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A Career in OB-GYN

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    1. A Career in OB-GYN Cathy Callahan, MD MPH December 1, 2006

    2. A Specialty in OB-GYN Field of obstetrics and gynecology OB-GYN Selectives (fourth year) Residency Fellowships Practice

    3. A Specialty in OB-GYN Will it fulfill the calling and the mission that led you to become a physician? Your personal needs assessment. How much do you enjoy the practice of Ob-Gyn now? How about 10 years Look at several role models. (generalists, academicians, sub-specialists) Consider day to day practice. Can you overcome the day to day stress? Will you be able to keep the threat of malpractice from being an overwhelming personal burden? Personal needs assessment. Studying these questions is not only important in selecting a specialty, but will help you begin to describe the type of residency program that will best suit you. How much do you enjoy the practice of Ob-Gyn now? How about 10 years Look at several role models. (generalists, academicians, sub-specialists) Consider day to day practice. Can you overcome the day to day stress? Will you be able to keep the threat of malpractice from being an overwhelming personal burden? Personal needs assessment. Studying these questions is not only important in selecting a specialty, but will help you begin to describe the type of residency program that will best suit you.

    5. Where do OB-GYNs work?

    6. Some numbers. 41 to 60 hours per week 48 weeks devoted to practice 85 patient contacts (80% in office) Our patients 80% of patients range 15-45 years old 70% of patients receive all medical needs from their ob-gyn

    7. A day in the life of an ob/gyn 7:30 to 9:00 AM Surgery/Hospital Rounds 9:00-11:30 Office Hours 11:30-1:30 Lunch (often used for returning phone calls, attending hospital committee or educational meetings) 1:30 -5:00 Office hours 5:00- 6:00 Telephone calls, administrative duties, hospital rounds

    8. Job Satisfaction Very satisfied% Dissatisfied% ENT 38.8 25.2 General practice 36.1 25.1 Obstetrics 34.4 24.2 Internal medicine 36.5 20.3 Pediatrics 48.1 16.9 Family practice 42.8 16.9 Medical oncology 50.5 11.3 Dermatology 56.1 10.8

    9. Income > 3 years out Emergency medicine $216,000 General surgery $291,000 Internal medicine $261,000 Obstetrics/Gyn $261,000 MFM $322,000 Pediatrics $175,000

    10. Fourth year selectives

    11. VCOM requirements for fourth year Medical selectives (3 months) REI MFM Surgical selectives (3 months) GYN oncology Urogynecology Electives (4 months)

    12. Selectives to prepare for training in Womens Health Nov and Dec are not good months for out of town electives Write early to programs you want to do electives. Some fill quickly Be realistic about where to do electives: If you rank in the middle of the class do not spend a month at a program that only takes AOA graduates to fill its residency positions Nov and Dec are not good months for out of town electives Write early to programs you want to do electives. Some fill quickly Be realistic about where to do electives: If you rank in the middle of the class do not spend a month at a program that only takes AOA graduates to fill its residency positions

    14. Residency in OB/GYN

    15. Who is choosing OB-GYN residencies? peak number entering obstetrics and gynecology 1218 peak number entering obstetrics and gynecology 1218

    17. During Residency Rotations High risk obstetrics Gynecologic surgery Gynecology oncology Reproductive endocrinology Urogynecology

    18. During Residency Other rotations Emergency medicine Internal medicine Family practice Ultrasound Neonatal intensive care unit Surgical intensive care unit Pathology Geriatrics Genetics

    19. GYN Surgeries Abdominal hysterectomy Vaginal hysterectomy Laparotomy w/o hysterectomy Surgery for urinary incontinence Lap. surgery for ectopic pregnancy Laparoscopic surgeries Hysteroscopy Conizations Induced abortion (surgical) Surgical sterilization

    20. Obstetrics Spontaneous deliveries Forceps deliveries Cesarean deliveries Breech deliveries (vaginal) Multifetal deliveries VBACs Surg procedures on antenatal pts

    21. Board certification CREOG examinations Written examination Oral examination Recertification every 6 years

    22. Fellowships Boarded Sub-Specialties Maternal Fetal Medicine (Perinatology) GYN Oncology Reproductive Endocrinology Urogynecology (not yet board certified)

    23. Application Process for Residency ERAS and NRMP

    24. ERAS process for application personal statement, a curriculum vitae, three letters of recommendation transcript, COMLEX scores dean's letter photograph, but cannot legally require one

    25. Lets look at the timeline

    26. WHERE TO GO???? WHERE TO LIVE Are there family ties or issues pertinent to a spouse or significant other that affect where you want to live? - Can your spouse or significant other continue developing his or her career or educational goals in the community you are considering? SIZE Large versus small University center versus community hospital CAREER GOALS? -Private practice: solo or group - HMO or multispecialty group - Academic medicine - Subspecialty training EDUCATIONAL CONTENT - Factors to be weighed in selecting a residency program are varied and highly dependent on individual interests. Following are some things to consider when evaluating a residency program: - Commitment to education (eg, number of formal teaching conferences, implementation of a structured 4-year curriculum) - Ratio of full-time teaching faculty to residents - Emphasis on subspecialty education (gynecologic oncology, reproductive endocrinology, maternalfetal medicine and urogynecology) versus private practice or primary care WHERE TO LIVE Are there family ties or issues pertinent to a spouse or significant other that affect where you want to live? - Can your spouse or significant other continue developing his or her career or educational goals in the community you are considering? SIZE Large versus small University center versus community hospital CAREER GOALS? -Private practice: solo or group - HMO or multispecialty group - Academic medicine - Subspecialty training EDUCATIONAL CONTENT - Factors to be weighed in selecting a residency program are varied and highly dependent on individual interests. Following are some things to consider when evaluating a residency program: - Commitment to education (eg, number of formal teaching conferences, implementation of a structured 4-year curriculum) - Ratio of full-time teaching faculty to residents - Emphasis on subspecialty education (gynecologic oncology, reproductive endocrinology, maternalfetal medicine and urogynecology) versus private practice or primary care

    27. Resources