Friday, November 6, 2009

Kevin might want to be an Ob/Gyn, yet might not.

Choosing the right career is a difficult task and it certainly doesn’t end with your acceptance to medical school. Finding the right specialty is a challenging thing and the first 2 years of medical school really aren’t that helpful. Sure preceptorships give you a quick glimpse, but it really doesn’t give you the full experience of what a doctor does everyday. In an effort to help future medical students, and perhaps just to put our own thoughts down on paper, David and I are starting a new series of articles that weigh the pros and cons of each particular specialty. Each article will feature 3 reasons why we liked that particular specialty and 3 reasons why we didn’t. Even though each article will likely be personal to our own interests and preferences, hopefully it’ll bring up some interesting points to think about as you make your own career decisions. Enjoy

3 Reasons why I want to be an OB/GYN
1. It’s the black and white cookie of medicine

When choosing a medical specialty, one of the biggest questions people consider is whether they would like to do a lot of procedures or whether they’d prefer something more cerebral. One would naturally lead you down the surgical path and the other likely towards something like internal medicine. But for those who would like a little bit of both, Ob/Gyn offers an intriguing alternative. Before my rotation my only knowledge of Ob/Gyn is that you probably deliver a lot of babies and treat a lot of gonorrhea, neither of which were particularly appealing. But what I didn’t realize was that a lot of things can go wrong south of the border and often times you gotta cut ‘em to fix ‘em. The docs I followed did about 2 procedures each morning on Monday Wednesday and Thursday and a full day of procedures on Tuesday. This ranged from tumor removal to urethral slings, prolapse repairs, ovary removal and every flavor of hysterectomy you can imagine. That’s a lot of surgery considering a general surgeon without specialization likely does less with more training time.

Mmmm... tastes like placenta

On the medical side there are a lot of diseases to that can happen to the entire baby making apparatus and you’re the guy/gal to fix it. Often times symptoms can be vague or the etiology multifactorial so there’s a reasonable amount of brain power that must be expended to properly take care of your patients. Not too shabby

2. Good subspecialty options
I only spent 2 days with a gyn/onc but I found the subspecialty pretty fascinating. It’s the only surgical oncology specialty that also manages chemotherapy. So there’s a good amount of continuity of care that lets you manage a patient’s cancer from presentation to remission. Pretty cool.

The surgeries themselves are pretty interesting as well. They’re not particularly challenging from a technical standpoint but the stories I’ve heard at hilarious. My preceptor told me about an obese patient she had that had a slow growing tumor inside her that weighed over 70lbs at time of presentation. In order to do to the surgery, she had to perform a pannectomy as well. By the time the patient left the OR, she was half the weight she went in.

3. Strong continuity of care
My main preceptor was an older doc who had been in practice for over 30 years and many of his patients have been with him for about as long. He’s delivered entire families and really followed some patients from the beginning of motherhood to menopause. This seems like a rewarding process and something a lot of other specialties don’t get to experience, especially if you’re in surgical field.

3 reasons why that might not be a good idea
1. The hours are terrible
OB probably has one of the worst call schedules ever unless you’re part of a large practice with an elaborate call system. When a mother is ready to deliver, she’s ready to deliver and there’s nothing you can do about it. If you have a large patient base and there’s 3-4 women laboring at any given time, you could be in the hospital constantly, at all hours of the night. It sucks.

2. Childbirth
I think I’ve said enough on that subject

3. You get sued a lot. A LOT
Hopefully, if you give OB/GYN any consideration, you would know this fact but it bears mentioning again. Ob/Gyn's get sued all the time. Their malpractice insurance is some of the highest in the entire industry and everybody has had at least one case brought against them for something or other. Basically, it sucks ass. All kinds of things can go wrong and 98% of it isnt your fault, but that doesn't stop patients from suing your ass because little Timmy isn't reading up to his grade level.


Albinoblackbear said...

Reason #4: For some reason (IMHO) obs/gyne people are the crankiest bunch of speculum wielding passive aggressive doctors I've come across.

(Mind you, I usually see them when they are having a tantrum because the ER doc didn't do a pelvic on the abd pain NYD he referred to them.)

pinky said...

I know a lot of Ob/Gyns. I am an L&D nurse who just quit last July. I do not think they are cranky. Most of them should be much more cranky. THey are all things to all people and they cannot do it all, as all that well. Unfortunately, too much is expected of them. If you don't absolutely love childbirth, DONT become an OB/GYN. If you don't have enough fortitude to be sued multiple times no matter whether it was your fault of not, DON'T be an OB/gyn. Every Ob I know has at least one case against them. Every one of them. Nobody is that bad!!! If you don't have an extra 80 grand to pay for insurance against malpractice, DONT become an OB/gyn....If you don't have enough self worth to take the nasty bitching you are going to get from the 1)general surgeon 2)Urologist 3) anesthesiologist when things don't go as planed, DONT be an OB/gyn. If you do love childbirth and find it very fulfilling, maybe become an obgyn but definitely not if you don't love love love childbirth.

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