Why a doctor chose OB over family practice

by RH+, MD

More than anything in life I wanted to be a family practitioner (FP).

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.

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 felt 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.

RH+ is an obstetrician-gynecologist who blogs at Mothers in Medicine.

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