Sunday, April 25, 2010

Why I became an OB/GYN

More than anything in life I wanted to be a family practitioner. Going into medical school there was little doubt in my mind that this was my chosen path. I chose a school that had a significant focus on primary care and was president of the Family Practice Club my second year. I had shadowed several FPs and truly enjoyed the continuity of care that went into FP.

When I started my rotations as a third year student, I was obviously excited to do FP as my first. After about 3 weeks, though, I wasn’t ready yet to admit it to anyone else, I was starting to have doubts. The practitioner I was working with was great he really took a lot of time to teach me and I saw some interesting pathology, but it wasn’t quite what I thought it would be. I told myself I had just built it up too much. I was a little concerned, but knew I had a few (our school required 6 months of FP) more months to try it out.

The next month, I did an away rotation in internal medicine with a wise internist who had been in practice for 30 years. While I didn’t love internal medicine, I did love the internist I worked with. I soaked up every bit of wisdom about life and medicine he sent my way. He really tried to teach me to THINK and not just memorize facts. On my last day of the rotation he sat me down and said essentially that I had done well on the rotation, but he really thought my personality was the most suited for OB/GYN.

My first thought was utter disgust… What a sexist! I was sure he was just saying that because I was a woman. OB was becoming a female dominated field, but the last thing I could possibly be interested in was doing PAP smears all day. Yuck. And child bearing had no interest to me whatsoever. WAY too messy.

I composed my initial thoughts and replied, with a simple No thanks!

When’s your OB/GYN rotation he asked?

The last one of the year I replied. I had postponed it to very last.

You should seriously consider moving it up to earlier, he encouraged me.

I thanked him for his advice as a courtesy. Then thanked him profusely for the other things he had taught me.

On the drive home I was still fuming about his remark. However, my thoughts began to wander. His wife and all 3 of his daughters were doctors…. none OB/GYNS. There were no other sexist things he had said or done the whole month. I respected him greatly and had trusted all the other advice he had given me. Perhaps, I should listen and at least move my rotation up to earlier in the year.

After several frantic phone calls trying to set up a rotation, the best I could manage was a local private practice doctor, in desperate need of some CME’s who agreed to let me rotate in his office. I ‘did’ very little during this month, but what I observed was life changing. I watched his daily practice, his rapport with his patients and the continuity of care. He was able to practice preventative medicine in a real way (one of my passions) and also do very interesting surgery. I watched babies born then same day I watched him remove a giant ovary full of teeth and hair. On my last day of the month as I drove home and I broke down into tears. I couldn’t believe my month was over… I didn’t want it to end …. Ever. I feel in love with the crazy life of being an OB/GYN.

Then began the soul searching. How could I have a family and balance in my life and be an OB/GYN? I loved my month of OB, but as I looked at the hours that the attending put in, I wasn’t sure I could hack it. After months of pro’s and con’s lists and long discussions with my husband, I finally decided to go for it. I would rather do something I loved for 50 hours a week then something that bored me to tears for 10 hours a week. After my required 6 months of FP…. I knew it wasn’t for me. OB was my Edward and anything else would just be my Jacob.

This life is NOT easy. The hours do get crazy. My husband and family are a constant in my life to help me my life balanced… that and a great practice. Also, I believe it was Dr Whoo who has said that you should only do OB/GYN if you nothing else will make you happy. I totally agree, this life is not for everyone.

So here I am, 5 years into private practice quickly approaching my 35th birthday reflecting on how my life is nothing that I expected it to be when I began this crazy adventure in medicine. I realize now, that it is amazingly better.

So, thank you Dr. Internal Medicine for your excellent advice and seeing something in me that I hadn’t seen in myself.

14 comments:

  1. I'm not sure what led me to neurology. But after 12 years, I'm glad it did. It fits me very well.

    Good post.

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  2. I truly believe that our specialty chooses us, and that loving what we do makes us able to bear the slings and arrows associated with such a demanding career. Thank you for sharing your story, Rh+...and happy early birthday, 35 is treating me well so far, may it do the same for you! :)

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  3. Jiminee, how times have changed. When I was a senior medical student in the late 1970's (and that's not really so long ago) OBGYN was very much a male dominated field and women where not encouraged. At all. I rotated as a student through one of the major private hospitals in the area whose surgical lounge was off limits to women, including the GYNs and surgeons--both of the women surgeons. We had to change into our scrubs in a janitor's closet (since the nurses wouldn't let us use their lounge) and stand by the operating room waiting on the next case since notification when the room was ready only came to the doctor's lounge.

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  4. Great post. I really think that loving what you do is important. I have 12 med students in a Doctoring class and was dismayed when the one woman with a passion for surgery decided that even if she loved it the hours ruled it out. She is content with peds but I don't see the zest she had during her surgery rotation. I am glad to have chosen HemOnc because every day I am happy to be at work. The day that stops I retire.

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  5. I know it sounds silly, but it honestly amazes me how everyone falls in love with a different field. I actually sort of enjoyed pap smears and preventative women's health, but passionately hated everything else about ob/gyn (deliveries, surgeries). There would be moments on L&D where I wanted to shoot myself and the intern would say (without sarcasm), "I love my job!"

    It makes me happy that there are people there who love the things I hate and vice versa. Otherwise, we'd all be unhappy.

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  6. Great post, Rh+! I didn't really hate anything I rotated on (OB included), but I loved pathology. Actively tried to like ophthalmology better, but I agree, once you rotate on something you love, it sticks in your head like a cheesy one-hit-wonder, until you give in and accept your fate.

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  7. Wow, mamadoc...... thank you for your trailblazing. What a good reminder of how things have changed and how much we take for granted.

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  8. Wow, it's amazing to me what was going on in the 70s, not too long ago....

    RH+, can you explain what would cause a giant ovary with teeth and hair? I just had a uterine septum resected and the idea of what it might have looked like when it came out and what happened to it kind of haunts me, though I've been too embarrassed to ask my RE.

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  9. We heard that you need to have a 99% STPE1 to get an interview at a lot of our home surgery program. I just wish all the primary care bashing would stop. All these lifestyle specialties can not continue to grow at the rates they have been - it just isn't possible. I am going to do what I love - not basing it on board scores or lifestyle. I seem to be in the minority at my school however.

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  10. Great post! Carrie, it was most likely a dermoid cyst. There are all sorts of potential cell lines in an ovary, so it is more likely to turn up something weird (like a tumor with hair and teeth) than a uterus.

    I tried to like endocrinology and FP, also, but ob/gyn has a strong call to those of us who hear it.

    I wish I was 35 and in private practice! Sigh. I will turn 40 my first year of residency.

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  11. I love hearing about how people find their specialties...or as it seems in most cases, how specialities find their
    people! I'm a premed, pretty certain that I want to go into pedes in some capacity, but I'm reserving judgment on subspecialty until much farther down the road, because it seems you never know!

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  12. A much-remarked phenomenon, which I think definitely has some weight: that our personalities guide us into our specialties in medicine.

    Funny story about med school rotations: I remember doing a plstic surgery rotation. I got to assist in the OR, and I never did learn how to do a one-handed tie. The surgeon asked me one day if I did a lot of sewing. I replied I hadn't had a lot of chance to practice on real patients. Only at the end of the day at home did I realize he probably was asking me if I sewed...FABRIC! It made me laugh but also made me even more irritated with this surgeon. At some point, he had told me that I was wasted in going into emergency medicine, that I should pursue surgery. How could he diss my chosen profession like that?! Fortunately, in hindsight I can see that he was complimenting me, despite my lack of proficiency with one-handed ties. :)

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  13. OMG! THANK YOU ! I know I am early but I am starting Med School in a few months and I was terrified about student loans and divorce and no meaning of being a doctor. I didn't believe it! All my profs told me I should do research instead and have a family and no debt. However, everyone I have shadowed and volunteered with has said I would be perfect for OGBYN. I shadowed one just for a few weeks, he was a friend of the doctor I did shadow (gen surgery) and I LOVE OBSTETRICS! I just hope I don't lose my prime years and have regrets.

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  14. This is interesting. I'm 27 years old and going back to school for nursing..although I'm starting to question if this is the right career path. I'd love to be a midwife, but I have to go through nursing school just to do this, and I'm starting to think I don't even want to be a nurse. Then I explored the idea of a health psychologist, and finally an OB/GYN. I never thought I'd go towards that field. I find birth and labor fascinating even though I've never given birth-I can't wait until I can. Which is another thing..my husband and I would like to start a family soon. Im scared to become and OB/GYN only because I'll most likely be 40 by the time I actually have a career. I'm lost on what to do!

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