Inspired by this tweet, I present: how to relate the Ob/Gyn rotation to your medical students interested in other specialties, a thread: https://twitter.com/toxicologist12/status/1361722601576534020

First things first: will you be taking care of female patients? Yes? This rotation applies to you. You don't like the idea of vaginas? Well, I hope that's for the same reason that I don't like eyeballs (they seem complicated and mysterious) and not because of sexism.

Once that's done, you're off!

Hematology: pregnancy has a BIG effect on all heme disease, including sickle cell and the entire clotting cascade. Getting a woman to deliver a baby and not bleed to death relies on these things working.

Oncology: many cancer treatments have significant effects on women's reproduction and sexual health. Ask your reproductive age patients their desires for future fertility. Breast cancer medications may cause severe vaginal atrophy. Also, Gyn Onc does their own chemo.

General surgery: Our surgical training is different than yours but no less important. Try to understand and respect why/how C sections are done the way they are. Also--please consider Gyn/Onc. Talk about general surgery--spleens, livers, bowel, ureters, and all GYN organs.

Radiology: it is safe to do a CT scan on pregnant women. Just counsel them! Denying a woman any type of imaging that will change her management and potentially put her life at risk for a missed diagnosis (again, see appendicitis above) because she is pregnant is antiquated.

Also Rads: please see transvaginal ultrasounds (it's nice to let the woman place the probe herself), pelvic MRIs, and mammograms. Also we do a LOT of our own imaging in the form of real-time ultrasound.

Interventional radiology: you will, at some point in your career, be asked to embolize some giant uterine arteries, either for fibroids, a postpartum hemorrhage, an accreta, etc. Know that you are needed and you saved a life.

Radiation oncology: please remember that women's sexual function matters after pelvic radiation! Please place vaginal stents and protect them as much as you would protect a man's prostate and erectile function!

Urology: we adore you guys. Please know that we are aware where the ureter is, and in the VERY rare event we need you to help us repair one, we are grateful. We'd be happy to help you with a hysterectomy/prolapse/female voiding. Please give vaginal estrogen for recurrent UTI!

Endocrinology: Reproductive Endocrinology and Infertility will be very interesting to you. As will abnormal uterine bleeding. It is important to understand the changes that pregnancy causes to any endocinopathy, including thyroid disease and diabetes.

Infectious disease: STDs, PID, recurrent UTIs/vaginitis, vaccine schedules (hello, HPV), and any infection in a pregnant patient (including antibiotic management) are very important to know.

Ophthalmology: you will see a lot of patients with lingering effects from high blood pressure after preeclampsia!

Neurology: Seizure disorders in women require pre-pregnancy counseling regarding the safety of their medications. Many neurologic diseases including MS, dementia, migraine, etc. are more common in women and are affected by estrogen.

Neurosurgery: you will be consulted at some point in time for pregnant women with intracranial processes, including shunts, tumors, strokes, etc. We may ask you questions about the safest way for them to deliver.

Anesthesia: beyond the obvious understanding of why epidurals are important for more than just pain, nobody needs better intravascular access and hemodynamic monitoring than pregnant women, who can hemorrhage liters in a matter of seconds. We love you.

Family Medicine: you take care of everyone, including well woman care and obstetric care. You will use everything you learn!

Internal medicine: optimization of any medical problem is important for a successful pregnancy and fourth-trimester recovery. Understanding midlife women's health is essential with regard to menopause, bone health, breast health, and cardiac health.

Critical care: an understanding of the treatment for OB emergencies (how to manage hypertensive crisis, eclampsia, or massive blood loss, for example) in a pregnant or post-partum patient will happen. Fluid shifts in ovarian cancer. Sepsis from PID or septic abortion.

ENT: Please encourage all men and women up to the age of 45 to get the HPV vaccine, since you know that it is responsible for head and neck cancers as much as it is cervical cancer. Also, look up something called an "Exit Procedure".

Dermatology: Anything on any part of the skin can and will happen on the vulva. PLEASE examine vulvas in the office. Studies show men get more thorough and complete skin exams because dermatologists skip over examining female genitalia. Don't forget PUPPS/pregnancy dermatoses.

Emergency medicine: Where even to begin?! It's all relevant. Our triage area IS the ED. Learn to judge what amount/quality of vaginal bleeding is concerning. Sometimes just knowing "when to consult" is the most important thing to learn. Please at least look between the legs! :)

Rheumatology: autoimmune diseases in women is one of the most poorly understood disease processes in medicine (please file also under: underfunded, under studied). Women suffer from incompletely understood disease a LOT. Validate their pain.

Psychiatry: a stabilized patient is the best patient, especially for pregnancy. We need you to help us with depression/psychosis, anxiety disorders, chronic pelvic pain syndromes. The list goes on and on.

Ortho: pregnant women need their bones fixed, too. Learn about intra operative monitoring. Pregnant women get common fractures related to the way they protect their belly when they fall. Always stabilize the mom first in ANY trauma. Get the same imaging you would normally get.

Pediatrics: any and all childhood disease will become relevant if a girl grows into a reproductive age woman. Asthma. Congenital heart disease. Genetic disorders. Cystic fibrosis. PLEASE counsel them on what it might mean for their condition to become pregnant--or ask an MFM!

Pathology: heroes! Gyn Pathology is it's own sub-specialty. Cervical cytology, Gyn Oncology cancer staging, fibroids, endometrial polyps, products of conception, endometriosis--the list goes on and on.

PM&R: pelvic girdle issues, pubis diastasis, lordosis, foot arch support, joint hypermobility--these are all musculoskeletal issues affected by progesterone relaxation effect from pregnancy. We also are huge fans of pelvic floor rehab.

Cardiology: heart disease looks different in women. Postpartum cardiomyopathy is a dangerous diagnosis to miss. Pulmonary hypertension is very common in preeclampsia. Pregnancy is the ultimate cardiac stress test and the volume and fluid dynamics involved are herculean.

Palliative care and pain medicine: so important in Gyn Oncology. Your compassionate care is deeply needed.

Adolescent medicine: so important for contraceptive health, congenital and genetic anomalies affecting the reproductive tract, and LGBT health. Again I will mention the HPV vaccine for ALL adolescents.

There are many, many more for all the never-ending list of subspecialties. Breast health. Pregnancy after bariatric surgery. Addiction medicine. Pulmonary medicine. Gastrointestinal disorders in women. Vascular surgery (hello, iliacs with abnormal placentation).

So, Ob/Gyn may not be for you, but you will inevitably improve women's health if you can put your specialty in the context of a woman's life trajectory. We are always here for a consult if you get stuck. Just remember: healthy women mean a healthy society. Good luck!

Ohhh forgot Plastics/Recon. Please see UroGyn and Pediatric and Adolescent Gyn for vaginal reconstruction, mullerian anomalies, gender affirming surgery, and indicated labiaplasty. And, some clinical correlates like c-section after abdominoplasty