Gynecology Oncology Fellowship

[bony00]

My DH is PGY2 OB/Gyn resident and he is considering Gyn Onc for fellowship. Is anyone's spouse a practicing Gyn Onc or in fellowship, if so where?
It seems a bit morbid to me, but my husband really likes the large amount of surgery. I am a graduate student in Epidemiology and I was hoping that he would lean toward Maternal Fetal Medicine, since I do a lot of work in perinatal epidemiology. But I guess that there will be very little research collaborations for us in the future.

[Sheherezade]

My DH is a gyn onc - 1.5 years out of fellowship. It is a very surgical subspecialty. I thought it was a major downer too when DH went in that direction. My first reaction to your post was "Turn back now!!!!" but DH does love what he does. It is meaningful work and in the academic branch there are lots of research opportunities. You might be able to work out a collaboration yet. You can PM me if you want, or ask whatever questions you may have. I'll let you know what our experience has been.

[Cumberland]

My DH is PGY2 in OB also. He went in wanting to do GynOnc but has decided against it, thank god, bc he feels GynOnc is even less familiy friendlyly than Ob, well that is one reason anyways. He is planning on applying for an MFM fellowship but feel a but unsure bc he will miss the surgery. I would love to hear the discussion if there is one!

[bony00]

Are the work hours for Gyn Onc really worse than that of General OB? I thought that perhpas sub-specialties give you a little more flexibility.

[Cumberland]

One of DH's GynOnc attendings made a statement to him that really hit home- he said "My daughter was born while I was in residency, and I was so busy during fellowship and then building my practice that I really didnt get to know her. Our relationship has really suffered bc of it". I was so sad to hear that- his career took precedence over his family. Where DH is, the gynonc service is incredibly busy - it is the rotation that he consistenly works 100+ hours a week, why they think the 80 hour rule doesnt apply to gyn onc is beyond me.

[bony00]

That is a bit scary. Definitely not what I anticipated. Well we will see. DH still has the rest of this year and some of next year to make a final decision. I was looking and there are only ~40 programs in the country, so I guess it is really competitive. Does anyone know what proportion of Ob/gyns go on to fellowship?

[Sheherezade]

Our fellowship was pretty brutal. 3 years, one research year. Second year he was on call 24/7, with 1 weekend off call each month. With a surgical service of between 15-25 patients and a full caseload each day, he was always at the hospital or asleep with his pager on his chest. He went in each morning his second year at 4:30 am and came home between 8-10 pm. His hospital also did cases all day Saturday. Lucky boy, huh? Third year, he didn't have to carry the pager after hours (Just 2 weekends a month), and he got to go in at 6 am(instead of 4:30). After 2nd year that was bliss. Research year for him was harder work, but he got a lot of publications out of it. He did get fantastic surgical training. But, the commitment was immense......

Supposedly, 80 hour work week regulations kicked in for fellows last year though. I don't know if that is honored or not. At his former program they restructered. Sadly, they took the time out of the research year to keep the service covered. Now, 2nd year is better 3 rd the same and research year is worse.

[Malpka]

Another Gyn/Onc widow...ehh, I mean wife here I pretty much concur with everything Angie has said so far. DH is 3 months into his fellowship here at U of Iowa. So far, the hours have been brutal. Thankfully (?) DH came from a residency program that was very challenging as well, so it has not come as a complete shock like it seems to for past fellows here. Typically, I think he leaves here at 5 AM and gets home between 7-10 PM. He does get every other weekend off, which is nice. Home call (after hours call) is split with the other clinical fellow and home call means LOTS of pages at all hours, and very often a drive back into the hospital.

I cannot lie, I have still not quite rsolved myself to the whole Onc thing. I loved loved loved the baby stuff. I was convinced that after our last homebirth that DH was going to bring low-intervention birth to the masses. He however, prefers slicing and dicing. I was in public health also (Maternal and Child Health) and I just knew we would be publishing together. Eh, not so much. I finished my MPH, but had to drop my PhD program when we moved for residency. Now with the kids, and the inflexibilty of his job, there is no way for me to persue that now. Especially when you have no say in where the next spot you might land may be! I am now at home full time.

That brings me to the whole interviewing thing. Onc is super competitive, and you have to take any spot you can get. I would say there are about 35 programs, and something like 200+ applicants. Research/publications in residency are very important to be a competitive candidate. Also, if his residency is not at a "known" Onc place, he should go do a month away at MD Anderson or Sloan Kettering or Cleveland Clinic. Paul had 10 interviews, and the expenses ran us about 7,500 last year

Complain as I may, I must admit that DH really does love what he is doing, and I can't imagine he would have been happy in any other field. It was a quick realization from knowing the attedings at his residency program and here, that the hours are permanantly horrible. The dangling carrot was always the "better hours- more money- no middle of the night deliveries". Well, that is just not so. Many of the folks in DH's residency class are making more than DH will likely make upon completion doing General OB, and the call is shared for them. Their schedules are not that bad! I see the Onc attendings are working like dogs as well as the fellows, and with less people to split the work with. However, they too seem to truly be fulfilled in their careers.

Depressed yet? Don't mean to be such a Debbie Downer. It is important work, and living in such a small town I have been able to run into some of DH's patients Their gratitude is so touching, and it helps me put the sacrifices our family into perspective.

[bony00]

Well thanks for your response....hmmn. I thought that lifestyle would be better after a fellowship. I guess not. BTW, I think that it is quite a coincidence that you are also in public health as well.

My husband really wants to do Gyn Onc. He likes research and did some work at NCI that he is planning to continue. His program in definitely not an onc place and so he will most likely have to do a month away. Thanks for the words of advice. He has some time still. We will see.
How do you like Iowa?

[mommax3]

My DH was encouraged by a couple of his gyn-onc attendings during residency to pursue a gyn-onc fellowship. He never seriously considered it, (although he did consider MFM) because he loves delivering babies, he knew the hours would be worse, and he knew the money wouldn't be any better and might even be worse. I think the only OB sub-specialty that consistently makes more money than general OB is REI, and DH was not interested in that. DH loves surgery and I guess he is pretty good at it, but I think I would have thrown the mother of all sh*t fits if he had actually wanted to pursue Gyn-Onc. I could have done 3 more years that were *less* malignant, but not 3 more years that were the same or even worse. Plus, for us, there was no question but that he would have done the fellowship on the military's dime, thus enslaving us for even more years......that was not something that either of us wanted.

My hat is off to those of you who have gone this route (or are planning on it). You are more supportive than I have it in me to be.

[Malpka]

How do you like Iowa?

I actually love it! Very surprising to me, as a lifetime East-coaster. The town is great- awesome schools, very safe, friendly people. We do get a decent amount of cultural things here as well through the university. It has been great so far!

One more thing. When talking about the money/schedule post-fellowship I am largely talking about academic medicine. We actually knew one guy in Gyn/Onc private practice, and he made a true killing. His schedule was worse though, and he had not been on vacation in 5 years!