Fellowship in Maternal-Fetal Medicine

David S. McKenna, M.D., Director

Curriculum

The Wright State University (WSU) Maternal-Fetal Medicine Fellowship at Miami Valley Hospital (MVH) was first approved to begin training its first fellow in April 2008. 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 15 months of clinical rotations at MVH, which had over 5,000 deliveries in 2012 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 20 hours per month of protected MFM specific didactic time. The 12 months of protected research time is spent at the WSU Boonshoft 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 nine months of elective rotations including options for focused research, advanced fetal therapy, maternal and perinatal research in Honduras and learning advanced sonographic skills such as fetal echocardiography and neonatal neurosonology. Fellows receive supplemental income for at home night call.

Schedule of Didactic Conferences

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:

 
Monday
Wednesday
Thursday
Friday
Week 1

Noon: Genetics Conference

1-3 p.m.: High Risk Clinic Conference

8 a.m.: Fellow’s Research Conference

Noon: SMFM Fellow’s Lecture

7:45 a.m.: MDAUC

8 a.m.: Isoimmunization Committee (2nd Year)

Noon: Fellow’s ABOG Review

Week 2

Noon: Genetics Conference

1-3 p.m.: High Risk Clinic Conference

8 a.m.: Grand Rounds*

9 a.m.: Fellow’s ABOG Review

7:45 a.m.: MDAUC

 
Week 3

Noon: Genetics Conference

1-3 p.m.: High Risk Clinic Conference

8 a.m.: Fetal Board

9 a.m.: MFM conference

10 a.m.: Fellow’s ABOG Review

Noon: SMFM Fellow’s Lecture

Noon: IRB (2nd Year)

7:45 a.m.: MDAUC

Noon: Fellow’s ABOG Review

Week 4

Noon: Genetics Conference

1-3 p.m.: High Risk Clinic Conference

8 a.m.: Grand Rounds*

7:45 a.m.: MDAUC

 
  • *Grand Rounds is the Ob/Gyn Departmental Grand Rounds; all other conferences are fellowship specific and focus solely on topics in Maternal-Fetal Medicine.
  • MDUAC: multidisciplinary antepartum unit conference.
  • IRB: institutional review board.
  • 20 hours/month of blocked MFM specific didactic time for all fellows, plus two hours/month for Departmental Grand Rounds, and two hours/month for second year fellow.

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. (Supervisor Rachel Barnett M.S., C.G.C.)

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. (Supervisor David McKenna, M.D.)

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. (Supervisor David McKenna, M.D.)

Grand Rounds: Weekly Wright State University Ob/Gyn Departmental Grand Rounds. Attended by fellows, faculty and community physicians. (Supervisor Jerome Yaklic, M.D.)

Fetal Board: Monthly interdisciplinary conference attended by fellows, ob/gyn residents, MFM faculty, NICU faculty, pediatric faculty, nurses, sonographers, and community physicians. (Supervisor Christine Kovac, M.D.)

MFM Conference: Monthly rotating conference attended by fellows, ob/gyn residents, MFM faculty, critical care faculty, infectious disease 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 (each once every three months). (Supervisor David McKenna, M.D.)

IRB: Monthly Miami Valley Hospital institutional review board. (Supervisor David Uddin, Ph.D.)

Fellow’s ABOG Review: 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. (Supervisor David McKenna, M.D.)

SMFM Fellow Lecture Series: This is a live web-based conference conducted along with other MFM Fellowships around the country. The series highlights a topic which is a high-risk pregnancy topic the first week and a genetics topic the third week. It includes a lecture prepared by an internationally recognized expert on the selected subject and a question and answer session afterwards. (Two hours/month.)

MDAUC: Multidisciplinary Antepartum Unit Conference – the current antepartum patients’ plans of care are discussed with the fellows, MFM attending, residents, unit nurses, care coordinators, social workers and dietician.

Isoimmunization Committee: Monthly conference attended by the second-year fellow, MFM faculty, and Department of Pathology faculty. Current isoimmunization cases are reviewed and recommendations for subsequent management are made. (Supervisor David McKenna, M.D.)

In addition to the recurring monthly conferences, all fellows will attend the Society of Maternal Fetal Medicine (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. The first-year fellow attends the annual SMFM Fellow’s retreat. During the second year, the fellow attends the Annual NICHD Maternal-Fetal-Neonatal-Reproductive Medicine. This four-day workshop is to prepare physician scientists for a research career in perinatology and reproductive medicine.

Schedules

Maternal-Fetal Medicine (MFM) Fellowship Rotations Three-Year Overview
 
Jul/Aug
Sept/Oct
Nov/Dec
Jan/Feb
Mar/Apr
May/Jun
First Year

Clinical MFM

Research – Introduction to laboratory techniques

Research – Introduction to laboratory techniques

Clinical MFM

Clinical MFM

Research

Second Year

Research – Completion of basic science project

Elective

ICU

Clinical MFM

Labor & Delivery

Elective

Clinical MFM

Third Year

Elective

Clinical MFM

Elective

Elective

Research

Research

  • All rotations are in two-month blocks, except where indicated.
  • Night Call: Fellows take at home night call providing coverage for the high-risk MFM private practice patients, and for maternal transports and consultations. There are no responsibilities for coverage of routine obstetrical or gynecological patients. The fellows are on call one weeknight per month and every third weekend (average five calls per month). There is always a backup MFM attending for the fellow on call. Fellows on non-local area elective rotations do not have night call responsibilities.
  • Fetal Therapy: Second-year fellow is on call for fetal procedures.
  • Perinatal Autopsy: Fellow on clinical MFM rotation is on call for perinatal autopsies. Each fellow completes five perinatal autopsies.