So...I love my OB rotation! Everything about this is fun (clinic, critical care, surgery, *babies being born*). It's a lot of hours, but I'm having fun doing it, and look forward to going back again the next day.

But... I should know better. I would hate being sued all the time, getting up in the middle of the night (exciting now, probably not when I'm 45), and being away from my family SO much. Right now, I'm thinking neonatology-perinatology, peds anesthesia or general peds might be a good fit. FP + OB seems like it is becoming extinct, and I'm not as interested in the geriatrics end of FP .

Any sage advice, ladies? (If I did a subspecialty, it would be Maternal-Fetal Medicine.) How different is MFM from neonatology?

When you're holding the retractor during C-sections, after the baby is born, where do you want to be? Do you want to deliver the placenta, or do you want to resuscitate the baby?

I loved OB too, because I like women's health, I like the variety, and I love babies. But really, I love the babies (and all kids up to teenagers) way more.

FP + OB-definitely not extinct! You can have the best of both worlds, and the babies keep your practice from turning geriatric:)

Seriously though, if you really enjoy the surgeries, OB is a better fit. I hated the surgeries but loved deliveries, that's why i chose what I did.

I agree 100% with what the above said. I absolutely LOVED my OB/GYN rotation. I even considered it for a career (for a split second). But I really like babies and would much rather be resuscitating than stitching. Yes it is a lot of fun but the excitement of delivering wears off for a lot of people.

There's not only a trend of FPs going away from obstetrics but also OB/GYNs from going away from obstetrics too. The appeal wears off.

I think most of the geriatric patients go to internal medicine. One of the major advantages of Family Practice that I can see is that it caters to families, particularly young families. If you work in areas that are less populated, you can do OB and peds and medicine too.

I think I was told something similar to what BE said. I thought it was generally pretty predictive, too. I liked vaginal deliveries, enjoyed delivering babies and always preferred following baby to the warmer. Despite the fact that I loved surgery in general, I avoided c-sections like the plague. Eh, just not into that.

Of course, the first lap chole was cool. The second was ok. The third was starting to get boring and my attention wandered. And I realized that as much as I liked surgery, it was not meant for me to be a surgeon. I deliver a (live) baby or two every year and that's plenty. (I deliver far more miscarriages unfortunately, which are the complex and tragic opposite end of the spectrum)

As mentioned above, it is only the surgery or is it also procedures that you enjoy? I realized it was the latter for me, and ended up in a procedure-heavy specialty. (I rock-paper-scissored a partner last night for a tube.)

Good luck, and you still have some time.

Dude, if YOU want a life do NOT do ob/gyn period. It may be fun NOW while you are a medical student but think about the "whole picture" once you are older, will you want to go in at all odd hours of the night/weekends/holidays and deliver babies? sued because the "baby is not perfect", etc. I mean if there is NOTHING else you enjoy, knock yourself out you can always later just do GYN which many ob/gyns end up doing anyways.....

Popcorn - would you mind sharing your procedure-heavy specialty you chose instead?

+1 on the OP's post. I am rotating as a first-year in a community medicine class with an OB, and I absolutely love this early exposure, but it is really reinforcing OB again for me (what I originally thought I wanted prior to med school). I am loving the variety of office OB check-ups etc. + deliveries + C-section surgery + GYN + GYN surgery. It probably also is helping that the OB I am assigned to as a preceptor won awards for teaching when he was a resident, so he is pretty much the Yodah of teaching. It's an amazing experience. I didn't think I was going to like surgery - I LOVE IT. I didn't think I wanted to be procedure-heavy. I DO. Surprise! OB seems a good fit, but I wouldn't be on this board if I didn't want to be a mom too....

Southernmd - see if you can rotate with or observe an OB/GYN residency. I think it gives you a good idea of how the residency changes you. I have friends who went into OB/GYN. It changes people. I'm not sure if its the rigors or what but the women I know go into it normal, fun-loving, decent human beings and emerge as hardened, aggressive, and seemingly miserable.

That being said, you are early in medical school and have more than enough time to figure it out. The world DOES still need OB/GYNs.

I thought everybody knew what I do... I'm the jack-of-all-trades, master-of-none, the heart attack, gunshot, ear-infection-at-3-am-doc... Master of airway, resuscitation, and crashing, krumping badness. And a whole lot of boring not-critical stuff, too.

Why, Emergency Medicine!

It's not as procedure-heavy as some, but more than most.

(And Efex, I totally cracked up at your use of "Dude." I thought we were the only ones who used that in common conversation... although usually it's "Dude, what were you thinking?" "Dude, just how much coke did you do??" "Dude... you put What, Where???")

Oh, and asunshine, don't pick OBGYN.

Thank you.



And thank you, dude.

There is hope for having a life and being an OB/GYN....
google search Laborist

now I do believe that most laborist positions require experienced OBs, but if you contract at a hospital that uses them, so many of those extra hours are taken care of. Whether this will be as popular as hospitalists has yet to be seen, but I think it will be a great boon to the profession, especially in my home state, there is a shortage of OBs.

I keep this in mind because I think I may really like OB too...but don't have the rotation for another month or so.

I wish I could tell you not to do Ob/Gyn... I wish I had found a specialty I loved more. But here I am, an OB/Gyn.

Though I haven't posted in a million years, I had to when I saw your post. My own road into medicine was complicated, but the decision to do OB much less so. I completed my residency in 2007 and spent two years in a practice that was a bad match for me. I left in September and have been a SAHM the past six months while my husband was mobilized (Army) and my oldest son diagnosed with Crohn's disease. Oh, yeah, I also had my oral boards in January and passed, thank God!

I will be going back to work in May, part time as a staff attending at the hospital where I was practicing. I'll be working two 12 hr shifts a week for a set salary and get an hourly rate for any additional work. No office! No call!

MFM is not anything like neonatology. MFM is obstetrics. It's a 3 yr fellowship after an OB/Gyn residency (though ACOG is considering a fast track option for the future). You would take care of high risk patients (lupus, complicated diabetes, difficult twin pregnancies+), perform and supervise ultrasounds, etc. Some choose to only do consults and u/s, some prefer to have patients in their care, and will do deliveries as well.

I would be happy to talk with you off forum in more detail. Residency sucks no matter what you do. It's what you want to do all day, every day that matters. PM me if ya want!

Linda

I am not the OP here, but I have been in a preceptorship for a bit in OB/GYn with a doc who is letting me learn A LOT hands-on, and I first assisted a c-section today....And he said I did really well! ARG - why do I have to love this so much already?

Please...tell me again? Ob/Gyn...I won't be happy? Are we sure about this? ??? I think I might be in love with this specialty, and it might not be puppy love.

Sorry to hijack the thread, but I feel the OP's pain here. I love this specialty so far! Everything about it! Please tell me what other specialty I can channel this to - I heart surgery/clinic/variety!

Thank you, Eema! You really are a hero for surviving all of that. I'm glad you found a gig that works for you.

To be totally honest, I probably would like MFM better than neo (I was an ICU nurse and really like the complicated stuff....and have this creepy obsession with ultrasounds). But, the bottom line seems to be that peds is a better lifestyle, even if I like OB more.

Love OB too. A very smart Cardiac anesthesiologist talked me out of it. I am currently in my last year of a FP residency with heavy emphasis on OB. Still love OB, but I get to see my peds, Geriatric and male patients too. I will never forget just a few months ago scrubbing on a c-section (first assist not primary) and breaking scrub right after because the baby was krumping. Great feeling being the jack of trade and master of none. And yes, FP has its fair share of geriatrics, just what you are comfortable managing.

I am currently a third year medical student. I have read this thread off and on as I have had the neonatology/OB debate with myself.

I am very interested in women's health and babies. I was wondering if anyone has heard of family practice w/ OB running a primarily women's and children practice. Do you think this type of practice would be practical and sustainable?

Also, how does the cost of malpractice insurance and the need to find an OB as back up effect the reality of going into FP w/ OB?

medimom, I think your idea is fantastic! I am an ob/gyn and would love a FP in our practice. There are so many women who use their ob/gyn as their primary care physician (we aren't really trained in primary care at all, so I am not sure why this trend seems to exist)and would be better served if someone trained in primary care was in the practice while the ob/gyns stick to more surgical gyn issues. While this arrangement might not work well with some ob/gyns, it's been my experience so far that most would be more than happy with the benefits this practice set-up would afford. It might be a little difficult to find an 'ideal' practice like this for you though, it is kind of a radical idea but you would be wise to pursue it. Maybe you could brainstorm with some of the ob/gyns you work with now during your residency to see what their opinion on the matter is. Another option is for you to do a year-long 'OB fellowship' for family practice physicians. Many smaller communities don't have any ob/gyns and their family practice physicians do all their own c-sections and even some general surgery cases (appys, choles, etc). You might want to seek out the ob fellowship route where you can learn to perform c-sections. Good luck!

I have heard that many FP's do kind of "specialize" in their preferred patient population. So you may just do women health and lets say pediatrics, others choose to do only geriatrics and adults, etc.

I think the more deliveries you do, the more your practice becomes about moms and babies. I have a very female, OB and pedi oriented practice. I am also the only one in my office putting in IUD's, and I could have been the one doing Implanon but I turned it down for a variety of reasons. I have my share of male patients and menopausal women (my least favorite subset) but I have definitely skewed my practice b/c of OB.

Sorry- late post but had to chime in. Fam Med with OB is not extinct especially if you do academic FM with a residency program. Most FM docs don't do OB because it is not something they enjoy-- they just drudge through their OB rotations in residency so that they can set up their practice the way they want. I'm sorry to offend anyone, but I don't understand why if you like OB and Peds then why you wouldn't do FM. If you are in practice long enough then you get to deliver the babies of the patients that you delivered as babies. In FM you get to do a lot of office gyn (EMBs, IUDs, paps, colpos, implanon, etc.)-- and most FM docs set up their practice the way they want- OB heavy, geriatrics heavy, etc. I had a colleague who trained with me in FM and then moved to rural Washington state where she started to do C-sections with a local OB since he was transitioning into retirement. Then she got tired of it and moved to the East Coast and did strictly palliative care (talk about 180 degrees). I know FM gets a bum rap. My family on the East Coast still doesn't understand what kind of dr. I am, but I was really surprised when I moved to a smaller city than the one I grew up in and they had no idea what FPs do. FM docs also have less malpractice concerning obstetrical privileges since we usually do lower risk cases.

With that being said, if you really like the complicated cases and the major surgeries then do go into OB, but as other posters said spend time with OB residents and watch female OB attendings to get a full grasp of the experience. The world does need OB docs and good ones at that.

Forgot to add that if you do choose FM with OB then go to a program that is OB heavy-- there are a lot of programs like this both in the inner city and rural areas. Preferably go to a program that is not Catholic- no offense to anyone, but your education in reproductive health is severely limited by it. Do electives at other hospitals in L&D, etc. and lastly consider an extra year of women's health fellowship post residency-- not necessary, but some find it helpful.

Asunshine - I totally forgot you were considering OB last year at this point. This thread is a year old now, and I like seeing it resurrected. It's interesting to see that a year later - I have been pining away for months to go back to my community medicine rotation with this OB and get back to it. I have literally been looking forward to going back to it for a year now. And I still have to keep waiting til June.

You may have ruled out OB, but I may end up being one of those OBs that the world still needs (as someone puts it - someone has to become one). Interested to see what third -year brings. It probably won't help that people LOVE the OB rotation at my school. It it supposedly not malignant and really amazing. And although I love the babies born, I am still more interested in the stitching up and what is going on with the placenta.

A reread of this thread was enlightening....

Ok, I think if you like Ob/gyn, you should do it. I always knew I wanted to see women only and went back and forth between FP and Ob and of course at the heart of this issue is life style. Well, you CAN have a life style, it's called shift work and yeah, I know that is not popular with many of the older (male) docs, but that is our reality. When I go home, I go home, I am NOT on call from home so my attention can be 100% focused on my home and family and when I'm at work, I'm at work. I love it and would never have survived in another specialty- I would be too bored. There is never a dull moment on L&D! The best thing about ob/gyn is that you can really tailor it to what you want, if you want to do just clinic, you can, if you want to be a surgeon only, you can, if you want to be a hospitalist on L&D, you can! I see a lot of adolescents, which I love, I run a colpo clinic and then rest of time I'm in the OR or L&D with the residents (I told you- I can't get bored!!) Please don't reject ob/gyn bc you think the hours are too much, things are changing and getting better! Oh and where I work on the border in Texas, getting sued is unheard of since 2003. Email if more questions.

Southern, in my area there are several mom OB's whose husbands stay home with the kids...they make enough that this is possible. This would be less possible if you were in primary care, the salaries are less. So if you are going to work FT, might as well pick a specialty you can afford to have your significant other spend more time home with the kids...

That's a really good point, and we really like having him with the baby, because it makes it easier for me to emotionally deal with being away. Thanks for all the feedback in this thread that I hijacked from asunshine! I don't think she minds!

asunshine, in Pediatrics you can do a lot of gyn if you want to. Most OBGyn's won't see women until 16 years old. This means the Gyn care of younger girls is up to the Pediatrician (unless you have a Pediatric Gyn in your area, not everyone does, and even if you do it may be impossible to get in with her). I know many Pediatricians who do gyn care for ALL their patients, even their older teens, as long as it is straightforward. If you have an interest and ability in this area, you would be very marketable as a Pediatrician! Plus ... no geriatrics! Good luck with your decision, and let us know how you are doing...

This is the BEST post I possibly could have read this morning!! I LOVE LOVE LOVE Ob/Gyn but I always try to talk myself into doing something else. 1) because of lifestyle concerns and 2) because everyone tells me how miserable Ob/Gyns are. I am nearing the end of my third year and looking forward to applying to residency this summer. This is exactly what I needed to hear. Thank you!

bootlegger - you are a year ahead of me. You'll have to post back on the forum next year after match and let us know what programs you found to come off as family-friendly and non-malignant. Good luck finishing out third year! You're on the homestretch - I'm so jealous!

Bootlegger-good for you-do what you love, and the rest should fall into place-good luck!

So I am going to find out where I matched into an OB/GYN residency and I am both very excited and scared out of my mind. Never in a million years did I see myself as an OB, but here I am. I love the constant motion, the variety of procedures and while I like most things fairly well scripted, I also like the level of uncertainty that each day as an OB brings. I love surgery, but I really needed something that lets me get to know my patients. What I am afraid of is becoming the bitter, hateful people that some of the residents can be. I am a fun loving person and just don't see the need to make others miserable because I am short on sleep or am struggling to keep my head above water. I am also afraid of what will happen to my family. My children are the best thing that ever happened to me and I love them and the time I have with them. I am scared about missing all of their ball games and important events. My goal is to make the best of the time I have with them during residency and hope that is enough. I just couldn't not do OB because I really loved it and because I believe women deserve to have someone who actually cares about them, but I pray and vow that I won't be sacrificing my family in the process.

Maturin - good luck today!

I'd be interested in knowing what residencies you considered to come off as family friendly on the interview trail? Would you private message me? I'm on a military scholarship, but my branch has a high rate of civilian deferral, so I'm trying to make some mental notes now, as I will still enter ERAS with everyone else....

Good luck, Maturin! We're proud of you!

southern, hijack away! I still love (Love!) OB, but there's enough other things I like, too