Dr. Tabatha Barber describes gynecology residency as heavily surgical and procedure-focused, with minimal training in endocrinology. She argues the field defaults to synthetic hormones and surgical fixes rather than deeper hormonal evaluation, and apologizes for practicing within those norms while dismissing patients' concerns.
Gynecologists are actually surgeons. I did a four year surgical residency. I spent four years delivering babies and doing episiotomies and suturing you up and doing surgeries and removing organs like ovaries and tubes and uteruses and repairing bowels and things injured from endometriosis. I focused on learning procedures in the office like colposcopies, IUD placement and removal, biopsies of the vulva and the vagina. It was very much hands on, surgically based. It was very much what we need to remove and repair. It was less about why did this happen and more about how to fix it. Gynecologists are actually surgeons. We did not do extensive training in the endocrinology system and all of the intricacies of our hormones and how they are related to the endocrine system of our adrenal glands, of our thyroid, of our pancreas with blood sugar and insulin. We did the basic basics of internal medicine rotation. So we got your basics. Like we knew how to admit someone with raging diabetes, get their blood sugar under control and send them on their way. We understood the basics of treating a sinus infection. We understood the basics of, you know, how an orthopod would help with a fracture. We got all the basics. And the same goes for hormones. We did a little bit in the endocrinology department, we did a little bit in the hormones. But mostly our hormone training is focused on what drug, so what synthetic hormone medication will combat your hormone symptoms. And it's very much focused on what birth control pill can we use to override this system. And then in menopause, if you're going to use hormones, which drug are you going to use? There was no training on bioidenticals. There was no training on the difference of that. There was no training on the intricacies of testing hormones and understanding optimal ranges. It's very much either you have an estrogen of 2000 because you have a tumor, or you're normal because your level is somewhere between 20 and 800. That is not hormonal hormone balance. That is not benefiting anybody. So I'm here to apologize that I didn't understand that and I practiced that way for a long, long time. And I'm sorry that conventional gynecology continues to be this way and that you are very much gaslighted and dismissed. You're told you're crazy. You're told you're fine. Fine. You're told to suffer and just deal with it. You're told that you're just aging and to get over it. All of those are unacceptable answers in my book, and we should no longer put up with doctors saying these things to us as women.
