How to Become an OB/GYN: Where to Start in 2025

You want to become an OB/GYN, but the path seems long, expensive, and honestly kind of confusing. How do you become an OB/GYN? How many years does it really take? Is the lifestyle worth it? And with so many premeds gunning for competitive specialties like this, what does it actually take to stand out?

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This guide breaks it all down. From what OB/GYNs really do, to every step of the journey, from undergrad to residency (and maybe even fellowship). You'll learn what to expect, what it pays, what kinds of personalities thrive in the field, and how it stacks up against other women’s health careers. 

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The first step is building a medical school application that rises above average. Our free Application Database includes 8 real AMCAS applications that earned acceptances to top med schools like UCLA and UCI, including my own. See what a standout application actually looks like, and reverse-engineer your own.

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Get your free resource here.

What Even Is an OB/GYN (And What They Actually Do Daily)

OB/GYN stands for Obstetrician-Gynecologist. These physicians specialize in two major areas of medicine: 

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• Obstetrics, which is pregnancy, childbirth, and postpartum care
• Gynecology, which covers the health of the female reproductive system at all stages of life.

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In plain terms, OB/GYNs are the go-to doctors for everything from annual Pap smears to delivering babies to managing complex reproductive issues like infertility, fibroids, or endometriosis.

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During residency, every OB/GYN is trained in both. But in real-world practice, many OB/GYNs choose to focus more on one side.

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Some stop doing deliveries and focus solely on gynecology with clinic visits, surgeries like hysterectomies, and managing long-term reproductive health. Others focus mostly on obstetrics, spending most of their time in the hospital managing labors, delivering babies, and handling pregnancy-related complications.

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Some go even further and subspecialize in areas like high-risk obstetrics (Maternal-Fetal Medicine), reproductive endocrinology and fertility (REI), or gynecologic oncology.

Education, Training, and Time: How to Become an OB/GYN

From your first college lecture to finally practicing as an attending OB/GYN, you're looking at a minimum of 12 years of training. This path is long, intense, and expensive, but every stage has a purpose. 

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Below, we’ll walk through each step, so you know exactly what’s ahead and how to navigate it.

1. Undergrad: More Than Just a Biology Degree

No, you don’t have to be a biology major to go to med school. You can major in literally anything, including English, music, or even economics. That’s as long as you complete the required pre-med coursework: biology, chemistry, organic chemistry, physics, and a few others depending on the school.

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That said, most students pick something science-adjacent because it overlaps with the prereqs and makes MCAT prep a little smoother.

2. Get Accepted to Medical School

This is one of the most competitive transitions in the entire journey. Nationally, fewer than 42% of applicants get in each year.

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You need:

• A GPA that proves academic readiness (typically 3.7+ for MD schools)
  
  
• A strong MCAT (510+)
  
  
• But most of all: a story that makes sense

Med schools aren’t just looking for robots who check boxes. They want people who’ve reflected deeply, pursued meaningful work, and know how to tell their story with clarity and direction. Your personal statement, secondary essays, letters of recommendation, and interview are where you either bring your story to life.

3. Med School: Four Years of Controlled Chaos

Years 1–2: Pre-Clinical
Classroom-heavy. Think anatomy lab, physiology, pathology, and endless practice questions. This is also when you take USMLE Step 1 (now pass/fail, but still taken seriously) and begin thinking about specialties.

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Years 3–4: Clinical
Now you're rotating through specialties: surgery, pediatrics, internal med, psych, and yes, OB/GYN. This is where you get real face time with attendings and residents, and where your performance on OB/GYN rotations actually matters if that’s your intended specialty.

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You’ll also take USMLE Step 2, which is still scored and often used in residency selection, especially for competitive specialties like OB/GYN.

4. Residency: The Real Gauntlet

OB/GYN residency is 4 years long and one of the most physically demanding residencies out there. Expect:

• 80-hour workweeks
• 24-hour calls
• Surgical training
• Vaginal deliveries and C-sections
• Clinic duties
• On-the-fly decisions with real consequences

Matching into OB/GYN isn’t easy. It’s classified as a "moderately competitive" specialty, but the trend is upward. More applicants, better scores, and tighter spots. You’ll need strong clinical evaluations, a well-crafted application, and ideally honors in your OB/GYN rotation.

• Consistent performance
• Genuine interest in women’s health
• Strong letters (ideally from OB/GYN attendings)
• Emotional maturity and work ethic

5. Fellowship (Optional, But Powerful)

After residency, most OB/GYNs go straight into practice. But if you want to subspecialize, you can apply for a fellowship. These are 3 additional years of training in areas like:

• Maternal-Fetal Medicine (MFM) – high-risk pregnancies
• Gynecologic Oncology – cancers of the reproductive tract
• Reproductive Endocrinology and Infertility (REI) – IVF and fertility
• Urogynecology – pelvic floor disorders and reconstructive surgery

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So, is fellowship really worth it?

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That depends on your career goals. Subspecialists often work in academic centers, do more procedures, and may earn higher salaries, but it comes with extra years of training, debt, and potential burnout.

Salary and Lifestyle: The Numbers, The Trade-Offs

Let’s talk about what everyone’s thinking: money and lifestyle. OB/GYNs are well-compensated, but like most of medicine, the paycheck comes with trade-offs in time, sleep, and flexibility.

The Numbers

As of the most recent national data:

• Average OB/GYN salary: ~$330,000/year
  
  
• New attendings may start closer to $250K, while experienced OB/GYNs in high-demand areas or private practice can earn $400K+

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But not all OB/GYN salaries are created equal. A few things that shift the number up or down:

• Practice setting: Private practice usually pays more than academic hospitals.
  
  
• Location: Rural and underserved areas often offer higher pay to attract physicians.
  
  
• Call burden: More call means more pay. Less call means less burnout (hopefully).
  
  
• Subspecialty training: Some fellowship-trained OB/GYNs (like Gyn Onc) can earn significantly more. Others (like REI) may see higher earnings through procedural volume.

OB/GYN vs Other Specialties

Compared to other specialties:

• OB/GYNs earn more than most primary care doctors (pediatrics, family med, internal med).
• But they generally earn less than surgical subspecialties like orthopedics, ENT, and neurosurgery.
• It’s middle-of-the-pack when you factor in the intensity of training and lifestyle demands.

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And compared to mid-levels:

• Nurse Midwives typically earn around $120K–$150K
• Labor & Delivery Nurses earn $75K–$100K

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OB/GYNs are the ones doing the surgeries, leading the teams, and managing complications, and their pay reflects that added training and responsibility.

The Lifestyle Paradox

Here’s the real trade-off:

OB/GYN is incredibly meaningful, but also unpredictable. Babies don’t care if it’s 3 a.m., and neither do emergencies like placental abruptions or postpartum hemorrhage.

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Even in group practices or hospital-employed roles, night shifts, weekend calls, and long surgeries are part of the job. The lifestyle can be demanding, especially if you’re doing both obstetrics and gynecology full-time.

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That said, many OB/GYNs adjust their scope over time:

• Some eventually stop delivering babies to reduce call hours.
• Others go into outpatient-only roles, teaching, or admin.

OB/GYN Subspecialties You Can Choose

OB/GYN is already a demanding specialty, but if you choose to subspecialize, the intensity (and compensation) can shift dramatically depending on your path. 

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Here's what the different routes look like in real life, from paycheck to pager duty.

Maternal-Fetal Medicine (MFM): High-Risk, High-Pressure

MFM specialists manage high-risk pregnancies. Think preeclampsia, twins, diabetes, fetal anomalies, and complex deliveries. You're not just delivering babies. You're running advanced diagnostics, guiding critical care, and often coordinating with neonatology and surgery.

• Salary: ~$400K–$500K
  
  
• Lifestyle: High pressure, heavy consult load, often on-call for emergencies
  
  
• Who thrives here: People who love acute care, fetal medicine, and being the calm in the storm
  
  

Reproductive Endocrinology & Infertility (REI): The Science of Hope

REI physicians deal with fertility, hormones, IVF, and cutting-edge reproductive technology. It’s outpatient-heavy and involves deep emotional connection with patients who’ve often been through years of trying to conceive.

• Salary: ~$300K–$450K (can be higher in private IVF clinics)
  
  
• Lifestyle: Clinic-based, more predictable hours, procedures like egg retrievals and embryo transfers
  
  
• Who thrives here: Science-minded, empathetic docs who enjoy longitudinal care and precision
  
  

Gynecologic Oncology: Where Surgery Meets Survival

Gyn Oncologists are the surgeon-warriors of the OB/GYN world. They operate on cancers of the uterus, cervix, ovaries, and more, often performing complex surgeries and managing chemotherapy.

• Salary: ~$450K–$600K
  
  
• Lifestyle: OR-heavy, emotionally intense, high acuity
  
  
• Who thrives here: Those who want to make a life-or-death impact and don’t mind long, technical surgeries
  
  

Urogynecology: Unglamorous but Critical

Urogynecologists focus on pelvic floor disorders. Think urinary incontinence, prolapse, and reconstructive surgery. It’s a field that doesn’t get a lot of spotlight, but the impact on quality of life is enormous.

• Salary: ~$300K–$400K
  
  
• Lifestyle: More elective procedures, clinic + OR balance
  
  
• Who thrives here: Detail-oriented surgeons who want a mix of technical work and meaningful outcomes
  
  

Minimally Invasive Gynecologic Surgery (MIGS): The Cutting Edge

MIGS specialists perform advanced laparoscopic and robotic procedures to treat conditions like endometriosis, fibroids, and pelvic pain. The goal is less blood loss, shorter recovery times, and better outcomes.

• Salary: ~$350K–$450K
  
  
• Lifestyle: Elective OR days, outpatient consults, fewer emergencies
  
  
• Who thrives here: Surgeons obsessed with precision, efficiency, and innovation
  
  

The Hospitalist Model: Shift-Based, Less Continuity, More Control

OB/GYN hospitalists (also called laborists) work scheduled shifts (day or night) and handle all deliveries, triage, and emergencies during that time, without having their own outpatient panel.

• Salary: ~$250K–$350K
  
  
• Lifestyle: Predictable shifts, fewer administrative burdens, no long-term patients
  
  
• Who thrives here: Physicians who want work-life separation, flexibility, or are looking to scale back from full-scope OB/GYN

OB/GYN vs Other Women’s Health Paths

If you're passionate about women’s health, becoming a physician isn’t your only option.

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Here’s how OB/GYNs compare to other key players in the women’s health space: midwives, women’s health nurse practitioners (WHNPs), and OB nurses.

OB/GYN: The Physician Leader

• Who they are: Medical doctors (MD or DO) trained in both obstetrics and gynecology. They manage everything from routine prenatal care to high-risk pregnancies, major surgeries (like hysterectomies), and reproductive cancers.
  
• Training time: 12+ years (4 undergrad, 4 med school, 4 residency)
  
• Typical salary: $300K–$400K+
  
• Scope: Full-spectrum care, including surgeries, deliveries, prescriptions, and complex cases
  
  

Certified Nurse Midwife (CNM): The Natural Birth Specialist

• Who they are: Registered nurses (RNs) with a master's or doctorate in nurse-midwifery. They specialize in low-risk pregnancies and holistic reproductive care.
  
• Training time: ~6–8 years (BSN + 2–3 year CNM program)
  
• Typical salary: $120K–$150K
  
• Scope: Prenatal care, deliveries (often in hospitals or birthing centers), postpartum care, birth control, well-woman exams
  
• Limitations: Cannot perform C-sections or manage high-risk pregnancies without physician involvement
  
  

Women’s Health Nurse Practitioner (WHNP): The Outpatient Expert

• Who they are: Nurse practitioners focused on outpatient women’s health, like contraception, Pap smears, STI testing, menopause management, etc.
  
• Training time: ~6–8 years (BSN + 2–3 year WHNP program)
  
• Typical salary: $100K–$130K
  
• Scope: Preventive care, routine gynecology, some prescribing authority (varies by state)
  
• Limitations: Do not attend births or perform surgeries
  
  

Labor & Delivery Nurse (OB Nurse): The Frontline Caregiver

• Who they are: RNs working in hospital labor and delivery units. They manage patients in labor, assist during deliveries, monitor fetal heart tones, and support postpartum recovery.
  
• Training time: ~2–4 years (ADN or BSN)
  
• Typical salary: $75K–$100K
  
• Scope: Supportive and clinical care during labor and delivery under supervision of OB/GYNs and midwives
• Limitations: Cannot prescribe, diagnose, or perform procedures

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Personality Fit: Who Thrives in OB/GYN (and Who Should Run)

Not every future doctor is cut out for OB/GYN, and that’s a good thing. This specialty demands a very specific type of energy: part ER doc, part therapist, part surgeon, part teacher. You’re delivering babies one minute, breaking devastating news the next.

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Here’s who thrives:

• Fast thinkers. You need to make decisions quickly, sometimes with two lives on the line. There’s no room for paralysis when a fetal heart rate drops or hemorrhage hits.
• Adrenaline junkies with heart. You love the action, but you’re also here for the people. OB/GYNs build long-term relationships. They’re trusted with stories, secrets, and the most intimate moments of their patients’ lives.
• Compassionate communicators. Can you talk about miscarriage, infertility, sexual trauma, or cancer with grace and presence, while staying clinically sharp? Emotional intelligence is just as important as clinical knowledge here.
• Team players. OB/GYNs work closely with nurses, anesthesiologists, pediatricians, and midwives. Big egos don’t thrive. Calm leadership does.

Are You a Future OB/GYN?

There’s no checklist that guarantees you’ll thrive in this specialty, but there are signs. You find yourself leaning in during labor stories, not out.

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Ask yourself:

• Can I stay calm when two lives are in my hands and time is running out?
• Do I want to advocate for people who are often unheard or underserved in healthcare?
• Am I comfortable talking about trauma, fertility, sexual health, miscarriage, abortion, and birth without flinching?
• Can I build deep patient relationships and pivot into surgeon mode when the moment calls for it?
• Do I want a career where no two days are ever the same, and I’m okay with missing sleep, holidays, and normal office hours because of it?
• Does the idea of delivering a baby, performing a hysterectomy, and counseling a teen on contraception in one shift excite me?
• Am I ready to emotionally carry both the highs of new life and the heartbreak of loss, sometimes within minutes of each other?
• Can I thrive on a team, communicate under pressure, and lead with both confidence and compassion?
• Do I have the drive to push through 12+ years of training to earn a seat at the table in women’s health?

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If you answered yes to most of these, or even if you're not sure, but you're curious, you owe it to yourself to keep exploring. 

Take the First Step. See Real Apps That Got Accepted to Med School.

You’ve got the ambition. You’ve got the curiosity. But let’s be real, this path can feel overwhelming. You’re staring down years of training, fierce competition, and a mountain of expectations, and you’re not even in med school yet.

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If you want to become an OB/GYN, your very first move is building a med school application that actually rises above the noise, not just with high stats, but with a clear, compelling story.

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That’s why we created the free Application Database:

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A collection of 8 real AMCAS applications that were each accepted to top medical schools like UCLA and UCI, including my own. You’ll see exactly what works, what stands out, and how successful premeds tell their story through activities, personal statements, and more.

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Use it to reverse-engineer your own standout application, and start your journey to OB/GYN the right way.

‍

Get your free resource here.