Session 54 Dr. Esther Koai is an academic general OB/GYN. Listen to what drew her to OB/GYN, what she recommends you do if you're interested in it and so much more. She talks about her role, why she chose the specialty, and what you should be thinking about if you're interested in getting into OB/GYN. Also, check out all our podcasts on MedEd Media. For suggestions of physicians you want interviewed here on the Specialty Stories, shoot Ryan an email at ryan@medicalschoolhq.net. [01:07] An Interest in OB/GYN Esther says she likes working with women as well as the comprehensive care OB/GYN's provide. She also loves surgery. Specifically, she loves working with women and women's issues, women's health, and women's sexual health. She does a lot of contraceptive counseling in the office. She finds a lot of women who may not feel comfortable of talking to their friends or mothers/family, or even a male provider about certain aspects of their sexual health. And they'll open up to a gynecologist or open up to someone listening specifically for certain things. "It's a good mix of both the patient side, the continuity of care, and the surgical aspect of care." She realized this was the path for her during her four year of medical school. She finished her OB/GYN rotation on the third year. It was towards the end of her third year that she applied to all of her neuro electives as she was going into neurology. Then her last rotation of third year was Pediatrics and she realized in the middle of that rotation that she was much more interested in the maternal fetal aspect of things. She missed the labor floor since she had so much fun at her OB rotation. So she ended up canceling all of her fourth year electives and reapplying for OB/GYN. [03:47] Traits that Lead to Becoming a Good OB/GYN Esther thinks that in order to be a good OB/GYN, you have to be a good clinician and have that clinical acuity. You also have to be able to act fast. Similar to emergency medicine where you have to be able to respond fast. You have to be able to recognize that this is an emergency and you've got to call your team in and all that. Additionally, you have to be able to be flexible and be able to go between your OB and GYN patients. That means you have to switch back and forth from doing prenatal care to doing a paps smear and all of that. As an OB/GYN, she can decide whether she wants to focus on GYN over the other and vice versa. She explains it depends on your department but you can say you can focus more on GYN and do more teaching. There are people who refer their hysterectomies to her. "In order to be a good OB/GYN, you have to be a good clinician and have that clinical acuity." [05:18] Academic vs. Community Setting Part of the reason she chose to go into academic medicine versus going out in the community is her love of teaching. She loves teaching both her patients and residents and medical students, which you can only get in the academic setting. They do a lot of grand analysis and statistics and a lot of academic activities sprinkled in throughout her week. And she enjoys those. She did interview at a couple private practices but she found they just weren't for her. Part of it too is the thrill of just being in a high, action-packed, high risk academic center. Because you can see all the cool, crazy stuff out there. You get all the referrals for the intricate medical puzzles. [06:37] Types of Patients, Typical Day, and Taking Calls Being at a big academic center, Esther is seeing a wide range of patients. They're an accreta center so they see a lot of placenta accretas. They do hysterectomies. They have a Level 1 NICU. So they're able to deliver very premature infant. Their MFM (Maternal Fetal Medicine) team is well-developed so they have a larger referral base. A typical day for Esther would be Mondays, she would have a morning off for paperwork. Monday afternoons, she precepts the residents in clinic. Tuesday mornings, they have their academic day