The Maternal Fetal Medicine (MFM) Fellowship curriculum consists of 18 months of clinical work, 15 months of research, and three months of elective time.
Most of the fellows’ first year is devoted to clinical activities, focusing on management of patients in three main areas:
1. Labor and Delivery
- High‐risk service, including critical care obstetrics
- Operative deliveries
- Vaginal breech delivery of second twin
- Consultant to low‐risk service
2. 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
3. Obstetric and gynecologic ultrasound
- Hands‐on instruction in comprehensive ultrasound imaging
- Progressive experience with invasive procedures
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 complete 15 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.
- Fellows receive didactic training in research essentials, to review IRB and FDA requirements for prospective and retrospective research studies and ensure compliance.
- The Division of Maternal Fetal Medicine holds a weekly research meeting where fellows both present their research ideas and interact with other scientists, both within and outside of the field of MFM. Opportunities for structured basic laboratory and/or clinical research are reviewed at this meeting.
- Fellows receive a didactic session on NIH, industry, and other sources of funding with the objective of understanding how to obtain research funding.
- Fellows identify their thesis topics by the end of the year, working closely with an assigned research mentor.
- Fellows submit abstracts to a national meeting.
- Fellows take formal coursework in epidemiology and/or statistics. (This can be completed as a PGY-6 or PGY-7.)
- Promotion of the fellows’ academic contributions to the respective subspecialty occurs through presentations at local, regional, and national meetings.
- Fellows are exposed to opportunities to obtain research funding and academic positions through local and national lectures and conferences designed to enrich their knowledge in these areas.
- Furthering the ability of the fellow to be an independent investigator through sessions with their research mentor. The fellow is asked to develop new hypotheses and answer the question, “What is the next step in this research?”
- Fellows are expected to present at a national meeting in this year if they have not yet done so.
- Completion of the thesis and development of the manuscript
- Promotion of the fellows’ academic contributions to the respective subspecialty by publications and presentations
Conferences and Didactic Sessions
Morbidity and Mortality Conference
Thursday is the academic day for the entire Department of Obstetrics and Gynecology at CUMC. The day begins with the Morbidity and Mortality (M&M) Conference, in which interesting cases from each service are presented by members of the house staff and are followed by lively and thoughtful discussion from the faculty and other members of the department.
Weekly Grand Rounds follow the M&M conference and feature presentations from within our faculty as well as many distinguished visiting guest speakers. Each second-year fellow is also required to give one Grand Rounds presentation each year, and these talks are often the highlight of the morning session.
Fellow Lecture Series
A core Fellow Lecture Series supplements the experience gained on clinical rotations to round out the comprehensive post-graduate curriculum.
Simulation and team training have become essential components of training in the specialty of obstetrics and gynecology. The Division of Maternal Fetal Medicine has developed a simulation curriculum to reinforce core learning objectives in subspecialty training. The fetal therapy portion of the simulation program uses innovative models to help fellows acquire facility with transvaginal and transabdominal CVS as well as needle-based procedures such as amniocentesis, PUBS, and shunt placement. The critical maternal care portion of the program focuses on developing fellows’ role as a team leader in the acute care of a pregnant patient. Simulations are often multidisciplinary and promote a team-based approach to managing scenarios such as hemorrhage, hypertensive crisis, eclampsia, cardiac arrest, and sepsis. Debriefs and focused didactic sessions ensure that fellows gain comfort with systems based practice and an in-depth understanding of the physiology of pregnancy that creates risks unique to obstetric patients.