Roxanne Williams MD'03

Why I chose the field:

I chose obstetrics and gynecology because of the diversity in the field. It's just the right combination of primary care with lots of hands on procedures for those who tend to be procedure oriented like myself. Also, I love the fact that I will be able to both diagnose and
surgically treat problems in my patients without having to send them to a surgeon. Some people tend to have concerns about the lack of diversity in caring for an all female population but I think that ob/gyn covers a very broad spectrum of problems from adolescence through adulthood and then the postmenopausal years. Also, delivering a baby has got to be one of the most exciting things I have ever done. Finally, I think what I love most about the field is that it's so realistic to life in that it's unpredicatable, it's happy, it's sad, and it's always changing. An added bonus is that I don't require a lot of sleep.

When did I do my rotation/longitudinal/sub-I:

My ob/gyn rotation was my third rotation, after medicine and surgery. I knew going into my third year that I was very interested in the field and I felt that having a strong medicine and surgical background would maximize on my experience and I was definitely right. I started my longitudinal in July and I am actually still doing it right now. I think waiting to start my longitudinal worked well for me because I felt comfortable with dealing with certain issues that perhaps I wouldn't have prior to doing my ob/gyn rotation. I think this ultimately helped to create the type of environment where my preceptor had a lot of confidence in me. I was able to spend more time with patients and figure out if private practice is something I could see myself doing after residency rather than trying to learn how to do a pap smear or a new ob work-up. I did a sub-I in urogyn surgery and MFM in August and September and I found the timing to be perfect because I had completed my ob/gyn rotation, was well into my longitudinal, and was able to have my evaluations in time for the interview process.

When did I do away rotations, how to plan, are they helpful:

I did not do an away rotation for two reasons. I was very interested in staying at the Brown program and I also wasn't particularly passionate about any one program out there. I certainly think that away rotations are helpful for people who have a strong interest in being in a particular place but certainly keep in mind that they can hurt as much as they can help.

What makes a successful applicant:

I think that the qualities that make a successful applicant include honesty, sincerity, enthusiasm, and dedication. I think the person that programs truly remember is the one who is him or herself. I really think that's the only real way to shine. Also, I think that the applicant that does his or her homework about a program and really does some soul searching prior to the interview so that he or she can give some meaningful responses will also stand out. It's always good to have a reason for selecting a program other than the fact that it's number 1 in the country. Rehearsed interviews come across as such so although the successful applicant prepares, he or she is also flexible with responses. Knowing the latest advances in your field is always a good conversation piece and it really shows dedication and interest in my opinion. Also, sincerity is something that people always, always remember. Even if you are not planning on ranking a program, write thank you letters because after all, these people did take time out of their schedule to talk to you; and you never know when your paths may cross again. Also, a successful applicant does not underestimate the importance of being respectful to the department secretaries and residency coordinators. They are the ones that make the day happen and they can easily put your file at the top or bottom of any given pile.

Thoughts/advice about the interview trail:

It's so incredibly easy to go into an interview and tell them what they want to hear but in the end, I think you end up cheating yourself. Tell them what YOU want them to hear but be polite and respectful. After I got over the nerves of my first interview, my attitude was to go in there, be myself and make sure that I conveyed that one thing or things that are truly outstanding about me and after that, I just hoped they would fall in love with me. I think it's
important to be aware of your strengths but it's even more important to be conscious of your weaknesses and have a plan in place to work on them. And when I say weakness, I don't mean the typical response of, "I'm too much of a perfectionist." You gotta dig deep! Don't just go around asking questions just because you think they are the right questions to ask and certainly don't be afraid to ask questions that you really want the answers to (e.g. it's okay to
ask about salary and whether or not you will be required to perform abortions) After all, you are talking about the next however many years of your life. Have fun at the socials but don't feel that you need to go in order to make a good impression. If you get the opportunity, talk to medical students at the programs you visit because they have a perspective that is truly priceless. Try to get some sleep the night before and be generous with the chapstick but ladies, do go easy on the make-up. Be prepared to present or discuss a patient who affected your medical school experience in some way and why. Also, it's always good to be have some residents in mind that were your favorites and not so favorites so that you can better formulate the picture of the type of resident you want to be and be able to effectively convey that to the program. It's important to know what you are looking for in a program and I promise you will get asked this question on every interview. Most importanly, have fun. This is probably the only time in your life that you will have the luxury of traveling to so many different places and meeting so many different people.

Ben Lannon MD'03

Why did you pick this field?

PROS: For me Ob/Gyn was a great mix of pieces I liked from each of the rotations. It offers both surgical and medical perspectives and skill sets, though not entirely one or the other. There are also opportunities to specialize later on e.g. gyn onc, uro-gyn for more surgical types, and MFM, repro endo for medical types.

The patient population is generally healthy, as in peds, and the care is often aimed at maintenance of a normal healthy process, as in an ideal family medicine world. Also the field advocates for the large population of women's health, not just an organ system. When the patients are sick, either in pregnancy or gyn oncology, it is not a chronic disease that requires endless lifestyle modifications by the patient (heart failure, diabetes, CAD, etc.) but is self-limited and requires an acute intervention by the physician i.e surgery, chemo, peripartum management.

CONS: The common complaints about Ob/Gyn are -
1) "Heavy estrogen load" - Residencies are about 80% women, with the whole field about 50%, the majority of men are at the attending level. Men in the field tend to specialize into one of the fellowships or work at academic centers. The disadvantage of this is that there is a small job market for men wanting to do community based general ob/gyn. The plus is that men are very desired for residency slots.

2) "Ob's are not academic" - traditionally ob/gyn was a non-evidence based field with a lot of folklore and home remedy. This has changed with the advent of the fellowships as well as the emphasis on evidence. The upside
of this is that there is a lot of research yet to do without being a career researcher.

3) "hours are too long" - Ob/gyn has traditionally had hard hours like surgeons, delivering babies at all hours of the night. With the 80/24 reforms in place this has changed drastically. Most programs have night shift systems for labor and delivery, such that residents don't take night call during the week. Expect many happier residents.

4) "training is too long" - Residency is 4 years with 3 more for fellowships. this seems very long at first but if you plan to subspecialize at all in any field, you will spend 6-7 years by the time you have done chief/resarch years.

5) "Malpractice is too high" Malpractice for obstetricians is among the highest of all fields. I suspect this issue will undergo revision in the next few years as tort reform and other issues are debated in the legislature. Also, if you do not deliver babies your malpractice will be similar to other surgeons.

6) "too much vagina" - can't get around this one. labor and delivery is a messy business, but don't rule out the field just becuase you don't like delivery. True you will have to get through residency but many of the subspecialties do not deliver babies.

How to plan your year:

I did not know for sure I wanted to do OB until later in the year after my other rotations. There are research papers saying that it makes no difference in outcome when you do your rotation. I did my longitudinal with Dr. Granai from gyn-onc. For me the longitudinal was an opportunity to get to work with someone who could eventually write me a recommendation letter rather than looking for a general clinical experience.The important sub-I’s for ob/gyn are MFM or Gyn-Onc. Repro endo and uro gyn are good but less structured for medical students. Brown has great
rotations in both. I chose to do my sub-I as an away elective. I found the away elective very helpful in seeing and being seen at another institution that I was interested in for residency. If you are the type of person that can give a true impression of your self in a short 4-week period then I would encourage doing something away. This will also allow you to put off your BMS required sub-I in medicine or surgery or peds until later in the year.

Thoughts on what makes a successful applicant-
Brown is very well regarded in the Ob/Gyn world. Our residency is one of the best in the country, particularly for MFM. Letters from our department will do you well no matter where you apply. Ob/gyn programs are looking for the same thing as every other program – smart, nice, caring, driven, etc.. In general, start thinking about what your application story will be. What makes you interesting? And make sure that is reflected somewhere in your application – letters, experience, etc.

Any thoughts/advice about the interview trail?
Very hard to generalize. My interviews were all very low key. Be prepared
to talk about abortion at some schools.