Interview Summary

BJ Harris is a retired OBGYN. She worked for two private practices in the Twin Cities area for a large portion of her career. She was always more passionate about the surgical side of her career, so in the last decade of her career she chose to work primarily in urogynecology.
Gynecology is the care of women’s reproductive organs when they are not pregnant. On the other hand, urogynecology focuses specifically on urinary incontinence and prolapse, which is when pelvic organs slip down into the vagina most commonly after women have children vaginally.
When BJ was working in private practice during the OBGYN portion of her career, she would work anywhere from 50 hours to 105 hours a week. This is changing with more moves to shift work. There are now laws restricting residents from working more than 80 hours a week.
BJ had a slightly indirect pathway to medical school because she did not apply for medical school until after undergrad. She initially thought that she was going to become an occupational therapist, but then professors, family, friends, and even her own doctor convinced her to apply to medical school. After taking her MCAT during her senior year of undergrad, BJ got a good score and sent in her medical school applications. The next year, she was studying to become a doctor.
BJ enjoyed her job because of the long-term relationships that she got to form with patients. She also found it to be really rewarding when she saw how the work she did for a patient improved their pain and quality of life.
BJ emphasizes how her job also had challenges because of the demanding nature of being on-call for obstetrics.
BJ advises those interested in healthcare to consider the time commitment that they want to put towards their career. There are many different pathways to get into the medical field, all with different demands and rewards, which is why it is extremely important to explore and consider your own interests.

Gynecology Interview with BJ Harris

What did a day in your life as a gynecologist look like?

When I was working in the generalist OBGYN portion of my career, I worked in a private practices with 7-9 other people. I would generally would work anywhere from 50 hours to 105 hours. When people were out of the office for vacations, sick leave or maternity leave there was more work to be done. For example, Wednesday, Friday, and Sunday could have been 24 hour on-call days, Monday could have been a full clinic day, and then another day could have been a full day of surgery. These weeks could be up to 105 hours assuming that I was awake the entire time I was on-call (in the field of obstetrics, this could very easily be the case). On top of the hours you are officially on call, you also need to do sign out to the on coming call doc for the day and commute to/from work, meaning that you could easily have a 25-26 hour day.

These working hours were common when I first started in practice around 30 years ago. In residency there were a couple weeks/year where we worked even more hours than that. But, since then, there are laws that restrict residents from working more than 80 hours a week. I think that this was a necessary move for the health of the providers and patients. However, the residents do not come out as well-trained as they used to, so they tend to need more training later on. Obstetrics is definitely a field with a big on-call demand, but if you love that, then this field would be great for you.

The field is also shifting in terms of the roles that OBGYNs hold and how they teach residents. One of these changes is that a lot of times now there are doctors who work in a laborist position. So instead of doing office work, surgery, plus on-call labor and delivery, they go do a shift on labor and delivery. This is similar to how you would work a shift in the ER if you’re an ER doctor. I think that this was a good choice for the field and the care of patients. There are also proposed changes in the OB/gyn residency where the residents will either go into a surgical tract or an obstetrics/office based-pathway in the second half of their residency. This way, residents could get more volume of practice in the area that they choose. I think that the more generalist positions where people do gyn surgery, obstetric call and clinic will slowly fade out. This seems like the right thing to do, but this variety was definitely one of the aspects of my work that I liked the most because I was never bored.

What does gynecology mean to you?

Gynecology is the care of women’s reproductive organs when they’re not pregnant. This includes pre-pregnancy, post-pregnancy, and the menopause phases. Urogynecologists take care of patients who have troubles specific to incontinence and prolapse.

The wonderful thing about gynecology is that I got to know women for many years. In some instances, I would care for patients from their teenage years all the way to their adulthood, where I assisted them after they had kids and sometimes performed their hysterectomies and reconstructed their pelvic floors. It’s amazing to be able to form these long-term relationships with patients, especially because it helps me to make shared decisions with them that are in their best interest.

Can you tell us about yourself?

I originally grew up in the small town of Minot, North Dakota. Later, I went to medical school at the University of Minnesota, where I decided to pursue the field of OBGYN. During residency, I realized that I was actually more passionate about the surgery than the obstetrics. But, because I was a second-year resident, I thought that it was already too late in my career to change. So, I pushed through and came back to Minnesota to be closer to family, where I started working at my first practice. This was an amazing place to work because there were terrific people, great surgeons, and strong autonomy. However, I ended up leaving that practice after 7-8 years due to office politics.

I worked for two different private practices in the Twin Cities before I reached a point where I no longer wanted to continue the obstetrics part of my job. My group decided I could stop doing obstetrics if I focused mostly on urogynecology. For the last decade of my career, I worked primarily in urogynecology, where I did pelvic floor reconstructions for pelvic organ prolapse, and managed urinary incontinence as well as other urinary problems in women. In 2007, I started doing some bigger surgeries robotically, and these were some of the first cases in Minneapolis and St. Paul. Now, robotics has really taken off. It is the gold standard for the treatment of significant and symptomatic pelvic organ prolapse for women.

I had always planned on retiring early because I knew that obstetrics was demanding, especially with how hardcore it was to be on-call. Because of this, my husband and I always lived below our means, so I was able to retire at the age of 55.

Full Q&A With BJ Harris

What was your favorite part of being a gynecologist?

My favorite thing was surgery and being able to make such a big difference in patients’ lives. I would see women who could not even lift their own child or grandchild because of prolapse or incontinence. After surgery and recovery, the transformation in my patients was incredible. People would go from not being able to lift their grandchild to the next year hiking in the Tetons. I found it especially rewarding to help women with prolapse and/or incontinence who are often living a less active lifestyle than they would like to, and they do not realize that there is something they can do about it. My work was so impactful because I was able to support patients in these circumstances and help them get back to an active and much more enjoyable lifestyle.

Another aspect of my job that was so special to me was having the ability to form long-term relationships with patients. If I had only done urogynecology and did not spend time working in general gynecology, I probably would not have had those long-term relationships. Although I did not think these relationships were as important when I was fresh out of training, after being in practice for several years I began to love seeing patients back year after year. Since I retired I have missed a lot of my patients.

How much education is required to become a gynecologist?

You need to complete four years of undergrad, four years of medical school, and four years of residency in either OBGYN or urology. If you choose to complete a residency in urology, then you can also complete a one-year fellowship to get into urogynecology. If you’re a gynecologist, then you need to complete a three-year fellowship to get into urogynecology. When I started my career, these fellowships to get into urogynecology were not required, but they are now.

How did you become interested in gynecology?

When I was in undergrad, I actually thought that I was going to become an occupational therapist because I really enjoyed the sciences and thought that this career would align well with my interests. I never thought that medical school would become one of my aspirations There were no physicians in my family as an example for me. However, I had multiple professors, friends, family, and even my own doctor ask me why I was not pursuing medical school. After receiving this encouragement, I slowly began to realize that medical school could actually be a possibility for me.

In my senior year of college, I took the MCAT (medical school entrance exam). After taking off for Europe for a few months, I came back and got a job. However, it turned out that with a biology and psychology degree and no teaching certificate, I didn’t have many options. So, I worked with developmentally disabled adults in Minneapolis for about a year. But, within a couple months of doing that job, I got my MCAT scores back and they were pretty good. The following year, I was in medical school.

I would definitely say that I had a more indirect pathway to medical school because I did not always know that I wanted to pursue it. But, once I started my schooling, I realized that I had made the right decision. At the end of my career, knowing that I made a difference was priceless, even though I had to put in a lot of work to get where I needed to be.

What advice would you give to someone who is interested in the healthcare field and is trying to figure out what profession is best for them?

Think about how much time commitment you want for training and once working in your field. This is not just a job: it’s a calling. The OBGYN field will take up more of your life than just a 9-5, but it’s also an amazingly meaningful career. It’s truly a wonderful thing to be able to take care of others and have them trust you with their health. Some people want it all and choose to go to medical school, I hope many more do in the future. At the end of my career, I don’t wonder, I KNOW I made a difference.

What is the career outlook for gynecology?

In terms of AI, I think that it will definitely have an impact on decision-making, counseling, and training. However, I never think that it will be able to do what a real doctor can. For example, I do not think that AI will be able to do surgery or make the decision to crash somebody for a C-section in the middle of the night.

In terms of the growth of the field, I hope that we continue to have excited people that want to go into gynecology. From what I’m seeing in my daughter’s generation, after students graduate from college, a lot of them are choosing to become nurses or physician assistants because the quantity of schooling is a fraction and the income levels can surprisingly close if you break it down to a per hour rate within the field of obgyn. So, it seems that there are more people choosing PA or nursing degrees. Another thing that is attracting a lot of people into PA or nursing careers is the fact that there is more job flexibility. For example, if a nurse or physician assistant wants to change their mind on their specialty, they can switch. There is not another full residency to complete, rather on-the-job training in that specific area. For example, my former Urogyn physician assistant now does thoracic surgery. If I wanted to go back to school to become a thoracic surgeon, however, I would have had to go back to school for eight more years.

What were the biggest challenges of being a gynecologist?

The biggest challenge of an obgyn career to me was that being on-call for obstetrics is exhausting. Doctors who deliver babies at two in the morning do not get paid enough for what they do. There are complications that can happen which are fully out of your control, and all you can do is try to save your patient and their baby (or babies). Some patients will just be grateful that they are alive, and others will be angry that their baby did not make it even though you did everything you could. There is a lot of stress involved. You can have two - three patients on the operating table at once (patient pregnant with twins). Another difficult thing is that pager is non stop. For example, I would be operating on a woman and getting calls from patients asking if their water broke or not.