On Call: Catching Up With Three Obstetrician/Gynecologists

What have graduates of the University of Wisconsin School of Medicine and Public Health been up to lately? Three medical school alumni who are obstetricians/gynecologists share their stories.

William MacMillan, MD '85

I stayed in Madison for my residency before heading East for fellowship training in maternal-fetal medicine at SUNY-Stony Brook. Following that, I returned to the Midwest, to Loyola University Stritch School of Medicine, for 14 years.

I'm now in the East again at Robert Wood Johnson Medical School of the University of Medicine and Dentistry of New Jersey.

In general, my practice focuses on pregnancies gone awry, whether maternal complications, fetal problems or both. This is illustrated best by my most "famous" case (some would say "infamous"). The case came in 2004 while I was at Loyola, delivering the world's smallest recorded surviving infant at 260 grams. The mother was very ill with severe preeclampsia.

Choosing a specialty was a two-step process for me; first obstetrics and gynecology, then the subspecialty of maternal-fetal medicine. In the three-dimensional Venn diagram of modern medicine lies the intersection of medicine, surgery, reproductive science and women's health that we know as obstetrics and gynecology.

Add the further confluence of neonatology/pediatrics, genetics and ultrasound imaging and you find yourself in maternal-fetal medicine. All of these are interests of mine and are used daily in my practice. I can't imagine being without any of these many facets of medicine.

My usual advice to medical students considering obstetrics and gynecology is to spend as much time as possible in Labor and Delivery.

Then ask yourself two important questions:

1. Are you comfortable in that environment? It's unlike any other unit in a hospital. It's part OR, part ER, part ICU, but clearly a space for and by women.
2. When an emergency occurs there (which is frequent), do you want to run to it or away from it?

The insights from those questions quickly determine if obstetrics and gynecology is a good fit for the individual.

Kristi Borowski, MD '00

I am an assistant professor at the University of Iowa School of Medicine. I did my residency at the Mayo Clinic, in Rochester, Minnesota, then came to Iowa to complete a combined fellowship in maternal-fetal medicine and medical genetics.

I stayed on the faculty after completing the fellowship two years ago.

As a new faculty member, I received a Reproductive Scientist Development Program training grant so I've spent the last two years in bench research studying genetic variation in intrauterine growth restriction and cholesterol levels and perinatal outcomes.

Clinically, I see women with high-risk pregnancies. These can be due to fetal abnormalities, multiple gestations or maternal conditions such as diabetes.

I think one of the most memorable cases for me was my first intrauterine transfusion. It is still amazing to me that we can diagnose a fetal condition like anemia by ultrasound, place a needle in the umbilical vein and transfuse the fetus while in utero. Seeing healthy outcomes after this is always rewarding!

I chose obstetrics and gynecology because I like the combination of clinical care and procedures. I love the variability in schedule and assignments, and that each day is unique. I also wanted to play a role in women's health care.

Obstetrics-gynecology is a great specialty for me. I am fortunate to have the opportunity to pursue a research career, have unique clinical opportunities - like the pre-pregnancy genetics clinic I just initiated - and be able to teach medical students, residents and fellows.

I tell medical students: Do what you love and create the job that fits your interests, abilities and life.

In addition to my work schedule, I'm busy at home with family. My husband, Bret Borowski, and I have three children: Aidan, 7, Macy, 5, and Mia, 5. I have fond memories of my time in Madison and always enjoy running into former classmates.

Kristin Clark, MD '00

I practice at Women's Care of Wisconsin in Neenah, and work mostly out of Theda Clark Medical Center, also in Neenah. I share call with 11 other ob/gyns and feel blessed to practice with such competent colleagues. Sharing call gives me more time to spend with my family and focus on being a mom.

I'm mostly involved in high-risk obstetrics and routine office-surgical gynecology. My senior partners have also trained me to perform advanced laparoscopic surgery, including total laparoscopic hysterectomy. I'm proud to be able to offer my patients these procedures, because not many other providers in this part of the country do.

I did my residency at the University of Missouri in Kansas City. But my husband and I are both from northeast Wisconsin so we moved back because we missed being close to our families. In my opinion, you won't find nicer people than those who live in Wisconsin. We especially enjoy being here now that we have children.  

When I started medical school, I said, "I don't know what I'm going to do, but I'm definitely not doing obstetrics." A gynecologist I knew as a patient (I was pre-med then) told me not to do ob/gyn. She seemed really unhappy, and I was immediately turned off to the specialty.  

Funny how things work out! As a medical student, I really liked radiology, but after I did my obstetrics rotation in my third year of medical school, I was hooked. The specialty is really suited to my strengths because I like interacting with people in the office and spending time in the OR. 

Also, this is mostly a positive specialty and is regularly filled with joy. Yes, there are great demands on your time and emotions, but I feel you get back more than you give.

I do informal mentoring with all levels of students. I do it because I really like my job and want to help others decide if they like it too. The mentors I have had in the past have helped shape who I am and how I practice - they were a vital part of my education. Now it's my turn to give back.