Curriculum

The Wright State University (WSU) Maternal-Fetal Medicine Fellowship at Miami Valley Hospital (MVH) is a fully accredited by the American Board of Obstetrics and Gynecology. The program uniquely integrates a private academic MFM Division located at a large intercity hospital with a university Obstetrics and Gynecology Department and Residency. The curriculum was designed by the faculty incorporating the best aspects of their own educational experiences with contemporary learning methods. Foremost, the fellow is a colleague and junior faculty. Good clinical practice is the foundation of the didactic and clinical curriculums. The faculty is committed to the practice and teaching of evidence-based medicine and fulfillment of the ACGME’s Core Competencies.

The fellow will learn to design and complete basic and clinical research protocols, apply research to evidence-based clinical practice, and all necessary procedural skills to be a leader in an academic or private practice. The fellow has 12 months of clinical rotations at MVH, which had over 5,000 deliveries in 2008 and over 40,000 outpatient obstetrical visits. There is generous clinical experience in high risk obstetrics, medical and surgical complications of pregnancy, fetal therapy and prenatal diagnosis, including first trimester screening, CVS and amniocentesis. There are 17 hours per month of protected didactic time. The 20 months of protected research time is spent at the WSU School of Medicine’s well staffed and equipped state-of-the-art laboratories. The fellow has ample research support in all areas including genomics, proteomics and animal research. The fellow has four months of elective rotations including options for advanced fetal therapy, perinatal research in Honduras and learning advanced sonographic skills such as fetal echocardiography and neonatal neurosonology. Fellows receive supplemental income for in house night call.

Didactics

All fellows have protected didactic time. During this time the fellows do not have other assigned duties and attendance is mandatory. The following is the recurring monthly blocked didactic schedule for all fellows:

Conference Descriptions

Genetics Conference: Weekly conference attended by the fellows, ob/gyn residents on the obstetrical service, genetic counselors, sonographers and the MFM and genetics faculty. The current database of fetal anomalies, abnormal maternal screens, and abnormal diagnostic tests is reviewed and discussed. (Four hours/month.)

High-Risk Conference: Weekly conference attended by the fellows, ob/gyn residents on the obstetrical service, high-risk clinic nurses, and MFM faculty. The charts of patients scheduled to be seen in the high-risk clinics and infectious disease clinic for that week are reviewed. Emphasis is on new patients and establishing a plan of care. (Four hours/month.)

Fellow’s Research Conference: Monthly conference attended by fellows, research assistants, MFM and basic science faculty. Fellows are responsible for providing updates on all on-going research. Planned projects are presented. (One hour/month.)

MFM Journal Club: Monthly conference attended by fellows, ob/gyn residents on the obstetrical service, sonographers and MFM faculty. Two current peer reviewed journal articles are critically appraised. (One hour/month.)

Grand Rounds: Weekly WSU Department of Obstetrics & Gynecology Grand Rounds. Attended by fellows, faculty and community physicians. (Four hours/month.)

Fetal Board: Monthly interdisciplinary conference attended by fellows, ob/gyn residents, MFM faculty, NICU faculty, pediatric faculty, nurses, sonographers and community physicians. (One hour/month.)

Maternal-Fetal Medicine Conference: Monthly rotating conference attended by fellows, ob/gyn residents, MFM faculty, critical care faculty, infectious disease faculty, cardiology faculty, anesthesiology faculty, and neonatology faculty. Interdisciplinary conference with a quarterly rotating main topic focusing on learning objectives in MFM in anesthesia, neonatology, and critical care/infectious diseases.

IRB: Monthly Miami Valley Hospital Institutional Review Board. Second year fellow sits as a full voting member of the IRB for one year. (One hour/month.)

Fellow’s Conference: Monthly conference attended by fellows, MFM faculty and other invited faculty. This conference is structured to provide a didactic review of the objectives specified in the Guide to Learning in Maternal-Fetal Medicine, and also for other selected topics such as ethics, IRB/research oversight, research design and medical informatics. Each fellow will be scheduled to provide a 5-10 page summary of his or her assigned objectives once every four months. At the completion of the three years of the fellowship, graduates will have a comprehensive written review of the MFM learning objectives that can be used for studying for MFM written and oral boards. (One hour/month.)

Isoimmunization Committee: Weekly conference attended by the fellows, MFM faculty and Department of Pathology faculty. Current isoimmunization cases are reviewed and recommendations for subsequent management are made. (Four hours/month, second year fellow.)

In addition to the recurring monthly conferences, all fellows will attend the Society of Maternal-Fetal Medicine’s (SMFM) Annual Meeting during each year of fellowship. The SMFM meeting provides the fellows with two days of didactic courses on current topics in MFM, and two and one-half days of presentations of current research. During the second year, the fellow will attend the Given Institute’s Annual NICHD Aspen Conference on Maternal-Fetal-Neonatal-Reproductive Medicine. This four-day workshop is intended to prepare physician scientists for a research career in perinatology and reproductive medicine. The third-year fellow will attend the annual meeting of the Society for Gynecological Investigation (SGI), and the first-year fellow will attend the American Institute of Ultrasound in Medicine (AIUM) annual meeting. Finally, from time to time the SMFM has held fellows retreats — our fellows will be funded and permitted to attend these SMFM functions.

Schedules

Maternal-Fetal Medicine (MFM) Fellowship Rotations Three Year Overview:

All rotations are in two month blocks.
In House Night Call: Fellows will have three in house night calls per month, two weeknights and one weekend for a total of 52 hours per month. Fellows on non-local area elective rotations will not have night call responsibilities.
Home Call: On-call from home for maternal transports and consultations one night per week, four to five nights per month.
Fetal Therapy: Second year fellow is on-call for fetal procedures.
Perinatal Autopsy: Fellow on clinical MFM rotation is on-call for perinatal autopsies.