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[Music]
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yeah hi
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all i'm dr melody salmona obgyn board
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certified
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welcome to our office women's health
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institute um i was going to talk to you
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about a day in the life of an ob gyn
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give you all the details that i go
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through on a daily life and maybe some
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tidbits of what happens outside the
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office
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so follow me into our entrance so here
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unfortunately things are a little bit
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different obviously with our coven
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and so we want to temperature check all
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of our patients as well make sure
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everybody's wearing a mask
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i normally wear a mask i promise but
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follow me in and then we'll tell you how
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everything goes throughout the day
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so in here all of our patients again
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after they've been temperature checked
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and wearing their masks are going to
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just check in
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and we'll let them come back here with
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one of our medical assistants
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so that they can get their temperature
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checked as well as their weight
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um and any other pertinent vital signs
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before we get into the office all right
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so follow me again
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patients are then going to continue down
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this hallway we usually have them follow
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into one of
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at least at our office one of our
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references where they are going to get
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their weight taken
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as well as their height
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and given that we do work down with our
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genito urinary system we make sure we
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get some urine samples for any of their
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potential problems that are either
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obstetric or gynecologic
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and they'll leave those zombies here
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with us as well
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okay so once that's been all of that
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pre-check done the patients will follow
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again our medical assistant
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and either do a couple of things they
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can either get an
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obstetric ultrasound or a gynecologic
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ultrasound which we have here in the
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office
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they might come in for their laboratory
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work first and then once that's done
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they'll follow me into one of these um
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patient
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rooms where we can actually talk about
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the visit that they're here for
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this is where i do my work in this
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office i actually have two offices this
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is one of them
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these are my three patient rooms that i
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have rooms one room two
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and room three so in here if you want to
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come on in
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patients will initially sit down here um
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and then we'll do our interview process
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as well so i'll take a seat here
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most of the time i bring in my computer
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so that we can go over their history
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make sure it's all nice and pertinent
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and ask for any new updates
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that are necessary so remember we have a
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different type of population here it is
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all women
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but we see both gynecologic patients as
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well as obstetric patients
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and all ages i have patients from ages
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10
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all the way to ages of 80s 90s and they
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all have different variable symptoms or
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problems that they'd like to get
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evaluated and then obstetrically we're
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confirming patients and we're also
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seeing them all the way through their
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postpartum visit so
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lots of good variety in the office that
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really helps you just kind of
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help women in general and all of their
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different needs throughout
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their year okay
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so once we're done with that we will
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review all of their results if they're
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needed
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and as they're done with our visit we've
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answered all their questions
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i'm giving them specific vaccines or
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injections that are required
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they're done with their visit for the
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day and they go right back out to the
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exit
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where they will make any future
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appointments with us um
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or any follow-up appointments that they
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might need and that's just right back
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where it came from
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so that was a quick overview of how the
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day goes but now we're going to actually
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go down and get into all of the details
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the nitty gritty stuff the really cool
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information that you want to know
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about how it is to work in a day in the
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life of an ob gyn
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let's go
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hi i'm dr melody samura obgyn board
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certified
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and today we're just going to be going
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into a further detail on what it's like
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to be an ob gyn what you can expect and
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hopefully answer some questions for
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you to make you come into my field
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because it's awesome
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so a typical day for an ob gyn i'm going
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to tell you is very variable from day to
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day because obstetrics itself is really
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relying on the patients particularly the
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ob
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part so what we do and i'm currently in
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private practice there are some other
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types of practice you know you could be
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just working in the hospital and be a
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hospitalist and only do obstetrics
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you could be part of a major um group
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like a kaiser and sort of have to follow
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their roles but for me we're private
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practice
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so i'll give you the details on that set
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so i do surgery on monday mornings
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so monday mornings i am up at around
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5 30 to 6 because my surgeries are gonna
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start at about seven o'clock
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i do them all morning on monday and i
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usually am able to do about
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three to four surgeries depending on the
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type of surgery
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the surgeries can include anything like
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a hysteroscopy
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which are those small little minor
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surgeries where we go inside the uterus
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and see if there's any abnormalities
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there for what particular problem the
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patient came in
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or something as significant in major
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surgery as a hysterectomy
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and i do robotic surgery personally we
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could always talk about that in detail
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if you had any questions on that further
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and that's my monday morning in the
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afternoon i follow that up with
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office visits so then i come back to
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this office here and see patients for
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the rest of the afternoon
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i will get some lunch in there so don't
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worry about that
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other days um thursday sorry tuesday
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through friday are definitely going to
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be our regular full day
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ob visits as well as gynecologic visits
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so all in the office
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as i had mentioned earlier i actually
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have two offices
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so it depends what part of the city i'm
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at the different kind of patient
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populations but in general we're seeing
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again obstetrics and gynecologic
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patients
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our office opens at 8 30 in the morning
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and we are done by about 5
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30. i do have a long day which we get to
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see patients who unfortunately like
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myself work all day and still need to
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see a physician so we extend our hours
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to about 7 pm for those patients as well
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and those office visits are usually
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going to be placed in 10-minute slots
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but we definitely take a little bit
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longer to see our patients so we are
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sometimes running behind and that's the
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nature of being a physician in the
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office trying to get to see as many
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people
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and help as many people as you can and
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you always want to make sure that you
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pay attention to your patients you're
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giving them that full undivided
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attention
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now obstetrics we have a call system
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in my group and so sometimes i'm doing
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24 hour calls in the hospital and so for
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those days
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i will show up at 7 am and i will not
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leave until 7 a.m the next day
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we live in the hospital so we're there
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for our patients
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24 hours and for any emergency needed in
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them
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er consults from the hospital list of
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patients that have already been admitted
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that have
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gynecologic or even they find out that
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they're pregnant when they came in for a
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procedure
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as well as our laboring patients and
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those that have any
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other issues emergently in the obstetric
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fashion
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so that is a general overview of all of
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the days
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again surgery office visits as well as
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obstetric and gynecology calls in the
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hospital
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so i started school i went to undergrad
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at yale university and then
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i did a post-baccalaureate program at
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georgetown and followed up with
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being at georgetown medical school so i
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love surgery i've always been very
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hands-on even since i was little
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i would always help my dad my dad
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actually has some experience in
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working as a butcher so he would always
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be able to tell me about the anatomy of
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certain animals and i was really into
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that so i knew i wanted to do something
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surgical
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but once you go into medical school you
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know the first two years
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books tests all that fun stuff you
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finally get to get into the hospital on
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your last third and fourth year
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and that's where you get to experience
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all of the different sub-specialties and
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see which ones you think
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are most fitted for you obstetrics and
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gynecology or my ob
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gyn rotation was at the very end and
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i previously before getting there was
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pretty into maybe some plastic surgery
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because again as i mentioned i
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really like surgery but then i did
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obstetrics and i delivered a baby all by
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myself and that is one of the coolest
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things you can ever imagine
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that you are the person that helped this
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couple
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get their baby i usually tell patients
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like there is some other human in this
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room and i'm gonna find it and it's just
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delivering a baby making everybody happy
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it's a great
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great um specialty to be in
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particularly for me i feel like it's a
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very happy um
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specialty we deal with only women and
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most of the time they're there to kind
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of
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ask you about problems that they're
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having and solving those problems
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whether they might be severe abnormal
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bleeding
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really terrible periods pelvic pain
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cancers such as breast cancers
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gynecologic cancers we are the ones that
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find those and then refer them
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to the subspecialties and so whenever we
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are able to one find these things or
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resolve their issues they're very very
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grateful and so again it's just such a
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happy place to be in
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i will say yes we have some downs
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particularly in our obstetric
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um specialty but when those things are
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bad you
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again are also there for your patient
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and they really appreciate that
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and you have such a better relationship
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when they come back for their
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subsequent pregnancy and everything else
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it works out very well
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so those are the reasons the patient
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population the variability
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of what you can see as i mentioned all
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of the gynecology stuff the obstetric
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stuff
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there's lots of different degrees of
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intensity in ob
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where patients may have to manage
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diabetes their thyroid problems
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their obesity their asthma even their
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mental illness so you really have to
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take in
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everything that you learned in medical
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school and apply it
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and i think it makes you such a good
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specialty where you feel like you're
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doing an
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overview and taking care of women for
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everything that they might need
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and it makes it a really satisfying day
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okay so you probably are all wondering
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how long does it take you to be an ob
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gyn how do you get to the finish line so
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as always you have to start with your
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undergraduate career so that's your
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four-year undergrad
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and then you will apply to medical
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school medical school is also four years
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once you're done with medical school
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then you will apply to residency
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particularly depending on your
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particular um
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residency choice you'll either have a
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two-year residency
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a three-year residency four five maybe
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even up to seven years
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for ob it is a four-year residency
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in that residency you are obviously
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taking those
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information and general knowledge that
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you got about physical exam
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um in the ob gyn field when you were in
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medical school and then taking that even
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a couple steps further
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and four years of being on the floor
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delivering babies
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learning how to start with your
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surgeries being able to pre-op a patient
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suggesting the right type of surgery or
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maybe just medical management so really
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honing in on those details that are
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going to make you a very good ob gyn
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and by the time you're at your fourth
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year you are definitely very well versed
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in the different types of surgeries that
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there are
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the nice thing about gynecology is we
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have a lot of minimally invasive surgery
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as well as open surgery in particular
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in my field and what i learned in
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residency was robotic surgery which is
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really cool surgery where you're able to
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have a patient kind of stay away
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on that part of the console and you're
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in a little your own little console just
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making sure you're using all of your
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instruments and doing the most minimally
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invasive surgery possible
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that takes years of practice and
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learning and you get all of that in
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residency
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in addition i am a general ob gyn
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ob gyn specialty also has subspecialties
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we have maternal fetal medicine for
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those of you who are really
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interested in really only doing
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obstetrics and those high-risk
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pregnancies
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um things such as again managing
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diabetes
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hypertension preeclampsia really
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rare things maybe something like an
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eller stand list patient or a patient
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that actually has a cardiac
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dysfunction that needs to be assessed on
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a much
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more rigorous basis than a general ob
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gyn
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you have fertility or reproductive
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endocrinology
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and infertility those are the docs that
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are going to be able to really help
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patients get pregnant
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or have any other reproductive trap
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abnormalities that they want to help
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that's another subspecialty you have
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urogynecology
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for those of you who are really into all
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of the female bladder
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prolapses that are out there the
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cystoceles the rectoceles
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that you really were into the type of
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surgery and you want to help women in
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that sense
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we also have gynecology oncology so
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remember you have ovarian cancer
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you have fallopian tube cancer uterine
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cancer cervical cancer
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and all of those things are definitely
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addressed by a gynecology oncologist
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and that is a very fulfilling specialty
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as well
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there is also a small minimally invasive
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or mis specialty that if you felt like
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you didn't get
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enough minimally invasive surgery in
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your residency depending on where you
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were
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taught or educated that you can do that
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and really hone in on those skills and
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then again become one of those surgeons
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that is really proficient in that type
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of surgery so you get to have all of
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those specialties if needed and that
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would be after your four years of
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residency
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i chose to do general obstetrics and
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gynecology because i love all of it and
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i wanted to be
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do a little piece of all of those and
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not be honed into one own thing
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however i am kind of more specializing
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in the robotic surgery
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as well which again is your own choosing
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particularly when you go into private
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practice
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that you can choose exactly the niche
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that you want
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for example another thing that i'm
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really into right now
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is being able to help those patients
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that are um
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transitioning and those transgender
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patients that would like to have a
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hysterectomy
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we're able to get those patients in and
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follow along with them as they do all of
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their hormones and things of that nature
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so there's a wide variety of things you
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can do but again you have to start from
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the beginning
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you do your undergraduate you do your
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medical school and anything that's going
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to help you get into medical school as i
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mentioned before i did do a one-year
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post-baccal award program
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at georgetown when i did medical school
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that really helped me
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to transition into my medical school
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career time
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following that your residency
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potentially maybe some specialties after
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that and finally being able to go out
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into open practice
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and forming all of the procedures that
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you'd like to do or just seeing patients
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in the office
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again you could also be a hospitalist
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which i mentioned those are people that
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only do obstetrics and gynecology at the
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hospital base so they just have a 9-5
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so you can definitely manage your hours
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as well because being an ob
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has a lot of extensive hours those calls
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that we talked about in terms of 24-hour
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calls in the office
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particularly depending on your group my
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group is actually very big so i have
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those 24-hour calls about two or three
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times a month
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but if you were in a much smaller
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practice you might have to follow your
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own patients and therefore be on call a
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little bit longer
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and so knowing the things that you want
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in your lifestyle
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and the type of doctor that you want to
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be
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will also help you tune in and hone in
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on the places that you that is going to
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be the best setting for you to be the
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best ob gyn that you can be as well
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so you put all your time in you went to
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all of the schooling you have
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so much in student loans how much am i
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going to get paid when i become an ob
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gyn
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i will tell you first of all that's
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going to depend what state you go to
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and again what choice you make obviously
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those sub-specialties of gynecology
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oncology urogynecology
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maternal fetal medicine they're going to
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be in the higher bracket
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usually probably coming in anywhere in
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the fours to 600
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whereas a general ob gyn you're getting
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into the threes to maybe 500s
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you could get much lower salary if
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you're at a very high population
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place um so for example i live in san
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antonio texas
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in austin they have a lot more ob gyns
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so their salaries are actually starting
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much lower somewhere between the
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150s to the 250s over time with
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experience you obviously will generate
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more revenue
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but when you first go into a practice
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and this is private practice
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you're going to have most of the time
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just a base salary
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and then from that depending on the
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number of patients that you see
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the number of surgeries that you do your
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income will start to increase
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so don't be alarmed if you choose a
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particular city
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that you're not seeing these 300 400s
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you're really seeing more of 150 to 200
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over time that will accumulate an
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increase however you sometimes will
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start on those lower numbers
00:16:47
depending on your choices again you will
00:16:50
have a difference if you're a
00:16:51
hospitalist
00:16:53
here in san antonio the hospitalists are
00:16:55
usually started somewhere at around 300
00:16:58
k per year where as
00:17:01
again general ob gyns here if you go
00:17:04
into a practice i think they're starting
00:17:05
nowadays more in the two
00:17:07
to 250s and so that's kind of a quick
00:17:10
overview of how money matters on this
00:17:13
um but obviously again with experience
00:17:15
with your
00:17:16
timing how many patients you see that
00:17:18
number keeps going up
00:17:20
so you do have to think about your life
00:17:22
balance
00:17:23
um and your life and work balance i
00:17:26
would say
00:17:26
because if you want to make much more
00:17:28
money then you can bring in 40 patients
00:17:31
a day
00:17:32
but how much time is that leaving you
00:17:33
for your family so you have to
00:17:35
prioritize that way
00:17:36
in general i will tell you in my
00:17:38
practice i probably see between 30 to 35
00:17:41
patients a day
00:17:42
um and again i do those three calls a
00:17:46
month
00:17:46
and that is particularly plenty for me
00:17:48
and satisfying in terms of where
00:17:51
um we lie in terms of monetary as well
00:17:53
as lifestyle choices
00:17:54
but you could always tweet those numbers
00:17:56
depending on where you really want to
00:17:58
see yourself
00:17:59
so a lot of things you've got to think
00:18:01
about is you know how are patients going
00:18:03
to
00:18:03
receive any information or what are some
00:18:05
issues that you might have
00:18:06
on your daily basis when you are an ob
00:18:09
gyn
00:18:10
so i think a few things we can talk
00:18:12
about on that front is
00:18:14
obviously results as i mentioned before
00:18:16
sometimes we're the first people who
00:18:18
actually diagnose
00:18:19
an endometrial cancer or a breast cancer
00:18:22
and so
00:18:23
one of those issues is one how you're
00:18:25
going to talk to the patient
00:18:26
obviously be empathetic but be able to
00:18:29
make sure that those referrals are done
00:18:31
appropriately and
00:18:32
quickly so the patient gets their best
00:18:34
outcome
00:18:35
now in some instances you have to really
00:18:37
talk to patients and make sure that they
00:18:39
understand the appropriate diagnosis
00:18:42
because they can leave the office and
00:18:44
maybe not follow up because they didn't
00:18:46
understand appropriately
00:18:48
and then you see them you know a year
00:18:49
later for their annual exam
00:18:52
and they never got any follow-up or any
00:18:54
of the recommended
00:18:56
direction that you had previously spoken
00:18:59
of and so
00:18:59
that really becomes an issue for a lot
00:19:01
of patients that they feel they weren't
00:19:02
treated appropriately or that
00:19:04
we miss something so you always want to
00:19:06
make sure you're following your
00:19:08
guidelines
00:19:09
documenting everything that you talk to
00:19:11
your patients about as well as
00:19:13
the risk of everything and what the
00:19:15
percentages are if you're able to kind
00:19:17
of quote those
00:19:18
so that you don't have to have that type
00:19:20
of liability in the end
00:19:21
ob gyn has a high high liability risk
00:19:24
one for that gynecologic part but more
00:19:26
importantly for the obstetrics
00:19:28
there is an entire new person developing
00:19:31
in your patient's womb
00:19:33
and so once they're born could they have
00:19:35
any issues in terms of as you guys i'm
00:19:37
sure have already heard is there any
00:19:39
autism issues was there a shoulder
00:19:41
dystocia that could have been prevented
00:19:43
why did i get a c-section when i wanted
00:19:45
a vaginal delivery
00:19:47
and all of those things are obviously
00:19:49
brought up or if babies end up in the
00:19:51
nicu
00:19:52
and why did they have to be in the nicu
00:19:54
was there something that we could have
00:19:55
done to prevent that
00:19:57
even to an extreme of an actual
00:20:00
congenital abnormality a heart condition
00:20:03
that was not seen on imogene and was
00:20:06
found subsequently after birth
00:20:08
you know do you have to go back and
00:20:09
review all of those ultrasounds
00:20:11
and make sure that we didn't miss
00:20:13
anything one just to make sure for the
00:20:15
liability purposes and two
00:20:16
as an education for the future so that
00:20:18
instant doesn't happen again
00:20:20
and so making sure that you are always
00:20:22
up to date on the latest in terms of
00:20:24
different testings what you could offer
00:20:26
your patients
00:20:27
as well as being up to date on
00:20:29
ultrasound reviewing imaging high-risk
00:20:31
physicians
00:20:32
are going to be the safest routes for
00:20:34
yourself but more particularly for your
00:20:36
patients you never want to
00:20:38
have any type of pregnancy or outcome
00:20:40
have a
00:20:41
abnormal outcome or a disfortunate
00:20:43
outcome when we could have prevented
00:20:44
that
00:20:45
those are going to be your major things
00:20:46
to really look for okay
00:20:49
so we did a really good review of what
00:20:51
to expect what to know how to get here
00:20:53
but what is the best part of my job in
00:20:56
general
00:20:56
my job is awesome i think the best best
00:20:59
part as i've mentioned a few times
00:21:02
is how satisfied patients are how happy
00:21:04
patients are
00:21:05
and the fact that i constantly have to
00:21:06
keep learning there are always new
00:21:08
recommendations that
00:21:10
you have to just stay on top of and so
00:21:12
you continuously are educating yourself
00:21:14
and you feel like you're stimulated in a
00:21:16
sense it's helping
00:21:17
the community itself a good example
00:21:19
right now is covid covid19 and pregnancy
00:21:22
obviously it's never happened before and
00:21:25
so i've been doing a lot of articles
00:21:27
and a lot of conversations with
00:21:29
different media groups as well as
00:21:32
social media to make sure that the word
00:21:34
is out there that patients
00:21:35
one are educated feel less scared about
00:21:38
being in this type of pandemic because
00:21:40
while they're pregnant making sure that
00:21:42
everything really works out
00:21:43
appropriately so my
00:21:44
best best days are when patients are
00:21:47
very thankful at the end that say thank
00:21:49
you for all of the information
00:21:50
i've never heard anybody describe it to
00:21:52
me that way no one's ever given me all
00:21:54
of this information i now completely
00:21:56
understand
00:21:57
if my patients can be their own
00:21:59
self-advocates after having a
00:22:00
conversation with me
00:22:01
i find that being the most rewarding and
00:22:04
so that type of life is wonderful
00:22:06
and i really really hope that you all
00:22:08
will choose be an ob gyn
00:22:10
the other major part is the surgery i
00:22:12
always will go back to surgical
00:22:14
intervention it is
00:22:15
a great um thing to do that you're able
00:22:18
to use your hands and help patients
00:22:20
in whatever way possible even in the
00:22:22
office i
00:22:23
do iud placements we do nexplanon
00:22:26
placements we do
00:22:27
biopsies in the office so there are lots
00:22:29
of small little procedures you could do
00:22:31
that will keep you really good at your
00:22:33
surgical techniques
00:22:34
as well as still seeing patients in the
00:22:36
office and keeping your brain working
00:22:38
your hands working
00:22:39
basically everything that you learned in
00:22:41
medical school you are literally using
00:22:43
every single day
00:22:44
um but on a specific group of patients
00:22:46
and your specialty
00:22:48
is the best one if you pick ob gyn
00:22:52
okay we are done for the day i hope
00:22:55
we've answered most of your questions
00:22:57
if we haven't please message down below
00:22:59
and we will comment right back and
00:23:01
answer all of those for you
00:23:02
i'd love to say a good shout out to dr
00:23:04
antonio webb
00:23:06
our solo shot guys we did an amazing job
00:23:08
of covering everything that we could
00:23:10
but i have to get back to it please let
00:23:13
me know if you need anything from me
00:23:14
otherwise i'll see you have a good one
00:23:25
[Music]
00:23:27
uh
