The mission of the Maternal‐Fetal Medicine (MFM) Fellowship at Columbia University/New York -Presbyterian Hospital is to train perinatal subspecialists who will become leaders in the field, both clinically and academically. This is a three‐year program that follows guidelines set by the American Board of Obstetrics and Gynecology (ABOG). In order to meet these guidelines, the division enlists specialists in MFM, neonatology, ultrasonography, fetal echocardiography, obstetrical critical care, diabetes, infectious diseases, genetics, obstetrical anesthesia, and the basic sciences. The department also utilizes faculty from Columbia’s Mailman School of Public Health to ensure that fellows have an education in epidemiology and biostatistics.
The program is designed to train graduate specialists to provide care and consultation for patients with obstetric, medical, and surgical complications during pregnancy. Fellows are trained to assess and treat the maternal and fetal effects of these disorders and to manage pregnancies complicated by primary fetal conditions, including structural and functional abnormalities, or primary maternal conditions, including complex maternal cardiac disease and placenta accreta.
Fellows learn high‐risk pregnancy management through a combination of didactic lectures and conferences given by MFM, human genetics, neonatology, pathology, and anesthesiology faculty. Fellows also obtain significant hands‐on experience and the opportunity to make independent decisions, in outpatient and inpatient settings, under the guidance of MFM faculty members.
Most of the fellows’ first year is devoted to clinical activities, focusing on management of patients in three main areas:
- Labor and Delivery
- High‐risk service, including critical care obstetrics
- Operative deliveries
- Vaginal breech delivery of second twin
- Consultant to low‐risk service
- Inpatient antepartum service and high‐risk perinatal clinics
- Preterm labor and poor pregnancy outcome clinic
- Multiple pregnancies and fetal anomalies clinic
- Diabetes clinic
- Maternal medicine clinic
- Obstetric and gynecologic ultrasound
- Hands‐on instruction in comprehensive ultrasound imaging
- Progressive experience with invasive procedures
On all rotations, MFM faculty members directly supervise fellows, with the objective to develop decision‐making, consultative, and leadership skills so that they can function independently upon graduation.
In the second year, fellows complete six months of advanced clinical training in critical care obstetrics, including cesarean hysterectomies for placenta accreta, reproductive and pediatric genetics, training in chorionic villus sampling, and fetal echocardiography; as well as advanced procedures such as multifetal reductions, radiofrequency ablation, shunt placement, cordocentesis, fetal blood transfusion, fetoscopy, and laser photocoagulation.
Fellows will complete 18 consecutive months of protected research time. Research facilities are available for MFM fellows in clinical medicine, ultrasonography, and the basic sciences. They may work in the MFM Division of the OB/GYN Department, in the laboratory facilities at CUMC, at Columbia’s Mailman School of Public Health, or in other clinical departments. Fellows design and structure their research projects with consistent guidance from MFM faculty and mentors. They present their projects to MFM faculty, residents, and their mentors as the research progresses.
The MFM Fellowship Program is structured to provide extensive clinical and research experience. Individuals who complete the program are able to work independently, managing complicated pregnancies using the most current diagnostic and treatment modalities available. The program graduates fellows who can appropriately interpret the literature for clinical applicability and research design. The management of a busy perinatal service, the provision of consultation to the clinical obstetrical service, the proximity of the strong basic science and clinical research environment at CUMC, and design and completion of an independent research project all prepare fellows for leadership roles in the specialty of MFM.
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