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OB/GYN, certified nurse midwife, or PA

I want to work with labor and delivery. I want to be there for my patients, championing them, while also helping them. I like the idea of being an ob-gyn because I'd love to perform surgical procedures, be part of high risk pregnancies, help women from conception through postpartum, and so forth. I like the idea of a PA for similar reasons. I like the idea of being a CNM because I'd get to be with patients more, while still getting to take part in labor and delivery. I do want to have a family one day and I also have a dog, so I know it can be hard to manage any of those careers with those things. I also do like traveling. I want to help people and I want to be the medical professional that make people smile and feel like everything is going to be okay. What should I do? #medicine #laboranddelivery #doctor #nurse #PA #career #certifiednursemidwife #nursemidwife #obgyn

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Rachel’s Answer

Hi Grace. Thank you for your question. First thing we need to do is decipher the requirements between the three because they are wildly different. All three will require continued education, however, some require more than others. In addition, some are more competitive than others.

To become an OB/GYN, you will need a Medical Doctorate (MD). To become a Physician Assistant you will need a Physician Assistance certificate (PA), which can be obtained through an accredited PA program where the completion of the program will be awarded a masters degree. To become a CNM, you will need to obtain a Master's of Science in Nursing at the minimum. The most difficult one to obtain, by far, is becoming an OB/GYN. But this can also be the most rewarding in both the work that you do and the compensation that you obtain.

Requirements for OB/GYN:
(1) Obtain bachelor's degree. Although science majors are recommended, it is not necessary. (example: my sister was an English major at UCLA , then received a masters in bio-chem, and is now in her first year at medical school)
(2) Take the MCAT and attend Med School (this is extremely competitive)
(3) Dring medical school, you will have 2 years in class and 2 years in clinic. (total 4 years)
(4) Take the BOARDS exam
(5) Attend residency (3-8 years)
(6) Degree received = Doctor of Medicine (MD)
- NOTE: a few things to note. Post High-School education will be 8 years, not including residency. Residency is required and will be another 3-8 years. Base salary starts at around $208,000.

Requirements for PA:
(1) Obtain a bachelor's degree.
(2) Complete the required clinical hours, which is roughly 2000 hours.
(3) Take the Physician Assistance National Certifying Exam (PANCE) (only six attempts in six years allowed)
(4) Degree received = Masters Degree
- NOTE: Few things to note. Post high-school education will be 6-7 years. Residency is only optional and can be 1-2 years. Starting salary is approximately $105,000.

Requirements for CNM:
(1) Obtain a bachelor's degree
(2) Obtain a licensure as a registered nurse (RN)
(3) Gain admission to an accredited Master of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP) program with a specialty in midwifery
(4) Degree earned = MSN or DNP degree, you will then need a CNM credential.
(5) Obtain a certification from the American Midwifery Certification Board. You will receive a CNM credential.
(6) Obtain certified nurse midwife state licensure.
- NOTE: a few things to note. Starting salary is likely $105,000-110,000

Each field will be time consuming when it comes to your daily free time. But that should not hinder your career choice. Many rewarding careers will consume most of your daily time. However, it is 100% possible to have a family, a dog, and have a time consuming career. The key is to balance all of these things once you get to that phase. Luckily, all three careers do not require you to bring your work home (i.e. attorneys bring their work home frequently). Once you leave the office, most times you will be free to enjoy your personal time.

As you can tell, they all require different paths. It is vital that you choose the path you want to take either prior to entering college or in the first two years of college. Personally, I believe OB/GYN will offer the most fulfilling career with regards to both the work you will be producing and the compensation you will be making. It will take longer than the PA and CNM program, but good things are worth the wait. It is also pretty important to note that to become an OB/GYN you would need to complete a residency in OB/GYN. This can be very difficult to get into because it is a very competitive residency field. With that said, you may not even know whether you will make it as an OB/GYN until you figure out the residency program that accepts you. Those are some risks to consider.

I hope this was helpful! Good luck!
Thank you comment icon Very detailed. Jemima A. Chukwu
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Dan’s Answer

All good jobs. All necessary jobs.

OB/GYN: consider this if you want to be the leader in women's health as well as the go-to-expert. Ton of schooling and work, but it is required for you to be exceptional which is what a physician must be . You will have to make choices that will affect the life of your patient and their unborn child.

PA: consider this if you want to be in the field concerning women's health but spending years in medical school and residency isn't something you want for yourself. You will be working closely with the OB/GYN.

CNM: consider this if you want to spend less time on the clinical sciences (OB/Gyn or PA) and more time with the patients.
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Carla’s Answer

Hi Grace,

I hope you have kept on track and are on your way to being apart of the medical field! The other commenters gave a lot of good advice. But I do want to add that if you still like Obstetrics more than Gynecology, CNM or physician would be the way to go. I am from Pennsylvania, so this could be very different than in California, but physician assistants rarely hold positions in Labor & Delivery. However, they often work in Gynecology (and Neonatal medicine).

In order to find out more information about what is customary in your state, I would go to job search engines like indeed or even to specific hospital websites, and look for Ob/Gyn Physician Assistant positions. You could also try calling the hospitals to speak to a recruiter from the Labor & Delivery department. Lastly try joining a facebook group for Ob/Gyn medical providers in California. You could pose this question and get feedback from people that actually work in the field.

Good luck on your journey to joining the medical field!