Hello All,
I
am an MS4 with seven months left til graduation, and more importantly
perhaps 25 days left before I hit the send button on ERAS. I have a
serious problem.
I am in love with OB. Absolutely in love. I like Peds, but I love
Neonatology. Who says you can be in love with two different niches?
The
problem as I see it is three fold. 1) I am in my late thirties with a
nine year old child that has some emotional issues, and a husband who
is not really a husband (ie, he cheated...habitually, horrible husband,
great father to our son and we have agreed to co-parent peacefully up
until this point. With such a predicament, I am wary of embarking the
OB path with the fear that I will not be as available to my son as he is
going to need me to be, that I will miss out on his growing up in lieu
of delivering the loves of other peoples lives.
2.) I keep hearing
how miserable OB/GYNs are, how they don't make any money, and how they
all stop doing OB and are doing GYN now for lifestyle purposes (but OB
is the part I really like!). Not to mention I constantly hear OB
residents are straight biotches (present company excluded Im sure). I
have a bit of it when pushed, but I don't want to be miserable all my
life!
3.) I did not care
for office pediatrics, but I did enjoy my neonatology clerkship with
relish! And I felt it was truly more thrilling to be handed a brand new
baby and tend to it than to pull one out and walk away. And to add to
that, Ive never heard nor seen a miserable pediatrician....a tired one, a
broke one, but never a miserable one.
How do I make the right choice? How do I do this without being an absentee mom?
Any advice would be quite helpful.
The clock is ticking.....
Sincerely,
The Phoenix
In the end you have to go with what your heart tells you. Neonatology is a great field though, and clinically is basically the same amount of time as Ob (3 years gen peds + 3 of fellowship, but really only 1 or so of fellowship is super intense clinical work). Also, if you're concerned about spending time with your son, Peds is likely to be more flexible. I know of three people who are currently doing part time residencies. Ob is a surgical specialty -- at least the training is. You really need to decide if that is something you can live without.
ReplyDeleteOMDG, thanks for your reply. What is a part time residency?? I have never heard of this. Is this found in the United States?
DeleteThanks so much for your help.
I've heard of people doing part time residencies as 1 month on and 1 month off, and taking 6 years in a peds program, or (same program) doing thee months on and one month off and taking 4 years. In the first example, a husband and wife couples-matched and alternated months so that they could take turns watching their kids.
DeleteYes, this is in the U.S. Not sure how common it is, or if programs other than peds permit it though.
Do not go into any surgical specialty if you are a single parent and worried about your tween's development. We have two young kids and a parent is a primary caregiver. Those surgical specialties are very difficult. The only thing worst for the family is possibly active deployment but maybe that is easier on the families because the parent is GONE for a while. Ob/gyn does have terrible hours and they don't pay what they should imo. Have you considered something like ER (3 years) and average salary (15 shifts/month garners roughly $250K annual salary) or anesthesia (4 years shift work as an attending garnering $300K-$400K annual salary as an attending). It's my firm belief when you have mouths to feed and grown children you have to make a decision based on your fulfillment with the career AND the needs/demands of your family. We are in the fourth year of our residency. It's beyond unbearable. The first year was tough. Second year we nearly broke up (we have been together for over ten years and have worked hard at our marriage with professional help). We decided to have another child third year and now we are into fourth year with intense issues with our kids. Health and behavioral that are a direct cause from an absent father (he loves all of us but he just isn't physically home to help out or be a dad). Peds residency is very family friendly. Ob/gyn residency and lifestyle is not. Good luck with your decision. If you do family medicine (3 year residency) you can do ob and peds and still have the flexibility of working ER shifts for more money OR joining a practice. There are many options to fulfill your career aspirations.
ReplyDeleteThank you for your unflinching reply. "beyond unbearable" is exactly the honesty Im looking for, and quite frankly exactly what I am afraid of. Unfortunately I did not enjoy family medicine, mainly because I get angry with adults who willfully abuse their bodies and don't listen to the medical advice given to remedy the problem. Ex. Man came in for constipation. I asked, do you eat vegetables? NO. Do you exercise? NO. Do you drink water? No. Can you just give me a pill to make my stool softer? *crickets* Besides that all I saw was diabetes and high cholesterol and obesity. I will die if that is my life everyday. The ER idea is interesting, but really somewhere between pregnancy and and adolescents is where my interest lies.
Deletewell unfortunately you will have a good portion of patients who don't do what you want - think mother's who smoke, drink and do recreational drugs; teenagers who refuse to follow through on std care, vaccines, etc. even as a surgeon you get people who are dying from vascular disease/diabetes etc but you've been seeing them for 10 years cutting off their legs, fixing their stints, etc and they refuse to quit smoking. I don't blame you for feeling like a corpse dealing with certain types of patients. There is a happy medium to be found in any specialty between giving people a second chance and not taking their lack of self worth and value for their health personal. I'm sure you will find something that interests you and meets your family needs. As you noted in the other comment below...your child did not sign up for this. We, as adults can handle anything for sure. What is making us crazy right now is seeing the toll a five year surgical residency takes on our kids. It's inhumane and we are at a very family friendly program that takes hour restrictions seriously. All I can say is proceed with eyes wide open and for sure talk to attendings who are 10-20 years down the road. They can tell you if they feel it's worth it. We are second generation doctor family and our parents say "it will be worth it" but honestly I don't believe them!!!! I'll let you know in a few years if in fact it was worth it. Praying for you to find a good resolution as this is an important and exciting life decision.
DeleteI was wondering why you weren't considering family practice, too, since you get peds and can do OB - and can do a surgical fellowship for C-sections after your training if your family life is stable enough at that time. I am only an MS2 so I don't know the ins and outs of all these things - just something I've heard people talk about.
ReplyDeleteProbably because she doesn't like office pediatrics... she likes the critical care stuff. You do family if you want to do OB as well as outpatient stuffs. Very few family docs spend all their time in the hospital.
DeleteI have a few friends that have become hospitalists after finishing a family med residency... however, then it's all adult inpatient, and I don't think the OP wants to do that, either.
DeleteChelle and Abounding Grace are both correct.
DeletePeds or Family Medicine - at a community-based hospital you'd get to do deliveries, nursery, NICU, etc . . . these are as "family friendly" as one can get in medicine.
ReplyDeleteI agree with this. I would caution you from taking any advice from current interns or people without kids. Interns have work hours restrictions that their more senior residents loathe. All the interns in our program have a major wake up call pgy2 and they go on to feel incredibly bitter and ripped off while everyone else just tells them to suck it up. It's unreal being at the hospital for 30 straight hours not knowing when your kid ate, slept or pooped last. Do what you want but make sure for residency you have a solid childcare situation that is reliable and will not flake out on you. You will definitely suffer through residency no matter what you do so for sure go into something you love BUT also be wise about the kind of career you want to have. Some people want academic only. Other's want to work, make their money and have free time to do other stuff (family/hobbies, travel etc) It's not black and white and when you have a nine year old makes it even more important to balance it all. You probably already know this but residency is harder than parenting and i've been told parenting is the hardest job in the world. The attending lifestyle can be very gratifying but you pretty much have to go through HELL to get there. I'm not trying to sound unsupportive--I just think some people who give well meaning advice aren't honest about the everyday struggles or maybe they just don't know. Good luck with your journey.
DeleteThank you, by no means is your honesty taken as being unsupportive. I consider Marriage the hardest job in the world. My son has been child's play (no pun intended) up until last October. Child care is my only fear. Im tough, Ive been through a LOT,I can take it. But my child didn't sign up for this. Im trying to be fair.
DeleteThank you for your responses.
You can be a pediatric hospitalist if you still love the hospital and want shift work. And you don't have to do a fellowship... which I really don't think you will have the energy for. But I am a 33 year old mother of 3... so, I've got my biases.
ReplyDeletehadn't thought of that...thank you
DeleteI have long followed this blog but this is the first time I have felt compelled to comment. I sat in a very similar professional situation almost 10 years ago. I had long thought I would be a neonatologist (it was my 5th grade dream!) then lo and behold I fell head over heels for OB. It rocked me to my core. So much so that I initially applied to Peds and OB to give me time to sort it out with additional sub-Is. I just couldn't shake the feeling that my heart was in Ob. You have to follow your heart, and none of us can tell you where that lies. Yes, your family matters a great deal, and will be the driving factor in your decision. But I am a firm believer that you don't have to sacrifice one for the other. What you may have to sacrifice is the illusion that only big name programs can give you a great education. I chose a community program for family reasons and can run circles around others with "pedigrees". I am now in fellowship for Maternal Fetal Medicine -- I am following that same 5th grade dream and caring for babies, only before birth, and I absolutely love what I do! Follow your heart! (And for the record-- the stereotypes about OB are just that!). I would be happy to answer any questions you may have about the field.
ReplyDeleteBefore I posted to MIM, my game plan was to apply to both OB and Peds (I have letters for both). I am scheduled for MFM in October, and OB and Peds Sub-I thru January. Hopefully it will become crystal clear where my abilities and heart converge.
DeleteI have never cared for "name-brand" anything, be it clothes or institutions, so thank goodness I am not stuck on that.
Can you tell me a little about your Fellowship? :)
GoodSamOb...I realize that this post was 5 months ago, but on the off chance you happen to see this reply, I would love to talk to you more about the field of OBGYN.
DeleteI am currently a MS-3 and have fallen in love with OBGYN but have been extremely discouraged by reading many practicing OBGYN's opinion of their career choice. Needless to say, your post is encouraging and I was hoping to hear more about your view of choosing this field as a career. Thanks!
Can't you become a neonatologist, as a superspecialism of paeds? Over here you can!
ReplyDeleteYes. That is the original plan. The problem is I really enjoyed OB as well.
DeleteAs an OB/GYN intern, I hope to dispel the rumors and stereotypes about our residents. More women in the field has been a good thing, demanding change in the way we work and make practicing medicine and family work together. I think the residents are quick in decision making and take no nonsense- it's sometimes tough to understand as a student, but it's not about you, it's about the patient. Even the roughest of residents I've found to be lovely with patients.
ReplyDeleteI'd second the comments above that the deadline is not days away but months away. If you're really on the fence, gather your letters and make 2 separate personal statements and apply to both. In the meantime, spend time in both specialties with electives, and hopefully between now and February, something will click, or you'll realize one camp or the other is more "your people." You can always leave it up to the ERAS gods in the spring, but I do hope you'll be leaning one way or the other by then.
Good luck!
That's exactly what I have done :) Thanks Erin!
DeleteApply in both and keep talking to people. Do another AI in both specialties. I applied in OB and Gen Surg. I did Gen Surg as my last rotation of 3rd year and fell in love with it even though I had already done two papers and gotten letters for OB. I applied in both, did another quick AI in both while waiting for interviews and I realized I wanted to do surgery. When it came to interview season, I only interviewed in Surgery. Try to decide before interviews because you want to be confident about your decision when interviewing, but its okay to take some extra time. Good luck!
ReplyDeleteI'm a new Ob intern and I absolutely LOVE my program! I had a lot of worries about the culture of OB and the rumors that all female ob residents are mean. I'm sure its true at some places but if you love Ob there are definitely programs that have great residents that almost all get along. The hours do suck but its residency no matter which you choose residency will never be easy.
ReplyDeleteChoose what you want to do based on what you love and what your family situation is and then when you interview keep tabs on which programs you felt the most comfortable personality wise.
Everyone says "follow your heart" and as trite as it sounds, it's true. Filter out everything else (including salary, in my opinion, because if you don't like what you're doing a little extra $$$ may not be worth it). You can consider the length and rigor of the training program (OB vs peds) but keep in mind that training programs are temporary and you have to get through it either way. If you love OB but don't love GYN, you'd have to go through a lot of training that doesn't excite you as much, similar to if you went the Peds/Neo route and had to go through office pediatrics training. If you did do OB/GYN, would you want to do an MFM fellowship? Consider the length of OB/GYN + MFM (= 7 years) versus Peds + Neo (= 6 years)...not a huge time difference.
ReplyDeleteI am a peds intern and mother of a 3 year old. I am training at a larger tertiary hospital that has less focus on outpatient peds stuff, which you could look for too. If you like acute care, search out peds programs with lots of high acuity care and maybe not as much outpatient-centric training.
Early in my M4 year I was still deciding between peds and OB/GYN but my heart told me to go for peds and I am so thrilled that I did. Work-life balance definitely did factor into my decisions, as did my perception of which residents/attending doctors seemed happiest and most balanced to me. I also liked that with peds I could be done-done in 3 years or have the option of doing a fellowship down the line if I decide to. I also realized that while I liked the acuity of OB work and was passionate about the issue of reproductive health (this was the focus of my MPH prior to med school), I didn't like the GYN stuff or the GYN-Onc parts. I just finished my intern NICU rotation and loved being at deliveries to resuscitate the babies. This also confirmed to me that I made the right choice and while OB was fascinating and exciting to me, I'm much more interested in the babies coming out of these women.
Good luck with your decision!
Ah! I love your story!! Thank you for sharing it.
DeleteI switched out of ob even though I loved the work and my program. To this day I have regrets, but it was the best choice for me as a mom (single mom at the time). There's no easy answer. I had to do a lot of soul searching about what kind of mother I wanted to be (and what kind of wife, if I happened to get married.. Which did happen for me). If your marriage is shaky, I would go into it thinking like a single mom... Residency is tough on even a solid marriage so you have to consider that and the potential effect on your role as mom and your child. I am still looking for a niche, and will likely transition to family med after a year of internal med (I miss deliveries and hope to do a little ob as an fm). What I don't miss is spending so much time away from my son and having very little life outside of work. And I loved ob! One thing.. Looking back I almost did peds and if I could start over I would have chosen pediatrics. It offers more flexibility and I think I would have enjoyed working with kids more than adults. But hindsight is 20/20 and it is hard to know anyone else's heart.
ReplyDeleteI second the advice to talk to seasoned doctor mothers in both specialties. I have found that interns and even residents have a different view, and it is a small amount of time compared to your lifetime career. Also people with kids have a different perspective. I actually really enjoyed working all the time before my son came along. And honestly, even after having him, I loved work itself but it was hard to feel like I wasn't giving him my best and was coming home exhausted. Another thing to look at is how much energy you have and how much sleep you need. I am not a super energetic person who thrives on 7-8 hours of sleep a night. When I worked all night, all I wanted to do was come home and crash for eight hours. seriously. But some ER moms and Ob moms I've talked to just require much less sleep... like they can easily get by on 4 hours. something else to consider.
ReplyDeleteI have nothing to add to the specialty choice discussion, as the advice and information already dispensed are excellent. However, I am a little concerned about the domestic situation you have described, as I have had a friend in a similar situation who suffered both emotionally and financially.
ReplyDeleteEssentially, she got married the summer before starting med school, to a guy who clearly did not love her well enough, and they had a baby at the end of second year. As soon as she got pregnant, he quit his job, under the pretext of going back to grad school (she was so supportive and did the bulk of the work on his application) and he lived off her loans (because he quit school after 1 semester) and her parents' help. Their baby had some developmental issues (not debilitating, but requiring special attention and some therapy for a while). The husband was a good dad in that he cared well for the baby/toddler, took him to therapy, etc., but was an absolutely terrible partner to her otherwise (cheating on her repeatedly with his ex-girlfriend as well as one of their child's therapists, emotionally abusive, not very responsible financially). She chose a very competitive surgical specialty, and worked very hard to shine while also being an amazing mom (absolutely brilliant and hard-working girl, and a really nice person too, I don't know how/if she ever slept). In her final year of residency, the week after she signed the contract for her first job post-residency, he filed for divorce. He was awarded primary custody of their child, in large part because he/his lawyer painted her as an absentee mother (which she was not at all!) using her residency work hours as a basis, and she had to pay him alimony and child support. He used the child to shake her down every time he wanted extra money (to support his increasingly irresponsible lifestyle). It took almost 4 years, an expensive legal battle, and him getting arrested for DUI and marijuana in his possession before she was able to get her child back.
She spent a lot of time beating herself up for divorcing him while still in med school. Anything that he was doing for their child, he could have continued to do, she did not need to be married to him for him to be a good dad.
On a positive note, she is now happily married to an absolutely wonderful man who loves, cherishes and supports her, and has been an amazing dad to their 3 kids. The way he interacts with and speaks about their oldest child (who will be going to college next year), you would never know that the child was from the first marriage and that he didn't really know the child until the child was almost 10.
The first line of the penultimate paragraph should read:
Delete... for *NOT* divorcing him while still in med shool.
It's hard to comment on what is the right choice for you. But, I'm an academic neonatologist and I LOVE my job. Rigor of residencies and fellowships will vary significantly by the program that you do them in, so I think any specialty is possible depending on where your heart leads you.
ReplyDeleteHi The Phoenix,
ReplyDeleteI would love to email you offline if you don't mind as I am planning to apply for medschool this june and will turn 34 next year, so I would be 39 when I finish medschool. I am also really interested in neonatology and would love to find out what you decide and what your experience was as an "older" applicant.
Thanks!
Sylvie