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Why on earth would you be an obstetrician and gynaecologist?

A lot of people ask me. “Why on earth would you want to be an obstetrician and gynaecologist?” I ask myself this same question - often. This questioning usually takes place at about 3am when the phone rings and I have to drag my weary body into the hospital. It also happens when I am in the throes of school drop off and the phone rings. In fact most of the time this questioning starts with the sound of my phone ringing – full stop. In the dark of the night the spirit of a lost career as a dermatologist quietly sniggers in the shadows in time to the buzz of my mobile phone.

A lot of people think that you would have to be some sort of a weirdo to be an obstetrician and gynaecologist. Having to deal with all of that, you know, women’s stuff. Seriously! Why would you do that!

Let’s get it out right from the beginning. I did NOT go into my medical career with the objective of being an Obstetrician and Gynecologist (O&G). In fact, I don’t reckon there are ANY medical students who commence their studies with the thought that they want to be an O&G.

By the time I finished my 6 year medical degree I was all ready for a career in rural medicine. Working in the great Australian outback, having to be able to do all sorts of different things – from fixing fractures, to extricating from car accidents, to treating pneumonias, heart attacks, asthma attacks, panic attacks – EVERYTHING. Often working by yourself or with minimum assistance. Thinking on your feet. Before I felt confident to enough to deal with all of these things and more I decided that I needed more experience in delivering babies and gynaecological “stuff”.

During the year that I was getting experience in this line of work I was lucky enough to have a great mentor who, bit by bit, got into my head that maybe I should do O&G as a career. I was initially terrified by a lot of O&G but I learned to enjoy it (most of it anyway). I also came to the realisation that it’s a great field to work in for numerous reasons ......

1. Women are better patients – Having dealt with both sexes in my junior doctor years I realised that, in general, women are more health aware and for the most part make better decisions with regards to their health. They seek help earlier. They (usually) do what you ask them to do (e.g. get blood tests, have ultrasounds). They tend not to engage (so much) in unhealthy habits (e.g. smoking, excessive alcohol consumption). They are more compliant in carrying out tasks that are prescribed (e.g. do pelvic floor exercises, take medication, lose weight).

2. Most of the time the outcomes are good – With most pregnancies you end up with a healthy baby and healthy Mum. If you have problems with heavy periods you can try some medication, have a Mirena, worse-case scenario – have a hysterectomy – problem sorted. Problems with a prolapse – see a pelvic floor physiotherapist, try a pessary, or have surgery.

It is true that some of the time the outcomes can be dreadful but in general at the end of the day the good outcomes outnumber the bad.

3. It’s a great combination of “medicine” (diagnosing, investigations, using medications, minor procedures) and “surgery” (as in an operating theatre). Some of the conditions of obstetrics are fascinating diseases (is it ok to be fascinated by a disease??). One of my senior registrars in the past was once told by an intensive care specialist that preeclampsia was far too interesting a disease to be managed by obstetricians.

I love the fact that on any given day it is possible for me to see a woman in my rooms in the morning regarding her problematic prolapse, perform a hysterectomy in the afternoon for heavy bleeding due to fibroids and then in the evening be lucky enough to witness a normal vaginal birth. How cool is that! By the way, did I mention that during laparoscopic surgery we get to use really cool gadgets.

So, next time you think about obstetricians and gynaecologists and their career choice, remember those three points.

- Better patients - Good outcomes - Fascinating diseases and cool gadgets

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