Likes and Dislikes In OBGYN

My first clerkship rotation has been OBGYN. I chose to start here because while OBGYN is on my list of specialties I'm considering matching to, it's not high on my list, so I don't feel too much pressure to perform. I've been able to focus on just adapting to clerkship and learning as much as I can. OBGYN is also one of the tougher rotations in clerkship, so it's a good place to set the tone for the rest of the year - with the exception of Surgery (which I won't have until the summer), it only gets easier from here.

Anyway, I've learned a lot in my first rotation, but here are my major discoveries:

1) I am not a surgeon

Ok, there's a long-standing controversy about whether OBGYNs are surgeons. Surgeons often say no. I'm betting if anyone outside of medicine saw what OBGYNs do, they'd call them surgeons based off the very simple criteria that they perform surgeries! With scalpels and cutting and everything! Now, that doesn't mean they're surgeons in the same way a General Surgeon is a surgeon - they clearly have less OR time in training and perform a relatively small variety of surgeries - but it's hard to say they're not surgeons at all.

Anyway, long story short, I'm not a surgeon. Didn't think I was going into things, but this basically confirmed it. Learning how to scrub in and go through the whole "now I put my hands and sharp objects into your body" ritual was fun, but the novelty wore off quickly. I'm just not enthralled enough by the anatomy or by the minutiae of what to dissect where, how, using what instruments and what sutures to employ when. It's not that I'm opposed to surgery, it was interesting enough, but I don't love it and with the long hours necessary to become a surgeon, I think you have to love it, at least a little bit. Which brings me to my next point...

2) Long hours probably aren't a fit for me

OBGYN involves some fairly crazy hours by regular-person standards. 50-60 hour weeks were pretty much the norm and even as a student, had a few that pushed closer to 80. That's 12 hours every weekday, plus 20 hours on the weekend. Night shifts are frequent and the work doesn't end when you get home - assignments, reading, and ECs still are there to take up what little time is left. Hard to complain though, residents definitely worked longer than I did.

I think I've managed pretty well. I've stayed quite active during pre-clerkship, so it wasn't like I was going from 30 hours of work a week to 60, more like going from a flexible 50-60 hour week with a short travel time to an inflexible 50-60 hour week with a longer travel time and some extra work added on. I also have plenty of experience with night shifts, something many of my classmates have never had outside of pulling an all-nighter while studying (which, for the record, is a really bad way to study). I've also worked a regular, full-time job in healthcare before.

Looking at my classmates, some are definitely having difficult adjusting. One or two also seem to be thriving, though it's hard to tell if that's more for show than a reflection of reality. So I don't think I'm doing too bad overall.

Now, could I handle this over the course of a full year, or a 5-year residency, or longer? I don't know. But, more importantly, I don't want to know. I've been managing, but this has been stressful. I'm not sleeping long enough, I have very little time to do the extra-curricular work I enjoy, let alone relax. I've been able to spend some time with friends and family by putting a priority on it, but that's about all.

As much as I want a good career, I want that as part of a good life overall. Even over the next 7 years - the time it would take me to finish a 5 year residency - I have some fairly significant life goals I'd like to work towards outside of medicine. I have no interest in sacrificing a good life for a good career, so keeping my working hours reasonable, both during residency and afterwards, is a big goal for me.

3) I love Obstetrics - Gynecology not so much

I'm really enjoying obstetrics. It's structured, from start to finish, which makes it easy to wrap my head around. It's a very hopeful field of work. From pre-conception planning all the way to deliveries, there are challenges for patients but ones that can be overcome. You can really feel like you're helping these women through a tough, but rewarding part of life. Usually there's a good ending. Even when there's not, there's a lot you can do as a physician to help, even if it's just on the emotional side of things. Overall, it's a very human part of medicine.

Gynecology also had a good bit of that human side of things, but the medicine was far less structured. The outcomes were often intangible and not nearly as good. Worse, there wasn't much that could be done for those with poorer results. There was nothing really wrong with this - it's pretty par for the course in many fields of medicine, and there is a lot that can be done to help patients in gynecology - but it wasn't as engaging as obstetrics, for me at least.

4) The happiness test

A piece of advice I got towards the start of clerkship when considering a specialty was "Go where the happy people are". It's a mantra I've heard repeated in many forms in only the first few weeks of clerkship and one I'm definitely buying into.

So, are OBGYNs happy? I'd say a qualified "yes".

The median person seems to be fatigued but still making jokes. On the ends of the spectrum of happiness are people who seem to have lost one of those traits. There were some super-happy people who don't seem to register fatigue, and more than a few who weren't joking around much. So, on the whole, I'd say OBGYNs are happy, but it's not a clear "yes". We'll see how that stacks up against other specialties!