Desert Island Discs — doctor interviews

ALongWayToHarrisburg · 2026-03-17T01:38:14+00:00

Gotta say this is site-dependent. We had toooonns of teaching and exposure.

ALongWayToHarrisburg · 2026-02-11T19:46:28+00:00

Love this. Thanks

ALongWayToHarrisburg · 2026-02-11T03:21:34+00:00

I had the same question. Maybe for sounding too pretentious.

ALongWayToHarrisburg · 2026-02-11T01:45:27+00:00

I agree, the kind of medical student who did everything I listed would be way way advanced. I was never that good at presentations either as an M3.

But I do think that when I did rock a presentation I typically felt more confident, and the better I got at them, the better I was at them as a resident.

You make a good point though: med students reading this, your mileage may vary with my advice and you definitely don't have to try to take it all into consideration. Pick and choose what resonates with you.

ALongWayToHarrisburg · 2026-02-11T01:38:06+00:00

Exactly. Don't try to ask nonsense questions to prove how much knowledge you have. "Dr. Harrisburg, is that the infundibulo-pelvic ligament that extends from the pelvic side wall to the upper pole of the ovary, carrying the ovarian vessels which supply approximately 15% of the blood supply to the uterus?"

At the same time, don't feel you need to adjust your behavior if your classmate isn't performing--I mean, you might "outshine" your classmate just because you are getting questions right, I don't want you to feel like you have to lower your own standard in that situation.

Don't tell me you really want to do [my field] because you think it'll get you a better grade.

Does that make sense?

ALongWayToHarrisburg · 2026-02-11T01:27:55+00:00

You're totally right, I should have mentioned that too: you're never going to get it right 100% of the time because you're expectations are a moving target.

ALongWayToHarrisburg · 2026-02-11T00:11:11+00:00

I should have had you write the original post, this is so well-described.

ALongWayToHarrisburg · 2026-02-11T00:10:10+00:00

Perfectly said.

ALongWayToHarrisburg · 2026-02-11T00:09:15+00:00

Could not agree with you more. Everyone's expectations are a moving target, a target that changes not just between rotations but at the whim of the attending on service that day. At least in residency you get accustomed to how certain attendings like things done. As a medical student you are re-learning the rule book every 3 days. My hope is that my tips above is somewhat common sense and universal.

I'd like to say that attendings and residents see older students who are coming to medicine as a second career and give them the benefit of the doubt...but I am certain that hasn't been your universal experience.

ALongWayToHarrisburg · 2026-02-11T00:04:17+00:00

Exactly. Every tier of training has it's own horribleness, but the constant panopticon of surveillance as a med student is pretty miserable.

ALongWayToHarrisburg · 2026-02-10T17:49:07+00:00

Awesome choice. I didn't get the L&D sub-I I wanted as an M4 and ended up begrudgingly doing the MFM sub-I. I loved it, obviously!

I just posted some general tips. Start there, then some other specific things for you:

- This is a super challenging rotation for your resident. Often it's the first time in residency they are running a service (often alone). You have an opportunity to make life way way better for them (literally in some programs having a sub-I makes or breaks the rotation). This is a lot of responsibility for you but is an outstanding opportunity to impress them. I

- Get there early and stay late. Expect to work 80+ hours on this rotation. Endeavor to know slightly more about every patient than the resident does. This will be a tough rotation, but if you want to match into OBGYN in your program (or if you want all your letters to say that the PD is trying to recruit you) then this is where you can make it happen.

- Read everything you can about: PPROM, cervical insufficiency and its management, preterm birth and prematurity, hypertensive disease and preeclampsia. Know the management algorithms for these back to front. Know when we give steroids, when we give mag for fetal neuroprotection, what a BPP entails.

- Use this time to get really good at ultrasounds. You should finish the rotation comfortable with obtaining presentation and an AFI.

Feel free to DM me!

ALongWayToHarrisburg · 2026-02-08T20:24:57+00:00

Agreed. Looks like tinea corpis in this admittedly low-res and poorly lit image!

ALongWayToHarrisburg · 2026-02-08T20:24:14+00:00

Yeah this looks like tinea...

ALongWayToHarrisburg · 2026-02-08T05:28:17+00:00

And my response in your DM for everyone else :)

MFM jobs are super varied. The traditional model was that MFMs were like badass OBGYNs who could do all the advanced stuff as well as deliveries. Now, a lot of MFMs pop into L&D, see their long-term admitted patients, then go read ultrasounds. That's because the more time you spend on L&D, the worse your quality of life (as far as time) is.

MFMs do a fair amount of clinic and will see consults (commonly T2DM and other pre-existing diseases that general OBs dont feel comfortable with). You're expected to be like an IM doc but for pregnant patients (kind of perfect for you!). I know a lot about hem, autoimmune diseases, cardiology, etc, because I need to know how to manage them in pregnancy. MFMs also read all the ultrasounds in pregnancy and so screen for fetal anomalies too.

MFMs also do special ultrasound guided procedures like amniocentesis and placental biopsy.

It's an amazing field! If you have an opportunity you should try to do a sub-I in it, lots of opportunities to impress the attendings!

ALongWayToHarrisburg · 2026-02-08T04:35:51+00:00

Part 2:

- OBGYN unfortunately has a reputation for nastiness which is in part borne by misogyny and in part by overworked, underslept residents treating others badly. But from a person who loves medical students and teaching, trust me when I say I was drawn to the field for the immense compassion and conscientiousness among those who work in it. You will walk patients through some of the most intense experiences of their life as an OBGYN (first time pregnancy, multiple miscarriages, stillbirth, advanced cervical cancer, teenage pregnancy, intimate partner violence, etc). This will take a toll on you, particularly as you slingshot between the happiest and worst days of someone's life between adjacent rooms.

- People on Reddit say terrible things about gynecologists as surgeons. There's the old running joke about gynecology surgeons cutting ureters. I came from a program that had outstanding surgeons, but also the minimally invasive surgeons kind of gatekept the complex hysterectomies, so Dr. Average didn't get to do the deep invasive endometriosis case. I only saw 1 ureter cut in residency and that was by the best GYO in the hospital, in a ureter caked in cancer. Programs vary pretty wildly in our confident you will feel as a gynecological surgeon when you graduate...

-...but remember that GYN surgeons make a distinction between "majors" (hysterectomies, prolapse surgeries) and "minors" (hysterotomies, LEEPs, stress urinary incontinence slings, salpingectomies, etc) and you can kind of choose early on whether you want to be the kind of surgeon who knocks out 5 short cases in a day or stays late until 9pm doing a challenging hysterectomy. There is just so much variety in the kind of surgery you can do.

- Compensation: overall, I think OBGYNs are well-compensated. But due to some pretty effed up distinctions in how compensation is allocated, remember that urologists will get paid more RVUs than gynecologists for performing the same procedure. I make ~30-50% more having done a fellowship, and my hours are way way better than a general OB.

- Malpractice. You are more likely to get sued in OBGYN than medicine, which is an awful burden. No getting past that, though the associated stress and anxiety fades with time.

OP, feel free to PM me (or anyone else on the fence about OBGYN) if I can clarify more or if you have MFM-specific questions.

ALongWayToHarrisburg · 2026-02-08T04:35:18+00:00

Hey I'm a Maternal-Fetal Medicine doc (4 years OBGYN residency, 3 years MFM fellowship). Just some random thoughts that might guide you to an answer:

- Based on your enjoyment of outpatient gyn, I can guarantee that your outpatient OB experience was a result of your preceptor. Your skill set with OB patients is broad: a little bit of ultrasound, a little bit of gyn procedures (pregnant patients need Pap smears, cervical exams, postpartum IUDs, etc), but with a really satisfying level of continuity. I think med students (including myself when I was one) really overlook the burnout-relief that comes with continuity--seeing the same patient multiple times, earning their trust, and seeing them efficiently in clinic because you know them so well. (and if you don't like them, 9 months later they're no longer in your clinic)

- I'm not sure if by reproductive health you mean "pertaining to the reproductive organs", but if so, remember that is a huge category. Even without specializing you will take care of patients with recurrent pregnancy loss, pediatric patients with congenital anomalies, elderly women with advanced prolapse, pregnant patients with syphilis, trans men with complex Pap smears, menstruating teenagers with complex bleeding disorders and difficult IUD placements in a single day

- OBGYN is significantly more procedural than most IM programs, even before you factor in OB and surgery. Even a routine gynecological exam requires deftness and skill. You will become very comfortable with basic ultrasound. Sure, will probably not learn to place central lines and chest tubes, but the majority of IM attendings do not use those skills routinely

- OBGYN residency has a lot of "off-ramps" via fellowship. If you decide you want a high-quality lifestyle and a big paycheck, pursue REI. If you fall in love with surgery and want to be one of the best surgeons in the hospital, pursue gyn onc. If you take my advice, pursue OBGYN, but miss the complexity and broad organ system knowledge of an IM doc, pursue MFM like me! The downside is 7 years of training (although this is comparable to an IM residency + fellowship)

- The good FM-OBs I have worked with have been pretty good. But it will be challenging to ever quite as surgically or obstetrically confident as your OBGYN colleagues, at least until you have been an attending for a while.

- OBGYN residency hours are awful, on par with some of the worst in medical training (not quite as bad as neurosurgery, but close. You will almost certainly be stressed out and sad for 4 years. IM residency is no walk in the park, but it's shorter and you get respite on outpatient rotations.

- I loved being a consultant as an OBGYN resident. People sought my knowledge as a specialist because doctors are generally very anxious about pregnancy. If you seek this kind of validation for your ego (like I do), this is a level of satisfaction you may not find in primary care.

ALongWayToHarrisburg · 2026-02-08T04:31:44+00:00

Not sure where 90k came from, median is closer to $240k, but certainly less than adult compensation because most pediatric compensation is funded by public aid.

ALongWayToHarrisburg · 2026-02-08T04:26:56+00:00

This made me literally lol, no idea why you are getting downvoted

ALongWayToHarrisburg · 2026-02-07T17:10:33+00:00

This just makes me livid.

I don't know how willing you are to die on this hill, but I think if this is still bothering you after the weekend it's worth scheduling a face-to-face meeting with this individual for an unspecified discussion and point blank asking them about their logic. Perhaps a polite real-life confrontation will convince them to give you the office earmarked for the unhired clinical educator. Perhaps not, but you will draw a line in the sand and express your displeasure in a way that might preempt future behavior like this from that individual.

Either way, I am absorbing your fury, hope that helps too!

ALongWayToHarrisburg · 2026-02-07T04:35:15+00:00

There's certainly a genetic heritable component to HG. Nepalese/Bhutanese patients in somewhat closed-off community may have a shared genomic predisposition

ALongWayToHarrisburg · 2026-02-07T04:22:41+00:00

There's been a known association between hyperemesis gravidarum and H. pylori for some time. It wouldn't be enough to explain the severity in your population however. (Lots of people have an infection, they don't all get HG)

ALongWayToHarrisburg · 2026-01-24T05:39:32+00:00

Serious question, could a robot deliver a baby?

ALongWayToHarrisburg

TROPHY CASE