How to Become an OB/GYN Doctor

By: Andrew Colucci, MD

Last Updated: Dec 17, 2018

A physician specializing in obstetrics and gynecology (OB/GYN) focuses on female sexual and reproductive health, pregnancy, and delivery. While many recognize OB/GYNs as the physicians who deliver newborns or perform gynecological exams, OB/GYNs also perform a wide variety of surgical procedures, from Cesarean sections to uterine fibroid resection. In addition, obstetrics and gynecology is one of the primary medical specialties to provide family planning services.

Workplace Details

As with many other specialties in medicine, OB/GYNs can practice in a wide variety of settings, ranging from smaller outpatient clinics to large teaching hospitals and academic medical centers. Thus, the percentage of time spent in clinic versus the operating room also varies according to the OB/GYN’s particular choice of practice setting.

For a given OB/GYN, the particular work schedule can also vary based on the medical focus and/or subspecialty training. For example, OB/GYNs who elect to remain actively involved in labor and delivery may find themselves taking a large amount of overnight call and working unpredictable hours, given the nature of pregnancy. As another example, OB/GYNs who have chosen to subspecialize in gynecologic oncology will typically find themselves spending the majority of their time in the OR as opposed to the clinic, but will often work more predictable hours.

It should be noted that, technically, obstetrics and gynecology are two separate specialties that many laypeople consider to be one and the same. While it is true that obstetrics and gynecology both focus on the health of a woman’s reproductive organs, obstetricians specialize in reproductive health during pregnancy, whereas gynecologists focus on female reproductive health outside of pregnancy. Many OB/GYNs practice both obstetrics and gynecology, although some choose to pursue one of the two fields independently of the other.

Hover over any state to explore local income and job growth data.

The U.S. Bureau of Labor Statistics states that the median salary for all physicians, including OB/GYNs, is over $187,200. A Medscape survey of doctors in 2016 found that the average salary for OB/GYNs was $277,000. As of 2014, the Medical Group Management Association reported the median salary for all OB/GYNs was $317,496. It is important to note that OB/GYN malpractice insurance premiums are among the highest for physicians. The listed salaries do not take into account these insurance costs, which can reach six figures for a single provider.

Overall for all physicians, the Bureau of Labor Statistics anticipates job growth of 14% from 2014 to 2024, which is considerably faster than average job growth. There is currently a shortage of practicing US-born, US-trained OB/GYNs. This is due in large part to the difficult lifestyle of the profession and the high cost to maintain malpractice insurance. Therefore the employment outlook in this field is exceptionally high and particularly robust in certain geographical regions.

The first step towards any medical practice is the successful completion of an undergraduate bachelor degree. In college, the particular subtype of undergraduate degree (BS, BA, AB, etc.) and your academic major are of minor importance. However, stellar academic performance is a requisite. Therefore, it behooves applicants to choose a major/degree that they enjoy and in which they excel. Regardless of major, pre-medical courses in general chemistry, organic chemistry, physics, and biology are required of all applicants.

Application to medical school is competitive, requiring a robust application that preferably demonstrates experience in research, leadership and volunteering, in addition to high academic performance. Additionally, applicants must study for, complete, and score highly on the Medical College Admission Test (MCAT), a massive cumulative examination that assesses basic scientific knowledge.

Medical school is four years long and essentially split into two components: a two-year curriculum of didactic (classroom) lectures, followed by two years of various clinical rotations. As with undergraduate study, a high level of academic rigor is required in medical school in order to maintain a wide breadth of options when applying for residency training. OB/GYN is a moderately competitive specialty, particularly at the more prestigious institutions; it required strong grades, high medical board scores, and preferably research in a topic related to your future medical specialty. Also worth noting is that students must pass the first two parts of the three-part United States Medical Licensing Examination (USMLE).

Following the successful completion of medical school, students are awarded the MD degree and press on to complete a four-year residency training program, during which they truly focus on obstetrics and gynecology as their chose specialty.

All physicians require a full medical license to practice medicine independently, and this can be obtained by application to the state following the successful completion of medical school and the USMLE.

To underscore their mastery of their chosen specialty, most OB/GYNs will seek board certification from the American Board of Obstetrics and Gynecology, a founding member of the American Board of Medical Specialties (ABMS). In order to obtain board certification, candidates must pass a two-day board certification examination.

Additional post-residency training can be obtained in subspecialty fields such as reproductive endocrinology or gynecologic oncology through the successful completion of a three-year fellowship.

Following the completion of residency, OB/GYNs can choose to start their own practice; join an existing group and work towards becoming a partner; or become employed through a hospital or large academic medical center. If the candidate chooses the latter, advancement comes through academic promotion. In hospital-based practice, promotions may allow for more administrative duties and increasing control over their practice. This may manifest as the ability to practice strictly gynecology rather than obstetrics, for instance.

OB/GYNs complete at least four years each of college and medical school. They also spend four years studying obstetrics and gynecology at the graduate level. This phase is known as residency.

Let’s look at each stage individually.

To enter medical school, you need to earn a bachelor’s degree and pass some required classes (prerequisites).

Many premedicine students choose to major in biology or chemistry. However, it’s worth noting that no specific major is required. Another common approach is to major in a subject you enjoy while minoring in a science.

Prerequisites vary a bit among medical schools but typically include a year each of English, biology, and physics, plus two years of chemistry. All science classes must be lab-based. It’s worth noting that the Medical School Admissions Test (MCAT) also covers subjects like sociology, psychology, and biochemistry.

When it comes to preparing students for medical school, some colleges have a better track record than others, so ask about admission rates. The best schools often have a dedicated premedicine program that provides academic advising, application support, and work and volunteer opportunities.

Take a look at any pre med’s schedule, and you’ll probably see some of the following courses:

Most medical schools begin accepting applications in June for the following year’s class. You’ll need to fill out applications (many schools use a centralized application service) and interview with the admissions committee. Admission decisions are based on your academic record, MCAT scores, interview scores, letters of recommendation, and overall fit for the program.

This is where you learn the fundamental skills that all physicians need to diagnose and treat patients. As you progress in the program, you’ll gain hands-on experience in a variety of specialties including OB/GYN.

Medical students describe the first two years of study as similar to college, but more intense. Days consist of lectures and labs. You’ll also practice basic skills like conducting a physical exam. Common Year 1 and 2 courses include:

During Years 3 and 4, you’ll begin working with patients under supervision. Your school will provide a variety of clerkships, also known as rotations, which expose you to different practice areas. These include both primary care (internal medicine, family medicine) and specialties like psychiatry, surgery, and yes indeed, obstetrics and gynecology.

If you decide that OB/GYN is the path for you, be sure to seek out additional opportunities during Year 4. Typically you’ll have some elective rotations on your schedule at this time to explore your interests.

Think of residency as graduate school for doctors. Now that you’ve learned your basic skills, it’s time to focus on obstetrics and gynecology.

As a resident, you’ll continue your rotations, but now with greater emphasis on your chosen specialty. Your program will likely include time in the obstetrics, emergency room, and women’s health services. OB/GYN residents earn a relatively modest salary ($45,000 annually) and care for patients under the supervision of more senior “attending” physicians (those who have completed the full spectrum of training and can practice independently). Clinical training during residency will include all aspects of outpatient and inpatient gynecology and obstetrics, including gynecological surgery (such as fibroid removal, for instance). You’ll also get exposure to different practice settings like doctors’ offices, community hospitals, and family planning clinics and take call some nights and weekends.

Each year of your residency, you’ll gain more independence to care for patients on your own. You’ll also take on more responsibility for teaching junior residents and medical students. During complicated cases - a difficult delivery, for example - you might still team up with an attending physician, but by Year 4 you’ll mostly be flying solo.

In addition to caring for patients, residents engage in the following activities:

Most residencies build in some elective rotations. This is a great time to delve deeper into your area of interest, especially if you plan to pursue fellowship training. Some residents also use this time for additional research.

OB/GYN doctors who plan to practice a subspecialty must complete an additional period of training called fellowship.

Board certification as an OB/GYN doctor is technically optional but will definitely make your life easier. For one, you’ll have an easier time getting hospital privileges (which you need to deliver babies). Patients - expecting families in particular - increasingly prefer board-certified physicians.

Three American organizations offer OB/GYN board certification: the American Board of Medical Specialties (ABMS), the American Osteopathic Association (AOA), and the American Board of Physician Specialties (ABPS). The ABPS credential may not be recognized in all states; check with your medical board for details.

To sit for your board certification exams, you must be residency-trained and licensed. The ABMS also requires two years of independent practice experience before certification.

For fellowship-trained physicians, board certification is also available in the following subspecialties from both ABMS and AOA:

• Female pelvic medicine and reconstructive surgery
• Gynecologic oncology
• Maternal and fetal medicine
• Reproductive endocrinology/infertility