Future obgyn with unusual contract opportunity
Need advice from people who have actually lived attending life because I’m very aware I have no clue what I’m doing yet.
I’m graduating med school this month and starting obgyn residency in June. My spouse is starting FM residency. We’ve always talked about eventually returning to a smaller community we already liked for family/lifestyle reasons, and recently a hospital there reached out about stipend support through residency in exchange for working afterward.
What surprised me is they seem genuinely willing to work with us on lifestyle and schedule. The salary numbers they initially discussed for both specialties seemed competitive from what I’ve looked into, and when we asked about part time, they said compensation and stipend support would just be prorated based on FTE. They basically told us to think about how much we’d want to work long term and then they’d start building contracts around that. Which feels unusual enough that I’m trying hard not to make decisions just because something sounds good right now.
For years my spouse and I have talked about wanting to work less for longer. Meaning, we’d rather have more time for family, life outside medicine, etc and hopefully avoid burnout instead of maximizing income and retiring early. I know lots of people probably say that before residency and then reality changes things, but it’s something we’ve talked about a lot.
FM seems easier to imagine part time. OB feels way harder because clinic, surgery, inbox/admin stuff, and call all matter.
The hospital is has ~700 births/year total from my understanding. There’s currently one OB and another joining soon. The OB taking most of the call apparently had ~300 deliveries last year. They’re actively trying to recruit more OBs, but obviously nothing is guaranteed and there’s a reasonable chance the current OB could retire within several years. One of my biggest worries is accidentally signing up for a lifestyle that looks great on paper and then ending up effectively full-time because staffing changes and suddenly I’m covering a ton of call.
Part of me thinks maybe 0.5–0.8 FTE with proportional call could be amazing. Part of me wonders if that’s a terrible idea early career and I’d regret not building volume/skills. I honestly just don’t know what I don’t know because I’ve never been an attending.
I’m also aware there’s risk in signing something this early before residency even starts. I’m not blind to that. But part of why I’m asking is because this feels like a pretty unusual opportunity to potentially build something closer to a dream setup in a place we already wanted to end up long term. I don’t want to jump at it blindly, but I also don’t want to dismiss an opportunity that could align really well with the kind of life my spouse and I hope to build.
A few questions:
If you could redesign your career from the beginning, what would you do?
Is part-time realistic early on, or is that naive?
What contract language would you insist on around call burden, especially in smaller communities where recruiting can be hard?
What did you think would matter as a resident, and then realized didn’t matter at all?
And maybe biggest question: does “work less for longer” actually work in medicine, or does everyone eventually end up working more than planned?
Appreciate any thoughts, especially from people further down the road. Just trying to avoid making decisions with the confidence level of someone who hasn’t worked a day as an attending.