From the Editor

Why is obstetrics and gynecology a popular career choice for medical students?

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About 7% of 2014 graduating medical students did not get matched to a residency program for their first-choice ObGyn specialty


 

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Every year graduating medical students participate in the exciting, challenging, and anxiety-provoking process of applying to residency programs. After thousands of miles of travel, dozens of hotel overnight stays, and many interviews, the students are matched to their residency training site and begin specialty training. The first residency “Match” (conducted by the National Resident Matching Program) occurred in 1952 with 6,000 applicants and 10,400 available PGY-1 positions. In the 2014 Match, 34,270 applicants vied for 26,678 PGY-1 positions.1

Of great interest to medical students and educators are the relative balance of applicants and residency positions in each specialty, and the magnitude of risk that a US medical student will not match to his or her chosen specialty. For students who have devoted years preparing for residency training in a chosen specialty the day they learn that they have not matched is heartbreaking, painful, and a test of their resilience. The Match does sponsor a supplemental offer and acceptance program that helps unmatched applicants to identify unfilled positions. This process helps unmatched applicants to continue their professional development without a delay.

When researching for this editorial, I consulted the National Resident Matching Program’s Results and Data 2014 Main Residency Match.1 The TABLE shows the percentage of US medical school seniors who ranked a specialty as their only choice and did not match. The fields of neurosurgery, otolaryngology, plastic surgery, and orthopedic surgery had the greatest number of US medical school seniors (more than 17%) who ranked a specialty as their only choice and did not match in 2014. The fields of physical medicine and rehabilitation, dermatology, general surgery-categorical, obstetrics and gynecology, and radiation oncology had 6% to 11% of US seniors who ranked a specialty as their only choice not match in 2014. By contrast, almost all US applicants successfully matched in the fields of medicine-pediatrics, diagnostic radiology, anesthesiology, pathology, internal medicine-categorical, neurology, pediatrics-categorical, family medicine, emergency medicine, and psychiatry.

Clearly, obstetrics and gynecology is a popular career choice among medical students. Why might that be so?

Deeply meaningful relationships, continuity of care, plus surgical challenges
Students select a career in obstetrics and gynecology for many reasons. During their clinical experience in obstetrics and gynecology students often experience deeply meaningful relationships with patients at poignant life milestones, including conception, birth, and major surgery. In addition, students recognize that the field offers the opportunity to develop continuity relationships with patients and perform surgical procedures. Primary care specialists often develop deeply rewarding relationships with patients and their families that extend over decades, but they do not perform many surgical procedures. Procedure specialists, including general and orthopedic surgeons, perform hundreds of operations each year, but seldom have the opportunity to develop relationships with patients that last decades. Obstetrics and gynecology offers the combination of long-term continuity relationships with patients and training in surgical procedures.

Many other aspects of the field are attractive to students. Students report that their passion for the field was catalyzed by many factors and experiences, including:

  • experiences with obstetricians and gynecologists who were superb role models
  • the opportunity to support women and advocate for their needs over an entire lifetime
  • the challenge of integrating unique cultural and religious perspectives with the medicine of family planning, sexuality, fertility, and birth
  • the scientific and technical complexity of rapidly evolving diagnostic, medical, and surgical treatments, including comprehensive genetic testing and minimally invasive surgery techniques
  • the opportunity to care for underserved women both domestically and globally
  • delivering babies!

Renew your enthusiasm for our field—mentor!
For practicing obstetricians and gynecologists the combined challenges of complex cases with unfortunate clinical outcomes, ever growing administrative burdens, and the difficulty of balancing work and personal-life may cause them to doubt the wisdom of choosing to train in the field. One of the best ways to erase these doubts is to mentor one of the about

1,250 newly minted physicians who will start their training in obstetrics and gynecology in the summer of 2015 or one of the approximately 1,300 US medical students who will apply to enter the field in 2016.

Medical students have a world of opportunity in front of them, with dozens of exciting career options. The fact that so many students select a career in our field is heartening. These students will become excellent obstetrician-gynecologistsand dedicate themselves to advancingthe health of the 150 million women in the United States.

Would you select a career in obstetrics and gynecology again? Answer the Quick Poll on the home page and see how others have voted.

Why did you select a career in obstetrics and gynecology? Tell us at rbarbieri@frontlinemedcom.com Please include your name and city and state.

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