How to become an OB-GYN

1. 1Earn a bachelor's degree with premed courses

   Time: 4 yearsCost: Varies by collegeSources 1

   Any major works, but you need the premedical sciences medical schools expect: biology, general and organic chemistry, physics and math, plus strong grades. Clinical experience matters for admission; shadowing an OB-GYN, volunteering at a women's health clinic or working as a doula or medical scribe shows you know what the specialty involves. Some universities offer combined bachelor's-MD programs that take 6 to 8 years in total.

2. 2Take the MCAT and apply to medical school

   Time: About 1 yearCost: $360 MCAT registration ($145 with Fee Assistance)Sources 2, 1, 6

   The MCAT is required for admission to almost all US medical schools. You can apply to MD programs, accredited by the LCME, and DO programs, accredited by COCA. Both lead to residency in obstetrics and gynecology, and ABOG accepts either an MD or a DO. Applicants with financial need can apply to the AAMC Fee Assistance Program, which cuts the MCAT registration fee to $145.

3. 3Complete medical school and licensing exams

   Time: 4 yearsCost: $297,745 (public) to $408,150 (private) median 4-year cost of attendanceSources 3, 4, 5, 1

   The first two years are classroom science; the last two are clinical rotations, including obstetrics and gynecology. MD students take USMLE Step 1 and Step 2 CK ($695 each); DO students take COMLEX-USA Levels 1 and 2-CE ($745 each). Students aiming for OB-GYN usually do extra senior electives or sub-internships on labor and delivery and gynecologic surgery before applying to residency.

4. 4Finish a four-year OB-GYN residency

   Time: 48 monthsCost: Paid as a residentSources 6, 3, 4

   ABOG requires 48 months of training in an ACGME-accredited obstetrics and gynecology residency, and residents may not skip vacation or needed sick leave to finish sooner. Training covers labor and delivery, gynecologic surgery and outpatient clinics, and every resident takes on chief (senior) resident duties in the third or fourth year. Step 3 ($955) or COMLEX Level 3 ($950) is usually taken during residency.

5. 5Get a state medical license

   Time: During or right after residencyCost: State feesSources 1, 7, 9

   Every state requires physicians to be licensed. Boards generally require graduation from an accredited medical school, passing all three USMLE steps or COMLEX levels, and completed residency training, with rules on how much residency is needed before full licensure that differ by state. An unrestricted license is also needed to apply for ABOG's oral Certifying Exam.

6. 6Pass ABOG's board exams

   Time: About 1-2 years after residencyCost: ABOG exam and application feesSources 6, 9, 10

   Board certification has two steps. The Qualifying Exam is a written, computer-based test at a Pearson VUE center, taken after residency. The Certifying Exam is an oral exam at ABOG's national center, based partly on a case list of your own patients from independent practice. You also need unrestricted hospital privileges, and residency graduates from 2020 on must show completion of FLS or EMIGS. Certification must be achieved within eight years of finishing residency. Subspecialists add a fellowship, a thesis and separate subspecialty exams.

Programs, tuition and graduates’ earnings

U.S. Department of Education, College Scorecard (most recent cohorts, released 2026-10-15). Scorecard groups programs by 4-digit field, so a row can include related programs. Tuition is the median published undergraduate tuition and fees of the colleges offering the program (shown only for undergraduate credentials); debt is the median of programs’ median federal loan debt at completion; earnings are the national median for the field and credential four years after completion.

Requirements differ by state. Check your state’s rules in the CareerOneStop License Finder (U.S. Department of Labor) before you enroll.

Decision-making in emergencies

A slowing fetal heart rate or postpartum hemorrhage can require a decision on cesarean delivery or surgery within minutes.

Surgical skill

OB-GYNs perform cesareans, hysterectomies and minimally invasive procedures, and ABOG requires FLS or EMIGS before its oral exam.

Sensitive communication

Visits cover pregnancy loss, infertility, sexual health and cancer, topics where patients need clear and private conversations.

Stamina for call

Overnight labor and delivery shifts followed by clinic or surgery are a regular part of practicing obstetrics.

Ultrasound interpretation

Reading prenatal and pelvic ultrasounds is central to tracking fetal growth and diagnosing gynecologic problems.

O*NET 31.0 rates these skills as most important for the occupation: critical thinking, reading comprehension, active listening, active learning, writing.

Training cost

$300K–$411K

Before financial aid

Time

12 years

Typical path

Median pay

$292,910

All US jobs: $50,980

Payback once qualified

1.2–1.7 yrs

Pay above the all-jobs median vs. cost

Low: AAMC median 4-year cost of attendance for public medical schools, class of 2026 ($297,745), plus the MCAT ($360) and USMLE Step 1, Step 2 CK and Step 3 ($695 + $695 + $955). High: the private-school median ($408,150) plus the MCAT and COMLEX-USA Levels 1-3 ($745 + $745 + $950). Cost of attendance includes living expenses. Not included: college tuition, application and interview costs, ABOG exam fees, license fees and loan interest. Residents are paid during residency. For comparison, median federal loan debt for medical graduates is $208,644 (College Scorecard).

Rough guide only: ignores taxes, aid, interest and earnings given up during training. How we calculate it.

• Maternal-fetal medicine or other subspecialist

  After residency, OB-GYNs can complete an ACGME-accredited fellowship, defend a thesis and pass ABOG's subspecialty exams to certify in gynecologic oncology, maternal-fetal medicine, REI, urogynecology or complex family planning.

• Residency program director or department chair$82,250 median

  OB-GYNs at teaching hospitals can move into faculty, program director and chair roles, usually after years of teaching and academic work.

• Physician executive$123,860 median

  Some OB-GYNs become medical directors or chief medical officers, often adding a master's in business or health administration.