You love babies and want to help make your patients’ dreams of parenthood come true.

你熱愛嬰兒，希望幫助你的病人實現為人父母的夢想。

Let’s debunk the public perception myths of what it means to be a reproductive endocrinologist

讓我們來揭穿公眾對生殖內分泌醫生的看法的神話

and give it to you straight.

並把它直接交給你。

This is the reality of reproductive endocrinology.

這就是生殖內分泌學的現實。

Dr. Jubbal, MedSchoolInsiders.com.

Jubbal博士，MedSchoolInsiders.com。

Welcome to our next installment in So You Want to Be.

歡迎來到《你想成為什麼樣的人》的下一篇文章。

In this series, we highlight a specific specialty within medicine, such as reproductive endocrinology,

在這個系列中，我們強調醫學中的一個特定專業，如生殖內分泌學。

and help you decide if it’s a good fit for you.

並幫助你決定它是否適合你。

You can find other specialties on our So You Want to Be playlist.

你可以在我們的 "你想成為 "播放列表中找到其他專業。

If you have a specific specialty you want to be covered on our next So You Want to Be,

如果你有一個特定的專業，你希望在我們的下一個 "你想成為的人 "中涉及。

make sure you’re subscribed to vote in upcoming polls.

請確保你已訂閱，以便在接下來的投票中投票。

Also, consider becoming a YouTube channel member to receive additional perks and priority

此外，考慮成為YouTube頻道會員，以獲得額外的福利和優先權

in helping us decide on future specialties.

在幫助我們決定未來的專業。

Click the JOIN button underneath this video for more information.

點擊本視頻下方的加入按鈕，瞭解更多資訊。

If you’d like to see what being a reproductive endocrinologist looks like, be sure to check

如果你想看看作為一名生殖內分泌醫生是什麼樣子的，請務必查看

out my Day in the Life of a Reproductive Endocrinologist video with Dr. Carrie Bedient on my second

請看我的《生殖內分泌醫生的一天》視頻，該視頻是Carrie Bedient醫生在我的第二篇文章中拍攝的。

channel, Kevin Jubbal, M.D., and subscribe for more Day in the Life videos covering other

頻道的Kevin Jubbal醫學博士，並訂閱更多涵蓋其他領域的 "生活中的一天 "視頻。

specialties in the future.

未來的專業。

Reproductive endocrinology and infertility, or REI for short, is the field of medicine

生殖內分泌學和不孕症，簡稱REI，是一個醫學領域。

concerned with helping people get pregnant who are unable to do so on their own.

關注的是幫助那些無法自行懷孕的人。

REI physicians are experts in all things related to conception and reproduction and are adept

REI的醫生是與受孕和生殖有關的所有事情的專家，並善於

at managing any issues that may be preventing patients from becoming pregnant.

在管理任何可能阻礙病人懷孕的問題方面。

REI doctors are often best known for fertility treatments such as intrauterine insemination,

REI醫生通常以宮內人工授精等生育治療而聞名。

or IUI, and in vitro fertilization, or IVF; however, their actual scope is much broader.

或IUI，以及體外受精，或IVF；然而，其實際範圍要廣泛得多。

REI physicians handle the full spectrum of issues that cause infertility from hormone

REI的醫生處理導致不孕不育的所有問題，從激素

imbalances to polycystic ovarian syndrome, or PCOS, to even some forms of cancer.

從失衡到多囊卵巢綜合症，或多囊卵巢綜合症，甚至是某些形式的癌症。

In addition, REI physicians also help patients preserve their ability to have children in

此外，REI的醫生還幫助病人保持他們的生育能力，在

the future through procedures such as egg and sperm cryopreservation.

通過卵子和精子的冷凍保存等程序，在未來的日子裡，我們將有更多的機會。

There are a few ways to categorize reproductive endocrinology.

有幾種方法可以對生殖內分泌學進行分類。

Let’s start with infertility versus reproductive endocrinology.

讓我們從不孕不育與生殖內分泌學開始。

In general, infertility comprises the bulk of what an REI physician does day-to-day.

一般來說，不孕不育包括REI醫生日常工作的大部分內容。

It encompasses all of the evaluations and treatments for patients who want to become

它包含了對希望成為 "大明星 "的病人進行的所有評估和治療。

pregnant but have difficulty doing so on their own.

懷孕，但自己做起來有困難。

The bread and butter of infertility is focused on the evaluation of the uterus, fallopian

不孕不育症的麵包和黃油主要集中在對子宮、輸卵管的評估上。

tubes, ovaries, and sperm, as well as the patient’s general health and genetics, to

觀察輸卵管、卵巢和精子，以及病人的一般健康和遺傳情況，以便

determine why the patient or couple is having difficulty conceiving.

確定病人或夫婦難以受孕的原因。

The infertility aspect of REI also includes various procedures to help patients become

REI的不孕不育方面還包括各種程序，以幫助患者成為

pregnant, most notable of which are ovulation induction and intrauterine insemination, sometimes

懷孕，其中最引人注目的是排卵誘導和宮腔內人工授精，有時是

called artificial insemination, and in vitro fertilization.

稱為人工授精，以及體外受精。

With ovulation induction and IUI, patients are given a series of medications followed

在誘導排卵和人工授精方面，患者要接受一系列的藥物治療，然後是

by a trigger shot to help their bodies release an egg.

通過注射觸發劑來幫助他們的身體釋放卵子。

Once the egg has been released, sperm is introduced into the uterus in an attempt to fertilize

一旦卵子被釋放，精子被引入子宮，試圖受精。

the egg.

雞蛋。

In contrast, in vitro fertilization requires the extraction of eggs from the patient after

與此相反，體外受精需要從病人身上提取卵子，然後再將其送到醫院。

which they are combined with sperm in a laboratory.

它們在實驗室中與精子結合。

The embryo will then be allowed to grow within the lab for a few weeks after which it will

然後，胚胎將被允許在實驗室內生長几周，之後，它將被送往醫院。

be transferred into the uterus to, hopefully, result in pregnancy.

被轉移到子宮內，希望能導致懷孕。

In contrast, the reproductive endocrinology aspect of REI is similar to medical endocrinology;

相比之下，REI的生殖內分泌學方面與醫學內分泌學類似。

however, it focuses solely on the hormones related to reproduction – namely estrogen,

然而，它只關注與生殖有關的荷爾蒙--即雌激素。

progesterone, and testosterone.

孕酮和睪酮。

The bread and butter of reproductive endocrinology involves working with conditions such as menopause,

生殖內分泌學的麵包和黃油涉及與更年期等情況的工作。

premature ovarian insufficiency, and PCOS.

卵巢早衰和PCOS。

Another method of differentiating an REI practice is academic vs private.

區分REI實踐的另一種方法是學術性與私人性。

REI physicians working in the academic setting will split their time between clinic, teaching,

在學術環境中工作的REI醫生將在診所、教學之間分配他們的時間。

and research.

和研究。

Depending on the arrangement, academic REI doctors may spend as much as 80% of their

根據不同的安排，學術界的REI醫生可能會花費多達80%的時間在他們的工作上。

time teaching and researching and as little as 20% of their time in clinic seeing patients.

他們只有20%的時間用於教學和研究，只有20%的時間在診所看病人。

It should be noted, however, that this varies significantly depending on the specific arrangement.

然而，應該注意的是，這一點因具體安排不同而有很大差異。

The majority of REIs work in private practice.

大多數REI在私人診所工作。

This means that they are either running their own clinic or working for a private group.

這意味著他們要麼在經營自己的診所，要麼在為一個私人集團工作。

In private practice, the focus tends to be on clinical medicine and less on research

在私人診所，重點往往放在臨床醫學上，而不是研究。

or teaching as evaluating and treating patients is often what drives revenue.

或教學，因為評估和治療病人往往是推動收入的原因。

That being said, hybrid practices splitting one’s time between clinic, research, and

話雖如此，但混合式的做法是將一個人的時間分割在診所、研究和其他方面。

teaching do exist.

教學確實存在。

In terms of compensation, physicians working for private practices will generally make

在報酬方面，為私人診所工作的醫生一般會賺取

more than their colleagues in academia.

比他們在學術界的同事更多。

That being said, there is a great deal of variation in terms of compensation within

話雖如此，但內部的報酬卻有很大的差異。

private practice.

私人執業。

Let’s clear up some of the misconceptions about REI.

讓我們澄清關於REI的一些誤解。

To start, many people believe that fertility treatment is only available for male and female

首先，許多人認為，生育治療只適用於男性和女性

couples.

夫婦倆。

This is not true.

這是不正確的。

There are many single women, LGBTQ+ couples, and even the occasional single male who seek

有許多單身女性、LGBTQ+夫婦，甚至偶爾的單身男性都在尋求

fertility treatment.

生育治療。

REI physicians see the full spectrum of patients with regard to race, sexual orientation, and

REI的醫生在種族、性取向以及其他方面為病人提供全方位的服務。

socioeconomic status.

社會經濟地位。

Another misconception is that REI physicians can help you get pregnant regardless of the

另一個誤解是，REI醫生可以幫助你懷孕，無論

situation.

情況。

People see celebrities in their 50s getting pregnant and believe that it’s possible

人們看到50多歲的名人懷孕，認為這是可能的。

for everyone.

為大家服務。

The reality is that REI doctors can help enhance your ability to get pregnant, but only if

現實情況是，REI醫生可以幫助提高你懷孕的能力，但前提是

it’s possible in the first place.

它首先是可能的。

Female patients who have children later in life generally either froze their eggs when

晚年生孩子的女性患者，一般都是在懷孕時將卵子冷凍起來。

they were younger or used an egg donor.

他們更年輕或使用卵子捐贈者。

If there are no eggs left in the ovaries or no sperm being created in the testicles, REI

如果卵巢中沒有卵子，或睪丸中沒有精子產生，REI

doctors can’t change that.

醫生不能改變這一點。

They can, however, provide a donor.

然而，他們可以提供一個捐贈者。

Lastly, many people incorrectly believe that it is an easy specialty.

最後，許多人錯誤地認為這是一個容易的專業。

REIs have to be incredibly detail-oriented as seemingly small mistakes can be the difference

REI必須非常注重細節，因為看似微小的錯誤可能成為差異。

between your patient becoming pregnant or not.

你的病人是否懷孕之間。

In addition, miscarriages, ectopic pregnancies, and negative pregnancy tests are common occurrences

此外，流產、宮外孕和妊娠試驗陰性是常見的情況。

and those conversations are never easy – even for the most seasoned physicians.

而這些對話從來都不容易--即使對最老練的醫生來說也是如此。

To become an REI physician, you must first complete four years of OB/GYN residency followed

要成為一名REI醫生，你必須首先完成四年的婦產科住院醫師培訓，然後是

by 3 years of REI fellowship.

通過3年的REI獎學金。

Occasionally there are urology residents who will cross over to REI; however, the vast

偶爾會有泌尿外科住院醫生轉到REI；但是，絕大多數的泌尿外科住院醫生都會轉到REI。

majority are OB/GYN trained.

大多數人都接受過婦產科培訓。

This makes sense as REI physicians still use many of their OB/GYN skills in their daily

這是有道理的，因為REI的醫生在日常工作中仍然使用許多婦產科的技能。

practice.

做法。

For instance, when patients become pregnant, the reproductive endocrinologist will typically

例如，當病人懷孕時，生殖內分泌專家通常會

follow the patient through the first trimester of pregnancy.

在懷孕的前三個月對病人進行跟蹤。

Additionally, REIs still have to deal with the many complications that can occur during

此外，REI仍然必須處理在工作中可能出現的許多併發症。

pregnancy such as miscarriages and ectopic pregnancies.

懷孕，如流產和宮外孕。

REI fellowship is generally divided evenly between research and clinical work.

REI的獎學金一般在研究和臨床工作之間平均分配。

Due to the heavy emphasis on research, REI fellows are required to present a thesis,

由於對研究的高度重視，REI的研究員需要提交一篇論文。

or original piece of research, as a part of their fellowship curriculum and as part of

作為其研究金課程的一部分，也作為其研究項目的一部分。

their oral board exams.

他們的口試考試。

The majority of time during the second half of fellowship will be spent in the REI clinic;

在研究金的後半段，大部分時間將在REI診所度過。

however, they are also required to complete rotations in medical endocrinology, pediatric

然而，他們還需要完成內分泌學、小兒科和婦科的輪訓。

endocrinology, urology, and genetics.

內分泌學、泌尿學和遺傳學。

In terms of competitiveness, OB/GYN is considered tier 4 or “less competitive.”

就競爭力而言，婦產科被認為是第四級或 "競爭力較弱"。

The average match rate is 89%, average Step 1 is 229, Step 2CK is 245, and the average

平均匹配率為89%，平均步驟1為229，步驟2CK為245，而平均

number of publications hovers around four and a half.

出版品的數量徘徊在四個半左右。

To learn more about the different tiers of specialty competitiveness, check out Why Every

要了解更多關於專業競爭力的不同層次，請查看《為什麼每一個

Specialty Seems Competitive over on the Kevin Jubbal, M.D.

在凱文-朱波爾醫學博士的辦公室裡，專業性似乎很強。

channel - link in the description.

頻道--描述中的鏈接。

That being said, REI is known for being one of the most competitive OBGYN subspecialties.

也就是說，REI以成為競爭最激烈的婦產科亞專業之一而聞名。

In 2021, there were 70 applicants that applied out of which 49 were offered positions.

2021年，有70名申請人申請，其中49人獲得了職位。

That’s a match rate of 70%.

這是一個70%的匹配率。

Medical students best suited for reproductive endocrinology and infertility tend to be detail-oriented,

最適合生殖內分泌學和不孕症的醫學生往往注重細節。

patient, and are adept at working in a slower-paced yet still high-stress environment.

有耐心，並善於在節奏較慢但仍有高壓力的環境中工作。

There’s a lot to love about REI.

REI有很多值得喜愛的地方。

To start, being an REI doctor is immensely gratifying.

首先，作為一名REI醫生是非常令人滿意的。

The feeling of satisfaction you get when you see a baby’s first heartbeat on an ultrasound

當你在超音波上看到嬰兒的第一個心跳時，你會有一種滿足感。

after you’ve spent months, or even years, helping a patient conceive is difficult to

在你花了幾個月，甚至幾年的時間幫助病人受孕後，你很難再有機會。

put into words.

用語言表達出來。

As an REI physician, you also get to spend a lot of time with your patients.

作為一名REI醫生，你還可以花很多時間與你的病人在一起。

This gives you the opportunity to build very close relationships which you don’t necessarily

這使你有機會建立非常密切的關係，而你不一定能做到。

get in many other specialties.

在許多其他專業中得到。

REI physicians also tend to have higher compensation.

REI的醫生也往往有更高的報酬。

According to the 2020 MGMA Physician Compensation Report, the median salary is $457,000 with

根據2020年MGMA醫生薪酬報告，工資中位數為457,000美元，其中

a mean compensation of $461,000.

平均報酬為461,000美元。

It should be noted that compensation can vary significantly, with some making $250,000 at

應該注意的是，報酬可能會有很大的不同，有些人的報酬是25萬美元，而有些人的報酬是20萬美元。

the low end and others making more than $500,000 at the high end.

低端的人，而高端的人收入超過50萬美元。

It should be noted, however, that those at the higher end of the salary range will generally

然而，應該注意的是，那些處於工資範圍較高位置的人一般會

own their own practice, which comes with all of the additional work that goes into owning

擁有自己的實踐，這與擁有的所有額外工作有關。

a business.

一個企業。

REI also offers flexibility within the specialty.

REI還提供專業內的靈活性。

If you want to focus on procedures, you can do that.

如果你想專注於程序，你可以這樣做。

Or if you’re more interested in the medical aspects of REI, that’s fine too.

或者如果你對REI的醫療方面更感興趣，那也可以。

And if you’re interested in teaching, the heavy emphasis on the basic sciences during

如果你對教學有興趣，那麼，在這段時間裡，對基礎科學的重視程度是非常高的。

your training also opens up many opportunities to teach.

你的培訓也為你提供了許多教學機會。

Lastly, the lifestyle is generally pretty good.

最後，生活方式一般來說是相當好的。

The hours spent in the clinic are fairly predictable and night-call or night emergencies are very

在診所度過的時間是相當可預測的，夜班或夜間急診的情況非常多。

rare.

罕見。

That being said, due to the time-sensitive nature of fertility treatments, you do have

話雖如此，由於生育治療的時間敏感性，你確實需要

to remain fairly accessible to your patients.

以保持對你的病人有相當的吸引力。

While reproductive endocrinology and infertility is an awesome specialty, it’s not for everyone.

雖然生殖內分泌學和不孕不育是一個了不起的專業，但它並不適合每個人。

To start, the training is longer than most specialties as you must complete 4 years of

首先，培訓時間比大多數專業要長，因為你必須完成4年的培訓。

OB/GYN residency followed by 3 years of REI fellowship.

婦產科住院醫師，然後是3年的REI獎學金。

In addition, if you’re interested in opening your own practice, there is a great deal of

此外，如果你有興趣開設自己的診所，有大量的

overhead that you don’t necessarily have with other specialties.

你在其他專業不一定有的開銷。

Even if you’re opening a small practice with only one physician, operating an REI

即使你開設的是一個只有一名醫生的小診所，經營一個REI

practice requires a large team.

實踐需要一個龐大的團隊。

You’ll often need at least a lab, a surgery center, an office, and the associated staff.

你通常至少需要一個實驗室、一個手術中心、一個辦公室，以及相關的工作人員。

This includes front staff, medical assistants, an embryologist, an anesthesiologist, and

這包括前臺工作人員、醫療助理、一位胚胎學家、一位麻醉師以及

other staff to help coordinate the care.

其他工作人員幫助協調護理。

As such, it can often be incredibly difficult to start your own REI practice.

是以，開始你自己的REI實踐往往是令人難以置信的困難。

Fertility treatments also don’t work 100% percent of the time and it can be incredibly

生育治療也不是百分之百有效的，它可能是令人難以置信的。

frustrating for both the patient and physician when things don’t go as expected.

當事情沒有按照預期進行時，病人和醫生都會感到沮喪。

In some instances, patients burn out, become angry, or don’t have the financial resources

在某些情況下，病人會倦怠，變得憤怒，或沒有經濟來源。

to continue pursuing fertility treatment and, as an REI physician, you’re often the one

作為REI的醫生，你經常是那個繼續尋求生育治療的人。

that has to bear the brunt of those frustrations.

必須承受這些挫折的首當其衝的人。

As such, REI can be stressful.

是以，REI可能是有壓力的。

You have to be confident in yourself and your abilities and be able to acknowledge that

你必須對自己和自己的能力有信心，並能夠承認這一點。

if someone doesn’t get pregnant, it isn’t necessarily your fault.

如果有人沒有懷孕，這不一定是你的錯。

No treatment is 100% effective.

沒有任何治療方法是100%有效的。

That being said, it can often be difficult not to internalize these feelings as there

話雖如此，但往往很難不把這些感覺內化，因為有

are very clear lines regarding whether treatment was successful.

關於治療是否成功，是非常明確的界限。

Either the pregnancy test was positive and the baby was born, or it wasn’t – and

要麼懷孕測試呈陽性，孩子出生了，要麼沒有--而且

that’s a heavy burden to bear, both for the patient and the physician.

這對病人和醫生來說，都是一個沉重的負擔。

How can you decide if REI is right for you?

你如何決定REI是否適合你？

You should enjoy both the procedural and non-procedural aspects of medicine and be willing to dedicate

你應該同時喜歡醫學的程序性和非程序性方面，並願意為之奉獻。

extra years in training for the satisfaction of knowing you’re helping bring new life

額外的培訓年限，因為你知道你正在幫助帶來新的生命而感到滿足。

into the world.

進入世界。

You should also be patient and persistent – willing to endure the rollercoaster of

你還應該有耐心和毅力--願意忍受雲霄飛車般的痛苦。

emotions that comes with unsuccessful pregnancies if it means ultimately getting your patient

如果這意味著最終能讓你的病人獲得成功的話，那麼你就必須對不成功的懷孕產生的情緒進行控制。

to that one successful pregnancy.

到那一次成功的懷孕。

Lastly, you should enjoy research and basic sciences, at least to some degree, as they

最後，你應該喜歡研究和基礎科學，至少在某種程度上，因為他們

are a major component of the training to become an REI physician.

是成為REI醫生培訓的一個主要組成部分。

Huge shout out to Reproductive Endocrinologist Dr. Carrie Bedient for helping me with this

衷心感謝生殖內分泌學家Carrie Bedient博士對我的幫助。

video.

視頻。

See a day in her life on my other channel, Kevin Jubbal, M.D.

在我的另一個頻道看到她一天的生活，Kevin Jubbal, M.D。

- link in the description.

- 描述中的鏈接。

And check her out on her social media platforms - links in the description.

並在她的社交媒體平臺上查看她--描述中的鏈接。

Are you hoping to become a reproductive endocrinologist?

你是否希望成為一名生殖內分泌醫生？

To get into medical school and match into a top OB/GYN residency, you’ll need to score

要想進入醫學院並與頂尖的婦產科住院醫生相匹配，你需要取得以下成績

well on your exams and have a killer application.

在考試中取得好成績，並有一個強有力的申請。

As you look for experts to work with, seek out those who are actual MD physicians who

在你尋找合作的專家時，要尋找那些真正的醫學博士醫生，他們是

crushed their MCAT and USMLE, gained multiple top medical school acceptances, matched into

順利通過了MCAT和USMLE考試，獲得了多所頂尖醫學院的錄取通知書，並被匹配到

competitive residencies, and even had medical schools fighting over them by throwing merit-based

競爭激烈的住院醫師，甚至有醫學院為爭奪他們而拋出擇優錄取的辦法。

scholarships to sway their decision.

獎學金來動搖他們的決定。

Only the top performers can best show you how to most effectively improve your own performance.

只有頂尖的表演者才能最好地告訴你如何最有效地提高你自己的表現。

At Med School Insiders, we’ve been empowering a generation of happier, healthier, and more

在Med School Insiders，我們一直在賦予一代人更快樂、更健康和更多的權利。

effective future doctors since 2016.

自2016年以來，有效的未來醫生。

By recruiting the top talent and pioneering a systems-focused approach to our services,

通過招聘頂尖人才和開創以系統為重點的服務方式。

we’ve become the fastest growing company in the space with industry-leading customer

我們已經成為該領域發展最快的公司，擁有行業領先的客戶群。

satisfaction.

滿意。