This question was posed by a future medical student:

I’m entering med school this fall, and women’s health and REI is a great interest of mine due to personal and familial reasons. Once you completed your Ob gyn residency, how difficult was it to enter into the REI fellowship? How long was the fellowship? I’ve also considered Perinatology– what are your thoughts on that field?

When I made the decision to go into OB/Gyn, I did not know I would end up in REI. I didn’t even consider it initially, mostly because I didn’t know much about it. As my residency progressed, I found a great mentor in one of my faculty who was once president of the American Board of OB/Gyn. His field was Gynecolgical Oncology and he encouraged me to go into that field. I was initially greatly drawn to Gyn/Onc because it involved a wide range of very skilled surgery, including GI surgery and urological surgery in addition to medical knowledge of chemotherapy. However, when I discovered REI, it became my new love. When my mentor learned of this, rather than being upset, he was fully supportive and did all he could to help me enter a fellowship at UCLA. Each person’s situation is different, so if I were to answer your question of "how difficult was it to enter into the REI fellowship", it was very difficult only in the sense that I had to go to the right med school and the right residency and earn the respect of the right people. Other than that, it was easy.

I can also help answer your question by presenting last year’s statistics:

Match Results Statistics
Obstetrics/Gynecology (OB/GYN) Fellowship

Match Day October 31, 2007
Appointment Year 2008

STATISTICS BY SPECIALTY

Updated 11/09/2007

As you can see, in Gyn-Onc, there were 49 positions available, of which 45 filled. In perinatology, also known as MFM (Maternal-Fetal Medicine), there were 77 positions available, all of which filled. In REI, there were 38 positions available, all of which filled. The newest subspecialty is Pelvic Surgery, of which 27 of 29 positions filled. There wasn’t a breakdown of the different subspecialites with regards to number of applicants, but overall for all the fellowships, there were 343 total applicants. Of those, 55% matched somewhere and 45% failed to match anywhere. I would estimate there are just over 1000 graduating OB/Gyn residents nationwide. There are also some foreign applicants adding to the pool. These data also don’t include applicants who were accepted outside of the match system.

When I counsel medical students regarding a career in REI, one recurring theme is the need to be happy doing general OB/Gyn as there is a very real scenario of OB residents failing to get into a REI fellowship and ending up practicing OB. A minority of students give up on the idea of going into REI because they don’t feel that they would be happy doing OB. As many students will attest, OB seems to be a polarizing rotation in the 3rd year with a greater % of students feeling the extremes of really loving it or really hating it.

I know many RE’s and many doctors in other specialties. There are happy RE’s and disgruntled RE’s. There are happy FP’s and disgruntled FP’s. I will offer an opinion that from my observations, RE’s tend to lean towards being more satisfied with their work than being less satisfied. As for myself, I’m an extreme when it comes to that question, being very very happy with my choice of specialty. Bear in mind that about 1 out of every 700 doctors is a RE, so we are very much a minority.

Finally, in answer to your question on my opinion on perinatology, I love the perinatologists with whom I work. They save us when we end up with triplets or more. I’ve witnessed some incredible work by the MFM miracle workers who rescue those of our IVF babies who happen to be born prematurely. When you ask a perinatologist what they think of RE’s, they might give a mixed answer of dreading the occasional sets of triplets and quads they get from us, but also acknowledging that we definitely keep them in business.