stuff you find interesting In school and understand that obgyn training is going to be grueling and it is surgical. I've worked with more than a few residents who didn't understand that going in and were miserable and after residency just did office gyn or office OB.

 

[KanyeWes]

I think it depends on your career goals. There are certain things only an obgyn can do, most obviously the OB part. While there are FM people who do that, realistically they cannot offer full spectrum obstetrics including surgical management.

Gyn Onc and REI you can only do as obgyn though there are parallel specialties in surgery and urology. Urogyn can be done through urology or obgyn. And " women's health" like office gyn can be done through IM and FM both of which are less stressful.

I chose obgyn knowing I wanted to be a subspecialist surgeon and do 0% ob, and still do not regret it as I'm going through my fellowship. I think it's a great speciality with a huge amount of flexibility that the other specialties I mentioned just don't have. For instance if as a gyn onc you just wanted to focus on cervical dysplasia (not even cancer) you could do that. You can't really do that in surgical oncology. You really have to decide what kind of stuff you find interesting In school and understand that obgyn training is going to be grueling and it is surgical. I've worked with more than a few residents who didn't understand that going in and were miserable and after residency just did office gyn or office OB.

My concern is matching into obgyn and not matching into a fellowship. I 100% absolutely do not want to practice obgyn w/o a fellowship.

Any thoughts on this?

 

[Dr G Oogle]

My concern is matching into obgyn and not matching into a fellowship. I 100% absolutely do not want to practice obgyn w/o a fellowship.

Any thoughts on this?

I will give you the same advice someone gave me when I was applying. Do not apply for a specialty with the sole goal of getting a fellowship. The sub specialties in obgyn are very competitive (Mfm, fpmrs, oncology and REI), MIS and family planning are not accredited and odds are you will also have to do OB to cover your salary or take a pay cut. That may change in the future but not the near future. If you do not want to take the risk of not marching a fellowship and practicing as a general obgyn, I would recommend a different specialty choice. For instance if you really like oncology, fpmrs or infertility you could more easily incorporate that into your practice as a general urologist than a general obgyn, with the obvious caveat that the majority of your patients will be men (except in fpmrs, which is not competitive out of urology)

 

[KanyeWes]

I will give you the same advice someone gave me when I was applying. Do not apply for a specialty with the sole goal of getting a fellowship. The sub specialties in obgyn are very competitive (Mfm, fpmrs, oncology and REI), MIS and family planning are not accredited and odds are you will also have to do OB to cover your salary or take a pay cut. That may change in the future but not the near future. If you do not want to take the risk of not marching a fellowship and practicing as a general obgyn, I would recommend a different specialty choice. For instance if you really like oncology, fpmrs or infertility you could more easily incorporate that into your practice as a general urologist than a general obgyn, with the obvious caveat that the majority of your patients will be men (except in fpmrs, which is not competitive out of urology)

Ty.

This is my general thinking. I am very nervous for general obgyn as the litigation is just too much to swallow. Hence my desire to subspecialize.

I don't think I am competitive for uro though. Thank you for the advice. The sub specialties are amazing. But General obgyn not so much.

 

[Dr G Oogle]

Ty.

This is my general thinking. I am very nervous for general obgyn as the litigation is just too much to swallow. Hence my desire to subspecialize.

I don't think I am competitive for uro though. Thank you for the advice. The sub specialties are amazing. But General obgyn not so much.

If litigation is more your concern rather then interest then fret not. That is bound to change in the future and while going through a lawsuit is far from a pleasant experience if you are an employed physician you face very little financial risk from a lawsuit, the place where you are at most risk is if you are in small or solo practices and there are fewer and fewer of those.

 

[KanyeWes]

If litigation is more your concern rather then interest then fret not. That is bound to change in the future and while going through a lawsuit is far from a pleasant experience if you are an employed physician you face very little financial risk from a lawsuit, the place where you are at most risk is if you are in small or solo practices and there are fewer and fewer of those.

I keep hearing this from obgyns. But do hospitals pay for punitive damages? Is that the standard or does that vary based on contract?

 

[anonperson]

My concern is matching into obgyn and not matching into a fellowship. I 100% absolutely do not want to practice obgyn w/o a fellowship.

Any thoughts on this?

Then you probably shouldn't do ON GYN to be honest. If you have the scores, do Urology or ENT. Reasonable training length with much better pay.

Or match into a major academic residency (think UTSW, Hopkins, UCLA, etc) where you are all but guaranteed the Fellowship of your choice.

OB liability is a real thing. ON GYNS are sued. It's the nature of the beast. Not a matter of if, but just when. If that's bothersome to you, don't do a procedural residency. Psych, FP etc have much lower malpractice rates and risk.

Getting a job as an ON GYN sub specialist can also be a bit challenging. Certain areas are saturated (southern California, NYC) and the jobs are not ideal if they are even available to begin with. I took a job in a desirable area but I'll be doing general OB GYN as well in addition to urogynecology for now. If I want to live in the mid west or a more rural area, then I could swing a pure urogynecology job.

 

[KanyeWes]

Then you probably shouldn't do ON GYN to be honest. If you have the scores, do Urology or ENT. Reasonable training length with much better pay.

Or match into a major academic residency (think UTSW, Hopkins, UCLA, etc) where you are all but guaranteed the Fellowship of your choice.

OB liability is a real thing. ON GYNS are sued. It's the nature of the beast. Not a matter of if, but just when. If that's bothersome to you, don't do a procedural residency. Psych, FP etc have much lower malpractice rates and risk.

Getting a job as an ON GYN sub specialist can also be a bit challenging. Certain areas are saturated (southern California, NYC) and the jobs are not ideal if they are even available to begin with. I took a job in a desirable area but I'll be doing general OB GYN as well in addition to urogynecology for now. If I want to live in the mid west or a more rural area, then I could swing a pure urogynecology job.

Thanks. That's what I also thought.

 

[Dr G Oogle]

Then you probably shouldn't do ON GYN to be honest. If you have the scores, do Urology or ENT. Reasonable training length with much better pay.

Or match into a major academic residency (think UTSW, Hopkins, UCLA, etc) where you are all but guaranteed the Fellowship of your choice.

OB liability is a real thing. ON GYNS are sued. It's the nature of the beast. Not a matter of if, but just when. If that's bothersome to you, don't do a procedural residency. Psych, FP etc have much lower malpractice rates and risk.

Getting a job as an ON GYN sub specialist can also be a bit challenging. Certain areas are saturated (southern California, NYC) and the jobs are not ideal if they are even available to begin with. I took a job in a desirable area but I'll be doing general OB GYN as well in addition to urogynecology for now. If I want to live in the mid west or a more rural area, then I could swing a pure urogynecology job.

Anonperson curious is your job in PP or academics? Are you having to do OB or just general gyn?

 

[finnasvaret]

I will give you the same advice someone gave me when I was applying. Do not apply for a specialty with the sole goal of getting a fellowship. The sub specialties in obgyn are very competitive (Mfm, fpmrs, oncology and REI), MIS and family planning are not accredited and odds are you will also have to do OB to cover your salary or take a pay cut. That may change in the future but not the near future. If you do not want to take the risk of not marching a fellowship and practicing as a general obgyn, I would recommend a different specialty choice. For instance if you really like oncology, fpmrs or infertility you could more easily incorporate that into your practice as a general urologist than a general obgyn, with the obvious caveat that the majority of your patients will be men (except in fpmrs, which is not competitive out of urology)

is there any cohesive push for minimally invasive surgery or family planning to become accredited soon? but if a physician does an unaccredited fellowship v. accredited one, the unaccredited one will allow them to expand their skill set and knowledge base and allow them to see patients with specific problems, even though it may not translate to a higher salary/formal qualifications?

 

[Dr G Oogle]

is there any cohesive push for minimally invasive surgery or family planning to become accredited soon? but if a physician does an unaccredited fellowship v. accredited one, the unaccredited one will allow them to expand their skill set and knowledge base and allow them to see patients with specific problems, even though it may not translate to a higher salary/formal qualifications?

For MIS there is a feeling that it may become an accredited field in the next decade or so. However, MIS is essentially a fellowship in surgical gynecology and they learn medical and surgical management of all of the conditions traditionally treated by a general ob/gyn (AUB, endometriosis, etc.), the idea behind MIS fellowship is that roughly 20% of general obgyns in practice are considered "high volume" for which the definition is at least 12 hysterectomies/year, which is not nearly enough to maintain surgical skills. So with MIS trained surgeons joining groups, other physicians can shunt their surgical patients to this person who then maintains a high surgical volume and skill set. That means that the others in the group will have a significant decrease in surgical volume or complete lack of it. Do you need an MIS fellowship for this to occur, no. Obgyn residents get more than sufficient training in MIS during residency to join a group right out of the gate and become the "surgeon" of the practice. The problem is this doesn't usually happen with someone who has not completed a fellowship because older partners in private practice will not want to give up their surgeries and academic programs generally want someone with fellowship training. Hence the fellowship was created to generate these high volume general gynecologic surgeons. In order for MIS to be accredited it would basically relegate general ob/gyn to obstetrics and office gyn, and doing surgeries in rural and less desirable living areas, and I don't see that happening anytime soon, because there is a huge shortage of ob/gyns and to limit surgical practice to only fellowship trained surgeons would severely limit access to care. However, the MIS fellowship still brings significant value and makes you a very marketable person, and yes, if you did an MIS fellowship you would be more likely to see patients with the pathology that you treat.

FP is a little different (though I have very little knowledge of FP so if anyone else wants to chime in, feel free). FP is 2 years and as I understand it, you also get a Masters degree in public health or epidemiology, so you are essentially being groomed for academic practice and a productive research career. I don't think there is much value in doing an FP fellowship and going into private practice, because the majority of your practice will still be general ob/gyn. Even in academics I think FP still do L&D unless they have research funding or have negotiated this out of their contract, usually with a significant pay cut because they will not be able to generate the same RVUs as a general ob/gyn or other subspecialist.

 

[anonperson]

Anonperson curious is your job in PP or academics? Are you having to do OB or just general gyn?

PP.
Doing everything for now.

 

[aggie08]

I'm just finishing up residency, but I have no regrets. I chose a program that I would feel supported at, since I had chosen to start my family as a medical student. I have worked a LOT the past four years, but honestly I love what I do and with very specific attention to priorities have managed to find somewhat of a balance. Again, choosing a program carefully is extremely important to this.

For practice I have chosen a large call group and hope this will allow me to continue with my desired balance. I hope to work my tail off and make more money when my kids are older, but for now I'll take lower compensation in exchange for more time with my children.

 

[Doctor ob]

This popped up on my Facebook as a thread so I thought I would comment. I'm a new aOB/Gyn attending been in practice 6 months now. I joined a private practice group that shares call with another group for one hospital.

Optho is way different that OB. So I think you need to decide what you like the most and what you would be happy doing all the time. I had no doubt I wanted to do anything besides OB/Gyn once I was finishing up medical school. But if you aren't sure that is exactly what you want to do I would really concentrate on which surgeries, patients, practices you think you like.

Why I liked OB/Gyn before going into it because I thought it would be nice to focus on women's health and not need to know a little bit about everything such as family medicine. I liked surgery but not necessarily incredibly long surgeries. And well delivering babies is amazing and I still think it's amazing (hope this doesn't change). Now I still like my choice I don't regret it. It is stressful but I think any new attending is stressed going from residency to being in charge. Yes some really ****ty things can come into Labor and Delivery that are emergencies so I'm still on edge when on call because you never know what you will be called for but I'm also new so this will hopefully ease up some. There are lots of different practice options for OBs now that have better lifestyles. Most are in larger call groups so you aren't on call every night and some people are OB hospitalist so they work their set shifts and that's it. You can look for whatever style suits you best when you apply for jobs there are tons of jobs out there, they predict that OBs will be very much in need and in shortage in the next 10 years.

Residency I think sucks no matter what for OB. You can try to get a feel for it when you interview but yes you will work long hours. Most everyone has went to night float so you get to work nights for weeks at a time or a few still do traditional call. Also you learn to manage the board on L&D and once in practice you often aren't just sitting on OB all day waiting for triages to come in or waiting for people to deliver. You are seeing patients in office and trying to time when you will leave to go to the hospital.

Anyways PM me if you have more questions. I don't regret my choice because like I said I didn't see myself doing any other specialty I guess it would be different if I had two choices I liked equally.

Hello Dr
Thank you for your helpful feedback
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