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Ob/Gyn vs Critical care

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9 years 6 months ago #73918 by Maturin
I am a third year medical student and have thought for the past 2 and a half years that I am going to be a Pulmonary interventionalist and critical care doc, but I just completed my Ob rotation and am now completely confused. The problem I have with Ob is based on my interaction with current, but older Obs who are tired and burned out.vs new Obs who tell me that as a woman I can demand the hours I will work, I can do as much surgery or clinic as I want, I will make amazing salaries and I will be generally fulfilled if you love surgery and continuity of patients. I think that ob is appealing because it offers much of what I like about critical care, the rapid thinking and fast pace with the added ability to do surgery. I just would really appreciate some outside advice that is not coming from attendings and residents who want you to do what they are. Any and all advice would be helpful.

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9 years 6 months ago #73921 by Popcorn
This thread might give you some insight.

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9 years 6 months ago #73924 by alkatz
It is funny, as I am starting my OB rotation and love it as well. I am told the same things as Maturin, that I CAN have good hours, etc. I will give it until the end of the rotation to decide. The only other thing I can see myself doing is EM. OB offers the same challenges that I love about EM. I am convinced that with Laborists the lifestyle WILL be better, it is just a matter of finding the right group and the right location.

Good luck to you!

The test of courage comes when we are in the minority. The test of tolerance comes when we are in the majority. - Ralph W. Sockman

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9 years 6 months ago #73928 by asunshine
I'm also one who leans toward ICU and OB for the same reasons. I have not been told I'll have good hours as an OB. The attendings and residents have told me that once you are first out, you are trying to establish your practice, it's stressful, and if you don't start out doing a lot of surgeries/procedures (slings, gyn onc, etc), you'll never end up doing them. If you start out as a laborist, you are pretty much kissing your career as a surgeon goodbye.

When I asked about part time, they said the closest you really get to part time is if you're in a medium-sized practice (ie 7-8 partners) where you have call every other weekday, and a whole weekend every other month, with 4 full days of clinic. But you'd have to give up delivering all of your own patients to be happy with that lifestyle.

I'm just an M3 also, but these are some of the things I've picked up. Also, the malpractice. Yikes. The attendings seem to blow it off ("you just have to practice good medicine and not worry about it"), but seriously, I don't believe that they're not worrying about it daily. I would.

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9 years 5 months ago #74061 by EemaMD
Ok. OB talking here.

No, when you first get out, you can't demand the hours you want and unless you are in an underserved area, the money isn't that great. You do a lot of clinic as an OB/Gyn. In my practice I was in the office 3-1/2 days a week. You need OB and office and surgery for your caselist to take your oral exams in year 3 of practice.

As for surgery, a lot is what patients come your way and how you practice. I had a partner I considered "surgery happy" and never met a uterus he didn't want to remove. I don't practice that way. Maybe it's because I'm a woman and maybe it's because of the way I was trained, but I try conservative management first whenever possible. As a generalist you might do some urogyn but you will not be doing onc. It's bread and butter - D&Cs, hysteroscopies, tubals, dx laparoscopy, ablation and yes, some occasional hysterectomies. ABOG wants you to be conservative and this is how they tested me on my caselist for Orals this past Jan.

OB is fast paced and patients are increasingly complicated with lots of co-morbidities. Your focus is healthy mom, healthy baby and I don't breathe easy until baby is out and all is ok. I still love it.

All that being said, I'm changing gears and joining as a hospital-based attending part-time (24 hrs/wk). No call. No piles of charts waiting for me. I miss my patients, but am happy to finally spend more time with family. I will be covering triage, or the residents, or their clinic. Two 12 hr shifts a week. Yay!

Happy to answer any other questions too...

Linda, Diplomate ABOG!

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9 years 5 months ago #74062 by southernmd
I love hearing these perspectives...although I'm only a first-year, we did a community medicine rotation under a preceptor who took me wherever he went for two weeks (surgery, clinic, rounds). And it just so happened the surgery schedule was stacked, because his partner was headed on a family vacation after I left, so lucky me - I got to really see a ton of variety of surgery.

And the two specialties I am strongly considering are IM - hospitalist type career in mind - or OB/GYN.

It is nice to know there are options for OB's in working 24 hours a week. That's amazing.

I hope this isn't too bold to ask, but could you essentially still support a family on a part-time income (please no pressure for numbers)? I would love to have my husband pursue his more artistic dreams of being a photographer, but to have that kind of schedule EVENTUALLY and still be the main breadwinner would be amazing!

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