Why don\'t more males go into OB/GYN?

[Hatton]

Well WCI asked this about EM.  No new threads on this Women's issue forum so I decided to start one.  I think I know the answer but I thought it would be interesting.

[jfoxcpacfp]

What are the stats today and what were they in previous decades?

[Hatton]

'

"Seven hundred thirty-seven Ob/Gyn, 1820 pediatrics, and 5007 internal medicine residents responded. The proportion of male graduating Ob/Gyn residents decreased from 46% to 23% (P < .001). Of those men, the proportion that proceeded with subspecialty training increased from 5.3% to 25.0% (P = .01). Women graduating from an Ob/Gyn residency program displayed a similar but smaller trend towards subspecialization, as did men graduating from pediatrics residencies. Men graduating from internal medicine residency programs demonstrated no change."  This is a study from 1997-2003 from AJOG.

[jhwkr542]

My main reason:  Many women when I rotated through OB/Gyn (and even my spouse and other women in my family) simply preferred a female OB/Gyn and requested for me to not be in the room.  Knowing this always made it awkward for me during the rotation because I had this underlying assumption that all women thought like this.  I could rationalize that this probably wasn't true, but it didn't make me feel any less uncomfortable.

Plus (anecdotal story alert), as a med. student, our jobs were to round on all the c-section patients we had scrubbed in for from the previous day, and we had to remove the dressing from the incision site.  Most women would try to expose just the bandage between their blanket and hospital gown, but one young patient (20ish) was more than happy to completely expose herself for me to take off the bandage.  When I pulled off the tape, she giggled and told me "it tickled".  Her boyfriend was sleeping in the corner of the room.

Other contributing factors included lifestyle/call and fear of malpractice.

[AlexxT]

In addition to the fact that many patients prefer female physicians, I have also heard, second hand, that the mostly female residents are less welcoming to the male medical students.

[Hatton]

It is fascinating to me how much attitudes have changed in the span of my career.  When I finished my OB/GYN residency in 1987 I stood out.  I was the first female at the first hospital I practiced at.  I was actually ordered out of the OB lounge by a guy walking around in boxer shorts.  I later found out he was considered a nut. I think the discrimination angle has come full circle now.  Young male residents and students are having a hard time now.  I really dont know what can be done because I really think a percentage of patients prefer female GYNs.

[jfoxcpacfp]

Pretty much every female I know, except those older, such as my mom, prefer a female (self included). Odd when you think about it, though - people in earlier generations were so much more modest than today. I guess, as you said, they didn't have the alternative to consider.

[Josh0731]

Wasn't an issue for me since I quite disliked my OB rotation :?    But I remember a couple of years ago sitting in the surgeon's lounge with a male OB, probably in his late 50s, who was complaining about this.  He claimed that more and more women preferred seeing women.  To be blunt, he sounded pretty irritated about it, and he claimed it was making it hard to reestablish his practice after recently relocating.  But then I discussed this with my wife - she's seen both and says she doesn't care.  My suspicion is that, as usual, good bedside manner and an air of competence makes up for a lot, but I guess if they never bother to see you the first time then it doesn't matter.

[VagabondMD]

I hated the OB/GYN rotation, punctuated with a woman dying from an amniotic fluid embolus during a delivery that I was assisting with on my last day--no prenatal care, came to hospital in labor, unsuspected twins with second delivery a breech, etc.

[DarrVao777]

Similar experience as jhwkr542, I just didn't feel welcome by the patients.

I will say that while female-dominated, the residents were much nicer to male rotators than to female rotators.

In the end, lifestyle was the biggest deterrent. I put in a 100 hour week as a medical student, my roughest week ever including all rotations as an intern. Call me weak-willed but I'm just not interested in working those kinds of hours.

[PhysicianOnFIRE]

WCI weighed touched briefly on this topic in my Q&A with him.

 

What is your specialty or subspecialty and why did you choose it? If you could turn back time, would you choose to practice medicine and choose the same specialty? Why?

Emergency medicine. I loved the variety, didn’t want to ever be on call, wanted to have the skills necessary to take care of a broad range of problems, and fit in with the people in the specialty.

I also considered OB/GYN and general surgery but was turned off by the people in the specialty and the brutal lifestyles. Despite enjoying the medicine, I never felt welcome as a male on the labor deck or in clinic by staff, the docs, or the patients. And the general surgeons seemed to consider medicine as the only thing they were going to do with their lives. I had too many outside interests to pursue that.

 

[MaxPower]

I did my Ob/Gyn rotation first of all my rotations as an M3. I wanted to get my feet wet, so to speak, in the clinical rotations doing something I knew going in I didn't want to do. And then I actually really liked it. It was a nice mix of surgery and clinic, and i thought that the physiology/medicine side of it was fascinating.

Watching a birth always (and still does) seem like such a miracle to me, and to share that bond with a patient and their family in one of the most emotionally fulfilling and intense moments of their entire life is something you just don't find in other specialties (even in cases where things didn't go well--miscarriages, etc.). Those things intrigued me about Ob.

Unfortunately, I also had a bunch of female residents who were unfriendly to the male rotators. They used to hold little didactic sessions with the female med students after they had sent us off to go round, which I later learned was a ploy to get the males away. I also saw the trend of patients preferring to see female OBs, and wondered how difficult it would be to establish and maintain a practice going forward. My good male friend from med school did OB/Gyn and seems to be doing OK, but he is also in an underserved area and treats lots of low-income patients who probably don't have a choice. That presents lots of issues in OB with poor prenatal care and worse outcomes.

Thankfully I had crushed Step 1 and ended up doing orthopedics. I think I probably would have ended up doing that anyway, but was surprised by how much I really enjoyed my OB rotation.

[Hatton]

I am truly sorry to hear about your experiences MaxPower.  Power corrupts.  Ob is a great field and gender really should not matter.  I guess I personally benefited by the preferences that patients expressed.  I would never anticipated that male  residents/students would feel out of place in Ob/Gyn.

[GXA]

I was speaking with someone in HR last week who was asking me about our local OB options.  Her daughter recently moved back to town and wanted a female obstetrician.  She told me she was surprised by her daughter's request as her own OB/Gyn is male and she herself had gone to whomever her PCP had recommended.

As more females choose a female OB/Gyn (as my wife also did), there will be a greater demand for them, and business may be more difficult for males in this field.

[OBGYNguy]

As a male in OB who has been exposed to OB/GYN patients in the Midwest, the West coast, and now New England, I think the statement that "most females prefer males" is entirely not true. There is data out there on this actually, and I will try and hunt it down, but the VAST MAJORITY of women, and even more so when in labor, do not care about the gender of their provider. This is what I have seen in practice as well. In my experience <2% of patients explicitly state "I prefer a female provider" to our medical staff, and that entire group almost exclusively occurs amongst women who have moral/religious objections to men other than their husbands seeing their genitalia. While I cannot speak for women and their preferences, I can just share my exposure, and that of my male colleagues (because we get asked this question quite regularly).

You cannot count your experiences as a medical student, where patients are uncomfortable with you being there for MANY other reasons and assume it is about gender. Would you feel super excited about a med student putting his first speculum in you? I certainly wouldn't, regardless of that person's gender...it's a sensitive exam, and while I can sit here and say I was turned away from more patients as a male med student than my female counterparts, the issue is too complicated to pinpoint down to a single cause like gender.

I think people have a lot of preferences with physicians in general, but few of them in practice actively do much about it and most people just care that they feel that you are competent and respectful (which is perhaps more emphasized in OB/GYN than in other fields due to the nature/sensitivity of much of our work). I also would like to point out that there is a relatively new phenomena where there is a decent sized influx of Queer men starting in OB/GYN right now, I am one of them, and while it isn't necessarily always obvious that your patients know your sexual orientation, once you establish relationships with your patients, things do sometimes come up, and word travels quickly...I do know for a fact that some of my patients seek out the "gay OB/GYN doc" because they feel very comfortable with that. Nurses prefer to come to me for their personal exams than even over most of my female colleagues, and while I can't guarantee it is because of my sexual orientation, it has been suggested more than once that it makes them much more comfortable. Just another random thing to think about.