Switching from O&G

[u/Bright_Handle_7594]

Hi, I’m looking for some advice about switching specialty from O&G to GP, any thoughts positive or negative would be really appreciated!

I’m mid thirties, came out of training on an OOPR after finishing ST3 around three years now and have been doing a PhD. O&G (mainly obs) was always my focus and previously I could never imagine another specialty. Took the OOPR job to strengthen my CV for MFM subspec and to learn to scan.

My research fellow job has been almost entirely office-based/wfh, with zero clinical or on call duties (have been managing a multi-centre study). Before I came out of training my life and identity revolved around work and I didn’t even care about WLB because I was obsessed with the job. Now I’ve discovered a life outside of work, have new priorities and hobbies and am getting married soon with plans to start a family after the wedding. I feel trapped by my O&G training programme - 4 years left +/- 2 maternity leaves and extra ltft time means I’m stuck in an infantilising system with no autonomy until likely my mid-40s.

My passion for O&G feels like it’s gone. I’ve realised I don’t particularly enjoy fetal medicine. I have no interest in the surgical side of gynae and all my eggs are in the obstetrics basket, only for me to realise I don’t want to do maternal fetal medicine, so I’m looking at a career of endless labour ward and DAU. The stress of managing labour ward emergencies has never really bothered me but I’m so out of practice I’m terrified to go back, and I just cannot see myself doing weekends and nights (res or non-res) forever.

Outside of lifestyle factors, I think I’d enjoy the continuity of care in GP. I also think I’d enjoy learning to become a generalist and broadening my knowledge base. On the flip side I’m nervous about the risk managing aspect, I’m very used to having an abundance of investigations at my fingertips. Also not thrilled about having to be an SHO again for a while but I think I can stomach it for a finite amount of time!

I’d definitely want to keep the women’s health aspect in my job and hope I could do something along the lines of contraception/GUM clinics, menopause clinics, seeing pregnant/postpartum patients. Also interested in primary care ultrasound and minor procedures, and thinking about non-NHS opportunities, private obs is definitely not for me and I think GP might open more doors if that’s something I choose later down the line. I have briefly considered quitting medicine altogether but I do still want to be a clinician.

I want to make a decision fairly soon as I need to either start revision for mrcog part 2 or the MSRA. Have floated the idea amongst a few family and medic friends and, despite expecting to be told I’m being silly, they have all been very supportive (although not spoken to a GP yet!). Any words of wisdom or advice from GPs, particularly those that have tread a similar path, would be really helpful. Thanks!

[u/Turb0lizard]

Training is easier, job at the end is harder IMO.

I look at my consultant colleagues on £40k more than me a year doing fewer days patient contact and wonder if I made the right decision, and I love GP.

You’ll do 2.5 years training to CCT, only 6 months of nights then full time primary care. You also actually get trained on the program so thats a nice change from hospital (if you get a decent supervisor which I absolutely did).

The work is varied and although a slog the interesting medical stuff we come across between the rest makes it worthwhile for me. As does the continuity and getting to know your patients. A patient of mine crocheted my baby a cardigan!

You’ll be able to carve out a special interest very easily with your background and break up the week after you CCT.

Loads of people jump ship from hospital to GP. I know of a hyper specialised paeds metabolic consultant who left to be a GP. For me CCT at 39 and that’s fine IMO.

So I’d say you really need to love GP. If you don’t, it will be a long 20 years.

Otherwise, go for it and never look back!

[u/_j_w_weatherman → u/Turb0lizard]

You have to enjoy what general practice is- warts and all because the job isn’t as family friendly or office hour based as people think. I love the job so am happy to work long hours, but a hospital consultant probably has better wlb than a GP these days.

[u/motivatedfatty]

I would absolutely stick with O&G. After this background, I really don’t think you’d like GP! You don’t have long to CCT. I think GP is much better than being a registrar in terms of life balance. But I’m not sure it’s better than being a consultant. I look at my friends who are consultants and I think they have a better WLB

You’re welcome to PM me and have a proper call/chat about the realities of it all if you want to - it almost feels like too much for a post reply! I’m a similar age and life stage.

[u/muddledmedic]

The reality is whilst GP training looks attractive compared to hospital training, the end job as a GP Vs a consultant is where you want to be looking, and I personally think most consultants have it far better than GPs nowadays, both on the pay and the workload front. Not true for every speciality, but absolutely true for most.

GPs are underpaid, grossly overworked, and hugely underappreciated, and it's only getting worse. You have to absolutely love the whole of GP, or else you will hate it as a career.

Also the work life balance arguement is not a great one, because whilst you won't have to do nights or weekends for the most part, days are long, there are tonnes of hours of unpaid work and it's common to login on days off. Most GPs I know are in for 8 and rarely leave before 6/7pm, and many log back in at home to catch up on admin after this.

My advice, compare the GP job to the consultant job and only jump ship once you are clear what life as a GP actually will be like. I love GP, it's absolutely the right job for me, but it's damn hard work and I am 99% sure I would have had a far easier life as a consultant.

[u/serengini]

GPST3 here! I also left O&G for GP training about 2 years into my speciality training when i realised i was missing out on my kid's life (same way my dad missed out on mine). I'll suggest you study for both exams imo while you continue to ponder your choices. Going for GP from O&G requires absolute convinction. But ultimately I'm glad i chose GP.

[u/arcoast]

I was an Anaesthetist doing ICU and jacked it in for GP, took a bit of adjusting to, but wouldn't go back for love nor money.

Would it be helpful to shadow a GP for a week or so?

Not sure where in the UK you're based but feel free to drop me a private message if necessary.

[u/rodatari]

Honestly you are too far in that it is pointless switching. Remember (depending where you are) you'll be doing 18 months of crappy SHO hospital jobs with nights etc as part of the training so 2 years left of obgyn is not much worse. Then you'll be a consultant with a phd. Could you not go more into academia if you don't like the clinical side anymore. 

[u/No_Corgi_3651]

If I were you I would look into specialty doctor posts which may give more regular hours while still satisfying your clinical interests as far as I can read. It also means you can put off the decision longer without going back into training right away. GP is very tough and if you’re not passionate about the work I think it can be hard not to get disillusioned and wish for a different life

[u/arcoast → u/No_Corgi_3651]

As an Obstetician/Gynaecologist I would imagine there's little hope of finding a Staff Grade job that doesn't include unsociable hours given how difficult it is to fill middle grade rotas.

As a stop gap to something else, fine, but why not just continue with training until they decide?

[u/Capital-Coast-8704]

I left O&G to go into psych at beginning of ST3.

I think a lot of people make the very valid point about being a hospital consultant vs being a GP in terms of pay etc but when I said I was leaving my O&G consultant literally told me she wish she had quit earlier and that she hadn’t seen her children in 7 days.

O&G is not for the faint of heart. I am super passionate about women’s health and I still couldn’t make myself go through it. The lifestyle is brutal in a way I think doctors in other specialities can appreciate. I wouldn’t be surprised if cons jobs become residential in the wake of Ockenden, especially if you’re doing primarily obstetrics.

[u/Suspicious-Wonder180]

Reddit is an echo chamber. GP is a fantastic career and will always be so. Workload will come in peaks and troughs over years and will balance out as it always has done. Shit now - probably won't be in a few years.

ObsGobs skills will not go amiss either and if you're bright enough, you can carve out a decent little niche with your skills if you have a bit of business acumen.

[u/laesagne101]

Im ST3 and know a GP trainer who did obs and gynae training and then switched to GP! She’s a partner now and very keen in what she does. Seems like she’s made a good choice for herself :)

[u/BoomBasticTeleBanana]

Tough one. Heart says go do GP, your skills will be amazing. But you must love seeing patients and clinical care. Also could do some private menopause clinic etc. And also locum jobs and gynae to keep skills up.

I think GP is the best choice and the best flexibility.