Why OBGYN?

Trying to figure out what kind of doctor you should become? Wondering what specialty you should choose? Then SheMD's Why Specialty Series is perfect for you! We're bringing you female physicians sharing WHY they chose their specialty. Today's post is on why Dr. Meljen chose the field of obstetrics & gynecology and why OBGYN is a great field.




Two facts to start:

I love what I do.

I treat every patient how I would treat my sister, mother, grandmother, or friend—with love. No matter what hour it is.


What is it about Ob/Gyn?

Obstetrics and Gynecology is not for the faint of heart. Obstetrician Gynecologists are brazen physician-surgeons who care for women. We believe in a future that is equal and will work to all ends to advocate for our patients.


How did I get there?

As a healthy young woman who grew up in a family without doctors, all I ever knew before going into my training was primary care. Throughout college and the start of medical school my goal was to practice Family Medicine. I applied for the NHSC (National Health Service Corps) scholarship and received this award which would sponsor my way through medical school in exchange for four years of service as a primary care physician in an underserved area upon completion of my training. Along the way there were hints that I would stay involved in primary care, but focus more on one particular population.


For me this started when my Abuela (grandmother) was abruptly diagnosed with cervical cancer, a preventable pelvic malignancy, and passed away within months. Abuela was extremely conscientious about her health and went to doctors often, but neglected her gynecologic health for decades due to cultural reasons. As a Cuban woman born in the 1930s, speaking about the “nether regions” was taboo. It pains me still to think that she might be here today if she had gotten routine Pap smears throughout her life; something I now do for other women most days.


I tried to channel the loss of my grandmother to do good and focused my energy into the study and art of medicine. During my first year of medical school I was enthralled by my anatomy course, dissections, and histology. The logic of the basic sciences and endocrinology spoke to me. As a novice, I remember grimacing while watching that first vaginal delivery video, feeling almost certain that I would never be able to take part in that every day. Now I know that some things are better seen in person and in context. There is hope for us yet!


Throughout my third-year clerkships I developed my interests further and discovered my natural aptitude for procedures and surgery, but still loved the idea of continuity of care and holistic medicine. During my Ob/Gyn rotation I was fortunate to rotate through Concord Hospital (NH) with a private practice that accepted medical students. This experience showed me first-hand the long-term, intimate, and supportive role that an Ob/Gyn plays in the lives of their patients. These were people I would’ve wished for my grandmother to have been cared for. My attendings were happy. They were personable and honest about their careers. Not one regretted their decision to become an Ob/Gyn. I had found my people.


A few considerations:

One of my most forthright attendings told me “You know that nauseating feeling when you’re exhausted in the middle of the night and get paged to go do something. Pick a specialty where when you have that feeling at that hour you still want to get up and go do the job.”


PGY1-4:


Most days I get home exhausted mentally, emotionally, and physically. Residency is all feast in terms of patient volume and workload, but afterward, for most, it is a mix of feast and famine. The intensity and speed of residency challenges you to be efficient and manage time well. You learn to handle emergencies calmly. Residency is hard, but rewarding.


As a resident you participate in an even broader spectrum of care than you will as an attending. You are involved in everything from genetic counseling and perinatology to chemotherapy management and end of life care. In the same shift as a second-year resident I have delivered a baby, operated on an ectopic (tubal) pregnancy, and then helped a woman through the last moments of her life. This field is extremely diverse and stimulating.


Continuity of Care: Depending on where you practice you may have a variable degree of continuity with your patients, but in most practices you will have patients that you can follow intimately throughout the different stages of their reproductive lives as you go through them too.


Girls supporting girls: The other day I was at the climbing gym-- my weekly routine that I’ve developed while in residency thanks to a colleague of mine—and a man stopped me to ask me how long I’d be training at the gym. He congratulated me on a great climb and said he was happy to see a woman excelling at this male-dominated sport and being a role model for his young teenage daughter. This was heartwarming, but what I really wanted to share when I told her “you can do anything” was how cool my day job is. Ob/Gyns, like other specialties, can help young women see what is possible and support women-- as their doctors, as a part of their community, and through the media.


The unspeakable: On a daily basis I have the honor of helping women through things that are often unmentionable in their day-to-day lives. I get to be the person my Abuela needed years ago. Women often suffer in silence. It is uncommon for the conversation at the gym, coffee shop, office, or party to revolve around leaking urine, abnormal bleeding, pelvic pain, miscarriages, sexual trauma, or the like-- But if you sprain a limb it’s a visible injury and its “normal” to talk about it. We break down barriers to these conversations, normalize their situation, and help them feel comfortable so that we can help them get through it and get better.


#ILookLikeASurgeon: The general public doesn’t often realize that Ob/Gyns are surgeons. The media doesn’t help this cause with its pink scrubs and emphasis on delivering babies and Gyn pelvic exams. As Ob/Gyns, not only do we provide outpatient and inpatient medical care, but we perform major abdominopelvic surgeries of all kinds. There is an amazing feeling that overcomes you as a young female Ob/Gyn when a patient realizes that YOU are her surgeon and expresses her excitement for your accomplishments and the fact that you will be providing her care. While it may seem “normal” to our generation to see young female surgeons and physicians, for many patients this is still new. In many parts of our country this is still new.


I am lucky to do what I do every day. It is a privilege to take care of women and educate trainees. Every patient is an opportunity to do good for her and the world. It takes every ounce of energy and passion to do it every day, but there’s nothing else I’d rather do.


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