I spoke with a long-time mentor who is an academic obgyn this morning. She currently has a career that I imagine myself wanting for my future. The gist of a long conversation is that she thinks I should seriously reconsider OB, and should opt instead for peds or family medicine. She thinks my personality would do better in something truly primary care. According to her, too many OB programs are malignant and for good reason. She also stated that she would reconsider family for herself if she could do it all over again.
It's looking like a research year might be the only option. Not necessarily to build up my CV, but to buy myself another year before having to make this decision.