Obstetrics and Gynecology

OBGYN is the field of medicine that specializes in the care of women from adolescence onward. A career in obstetrics and gynecology is extremely rewarding, gratifying and diverse as OBGYNs have the privilege of guiding women through some of the most intimate decisions of their lives.

• Mix of surgery, primary care, and subspecialized care.
• Career paths varied: Some become generalists. Others go on to fellowships.
  1. ABOG Fellowships: Gynecologic Oncology, Reproductive Endocrinology and Infertility, Maternal-Fetal Medicine, and Female Pelvic Medicine and Reconstructive Surgery
  2. Non-ABOG Fellowships: Family Planning, Global Health, Pediatric and Adolescent Gynecology, Minimally Invasive Gynecologic Surgery, Breast, and Women’s Health
• OBGYNs practice in a variety of settings: private practice, academics, public health.
  1. Practice can be flexible with people moving back and forth between different settings. Some also choose to eventually practice OB or GYN (but have the same residency with training in both)
  2. A typical week in the life of OBGYN can mean something different every day! For example, a general Ob/Gyn (out of residency) will probably spend 3-4 days a week in clinic seeing Ob ad Gyn patients, 0-1 days in the OR, and 1 day on labor & delivery.

• OBGYN is a field for female physicians only: definitely not! Programs love male applicants, and female residents love having male co-residents to provide a good mix and balanced work environment. There is the occasional patient that will insist on a female physician for various reasons, but this is rare and in no way interferes with male residents from getting the same “numbers” as female co-residents.
• OBGYNs have the worst lifestyle: False. Any residency is going to be taxing. Most OBGYN programs say their residents work up to the 80 hour work limit. However, life gets much easier after residency depending on your specialty within the field and how much OB call you decide to take. Most practices (both academic and private) use a laborist model with patients seeing many providers within the practice during their pregnancy with the understanding that whoever is on-call when they go into labor will deliver them, rather than their personal physician. In very large call pools, attendings may take call only a few nights a month. In addition, many practices work closely with midwives, which can help reduce the workload in a laborist practice. There is a lot of flexibility after you graduate and can fit the lifestyle to what you want!
• OBGYN residents are mean and residency is “malignant”: This seems to be a rumor that has been propagated for unknown reasons. You can have aggressive co-residents and intimidating attendings in any field, but this is more an exception than the rule. Also if you love a field, small hiccups can be overlooked and should not be a reason to not pursue that residency.
• No one should go into OBGYN because malpractice is terrible: Malpractice is an issue in any field. Compared to the past, malpractice cases against OBGYNs have decreased. In our experience on OBGYN rotations, malpractice was rarely even mentioned.

• OB/GYN is considered to be a specialty of high competitiveness based on the overall number of U.S. applicants who match each year. It is rapidly becoming more competitive given the highly surgical nature of the specialty and diversity of possible career paths. Competitiveness varies tremendously from program to program.
  • During the 2019 Match, Obstetrics and Gynecology offered a record-high 1,395 positions, and all were filled when the matching algorithm was processed.
  • Good scores on USMLE Steps 1 and 2, Honors in Ob/Gyn and Surgery, strong letters of recommendation, and good interviews are important for a successful match.
  • As OBGYN becomes more competitive, away rotations are becoming more common/recommended. Although not necessary, if you have a particular program or location you are interested in, it is worth condisering.

• Board scores: A score of 200 or greater is expected at almost all institutions. However, most programs don’t have strict cut offs. The mean Step 1 score of U.S. seniors who matched in 2018 was 230 and the mean Step 2 score was 247.
  1. All programs want to see CK scores before its time to rank (before February).
  2. If you scored less than 210 on your Step 1, take your Step 2 CK VERY early (July or August) during your fourth year and definitely use one of your months off to maximize study time..
  3. In the past, some advisors have said that if you had a “good” Step 1 score you could/should wait to take Step 2 until later. However, advice across the country seems to be that you may not be offered an interview if a school cannot see your Step 2 CK score. Take it earlier rather than later to avoid any issues.
  4. Pay attention to Step 2 CS dates: a few programs required passing scores several weeks before the ROL deadline meaning late December was the latest to take it. However, it is not necessary to have Step 2 CS passing score in before interview season.
  5. Do not forget to re-submit all your CS and CK scores via ERAS as they become available!

• 3rd year LATE Spring
  1. Start asking for letters of recommendation. You will need 3 + an OBGYN chair letter.
     • You will have a meeting with Dr. Harman (OB/BYN chair) during the summer so he can meet you before writing your letter. You should also treat this as a mock interview, as he will ask you some interview-type questions and it is a good time to practice some answers/etiquette. Dress in interview attire and be prepared!
     • One letter should come from your 4th year OBGYN sub-I or an OB/GYN mentor that you have worked with. The rest do not all have to be from OBGYN: the best one is the individual who can write you the most personal letter. On the interview trail, programs really stress having STRONG letters that can speak to who you are. Letter writers will say if they only worked with you for a week, so choose accordingly! A letter from your surgery rotation may be a good idea since OBGYN is a surgical subspeciality.
     • Your other 3 letters can come from various rotations that you excelled on, and these can be from third year rotations. You can ask for more than 3 letters and then pick and choose which ones to send to specific programs (but don't ask a million people). This isn't really necessary unless you have extenuating circumstances.
     • Email UMD alums in OBGYN about their experiences, especially if you are still on the fence about the specialty. OSA can give you contact information.
  2. Start working on personal statement: Why do you want to be an OBGYN? Do not use “I like OBGYN because it is a mix of surgery and primary care”, that’s why most people go into OBGYN. Elaborate on a different reason why you choose OBGYN. Beth Singer, Residency Coordinator, is a great resource for editing personal statements. This is also a common question while interviewing, so be prepared.
  3. Start polishing your CV: OSA and OBGYN faculty are good resources.
•  Must do an OBGYN Sub-I: Currently at Maryland options are MFM and GYN ONC. Doing well on your sub-I is a great way to impress programs. Be prepared to work harder than you ever did 3rd year (it’s only a month!). Good options for your second sub-I: Medicine, Trauma ICU, SICU, NICU, Gen Surg
  1. Get a rec letter from OBGYN Sub-I, plan to do it earlier in the year (so that it will also be on your MSPE: by September). Keep in mind if you are on the MFM Sub-I, that your attending will change every week.
  2. Electives: one OBGYN elective 4th year is enough! You will be doing this the rest of your life. If you rotated at Maryland I suggest doing an elective at Mercy or vice versa so you can see both sites. Otherwise do electives in things you may never do again or may be helpful for a successful intern year: radiology, critical care consults, clinical applications of anatomy for surgeons (fills up fast!), OB US.
  3. Make friends with the residents! They will be your best resource this year.
  4. Start paying attention to things you didn’t notice as a 3rd year student: roles of different level residents on the team, interactions and vibe among residents, residents plans after residency, relationships between residents and faculty, impact of program size on residents, strengths and weakness of different programs, information about where residents came from and what they looked for when they were in your place.
  5. Away rotations: Unlike some other specialties where it is a requirement, OBGYN does not require an away rotation. However as the specialty is becoming more competitive, away rotations are becoming more important. It can be challenging to be thrown into a new environment and be expected to function at the level of an intern. Still, aways can provide an opportunity to get to know a program better and if you do well it can really help your chances of getting an interview. Additionally, if you are considering a geographic area that you have never spent time in but are not dead set on a specific program, an away may be a good idea. If you decide to do one, ask previous students about their experiences at specific programs. Do a rotation in something you do not have much exposure to or is not offered at Maryland. Application for most programs is through VSLO and begins in early spring. Start working on obtaining immunization records early (Jan-Feb) as student health gets swamped fast and you may need to get re-immunized. If you want to do a total of one away rotation, most people apply to between 1-3 to increase chances of getting one.
• 4th year summer: start using databases (see below) to very generally look at programs. A good option is Frieda as you can look at programs by region or state, Doximity can also be helpful (but take their rankings with a grain of salt). It’s also a good idea to look at the residency’s website as sometimes Frieda is not always up to date. A great way to organize the programs you are interested in is to make an Excel spreadsheet with boxes for things you are looking for in a program. 
  • OSA is a GREAT resource for this as they have a database of all the interviews that recent students have received. They can help you choose which programs you are more likely to get an interview from based on previous years from University of Maryland as well as your specific scores/stats.
  • Factors to consider: location, program size, number of hospitals / sites residents rotate through, type (community vs academic), patient population, exposure to subspecialties, available fellowships (it is generally easier to get into fellowship coming from a residency that has that fellowship due to connections, research opportunities, etc.; however, it is not an absolute necessity), paths of grads.
• September: finalize ERAS application and program list
  • Avgerage number of programs applicants for OBGYN from Maryland applied to for 2020 was around 50-60. It is becoming more competitive so have a range of programs, especially if you are not top of the class. Aim for 11-15 interviews so you can rank greater than or equal to 10 places. Plan to submit ERAS the day it is due as interviews are offered on a rolling basis.
  • Don’t panic if you don’t hear from places right away, the majority will not send interview invitations until after the Deans’ MSPE is released (late Sept –Oct)
• October: be ready to be checking your email all the time. Have a calendar either on your phone or on paper with you at all times. Be ready to respond to interview invitations immediately as spots fill up very quickly. Many interview dates among programs overlap, and some programs are known to give out more interview offers than there are actual interview spots. This is a process that is currently changing but it is still better to be as prompt as possible. Most OBGYN programs send mass emails and then you have to respond to the program coordinator with your top choices of dates or you may have to use a scheduling website/application. If you do not respond fast enough you will be waitlisted
  • Not a bad idea to make a list with all the available interview dates for programs you applied to, especially those you are most interested in to help facilitate quick decisions regarding interview dates, as they commonly overlap
  • If possible, have a family member or significant other check your email, especially if you are on a surgical service and will be in the OR
• November-January: Go on interviews! Most programs interview late October through early January, with the majority happening in November and December. Consider taking a month or two off to interview (most people take Nov and Dec) but be prepared to miss several days of another month; you are only allowed to miss 2 days of sub-I and 5 days of an elective. Enjoy the interview season it is lots of fun, though it can get tiring. Try not to schedule too many back to back - four in one week is too many but sometimes not avoidable. Try to go to the social events the night before as it is often the best time to chat with residents and observe their interactions with each other - also almost all programs keep track if you attend the pre-interview dinner, and can be a mark against you if you don't. Always remember that someone will be watching you at all times; therefore, always be nice and positive!
  
  • Things to ask residents: things they love about/wish they could change about the program, how supportive faculty is, the mix of married/single/social people in program, do they actually hangout outside work, how much driving they really do.
  • If there are still programs you have not heard from at this point and you are still very interested, email the PD or coordinator stating your continued interest, some may offer you an interview this way. Try and email earlier rather than later as spots fill up quickly.
  • Interview questions you may get asked: why obgyn, research experience and interest, future career plans (i.e. academics vs private practice, interest in fellowships), why this location or program, behavioral questions (almost every place had these, examples: tell me about…a difficult situation, a time you didn’t get along with someone, the worst day of your life, etc).
  • Questions to ask interviewers (always have a list ready in your head): how do you feel about the quality of residents coming out of the program, how are you approaching FLS (new-ish to OBGYN), what kinds of support systems do you have in place for residents, do you have any formal curriculum for residents as teachers, how do you handle feedback to residents and also about the program, what is the one thing you would change about the program, what kind of support is in place for residents pursuing fellowship?
  • Consider going on second looks only if there are things you are not sure about regarding a program, like the residents. This is not necessary at all and is only for your benefit. It is not another opportunity to meet with program directors and does not give you any benefit in terms of ranking.
• February: formulate and Submit ROL. Feel free to run by mentors and deans (get input from OSA and from OB/GYN faculty or residents), send #1 choice an email to let them know you are ranking them #1 (this is important), consider additional interest letters to top 2-4 programs (PDs have noted in recent years that they are less helpful; therefore, this is a good thing to discuss with your advisor before sending).
  • Programs, in general, do not send any post-interview communication, so do not expect anything!

For more information or any questions about OBGYN, please contact:
Kristen Langan 443-616-4993

Last Revision: January 23, 2020