This past August, I attended the American College of Obstetricians and Gynecologists (ACOG) District VI meeting in Wisconsin. The theme of this year's meeting was "Bringing it Back Home," with a keynote presentation focused on developing the emotional habits to influence others and "embody the inner attitude of a leader." After a day of much self-reflection, I decided to stop by the poster presentations during a break between the major talks. ...

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In the recent book, Range: Why Generalists Triumph in a Specialized World, David Epstein makes a strong argument for exploring or sampling different interests and jobs before settling on a career of choice, a process that leads to “match quality,” which describes the degree of fit between one’s work and who they are. This idea flies in the face of our strongly held belief that early specialization, or ...

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As a profession, we’ve yet to standardize maternity leave and breastfeeding allowances for women. Given the length of medical training (seven-plus post-graduate years), timing (prime reproductive years) and slow increase in the ratio of female to male surgical residents, females choosing to start families during training are particularly afflicted. We just celebrated my son’s first birthday. I had him during one of the busiest years of my surgical residency, and it’s ...

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I am an experienced OB/GYN, well-versed in obstetrics, infertility, gynecology, surgery and — yes — menopause, or so I thought. So why was I so blindsided by my own menopause transition? I thought I was going through burnout, with anxiety, anger, mood swings, irritability, and depression. I was at a point in my career as an OB/GYN of 20-plus years that patients flocked to me because of my reputation and expected ...

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The field of teratology (also known as dysmorphology) is rapidly growing with daily innovations in prenatal medicine, genetics and preventive care that show its uniquely intersectional nature. But, the term teratology, and its derivatives teratoma and teratogen — derived from the ancient Greek root teras — do not do justice to the promising future of this field. I would like to see the field move away from this term for two reasons. First, ...

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When I walked into my first shift on labor and delivery as a brand new OB/GYN intern, complete with a freshly starched white coat, I was 33 weeks pregnant. As I listened to my chief resident effortlessly sign out the labor board, I was terrified. As the words pre-eclampsia, chorioamnionitis, and postpartum hemorrhage swirled around the room, I couldn’t get my heart rate under control. “They already hate ...

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It has been a savage few months for reproductive rights, with 12 states passing 26 bills to ban abortion, including measures that ban abortion as early as six weeks into pregnancy, as well as attempting to outlaw safe methods of abortion. In the face of this extreme, unprecedented wave of attacks, several states pursued an alternative route, passing laws that expand the scope of abortion providers to ...

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At the end of a long table covered with hors d’oeuvres and a birthday cake, I struck up a conversation with three primary care physicians.

I was hungry for their opinions. Inside the crowded apartment, we spoke for some 20 minutes about the systemic and cultural causes of burnout in primary care—a conversation that informed the first article in this series. As I was about to leave, I ...

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"You're 27-and-a-half weeks pregnant." As I lay on the exam table, time froze. How can this be? I wondered dazedly. I'm a second-year medical student. I've just completed a course in female reproduction and endocrinology. How could I have missed the signs? I attribute my obliviousness to the surgery I'd gone through only months before: the removal of a 27-pound, mucus-filled ovarian cyst. My lack of menstrual periods was nothing new; they'd been ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 25-year-old woman is evaluated in the emergency department for chest pain after a belted motor vehicle accident. She is pregnant at approximately 23 weeks' gestation. She reports no additional symptoms and is otherwise well. Her only medication is a prenatal vitamin. On physical examination, the patient is afebrile, blood ...

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