While schedules can be individualized, the general schedule for each fellowship year is as follows:
First year
- 3.5 months covering MFM patients on the Inpatient MFM Service. During this time, the fellow gains knowledge in the management of obstetrical complications, medical illnesses, critical care, and all aspects of maternal and fetal intensive care. In addition to patient care, the fellows are responsible for teaching rounds with the residents, for review of fetal heart rate tracings, and for participation in regularly scheduled conferences. This is not a consultative role, but a hands-on immersed experience in operative obstetrics (including experience with transvaginal cerclage, abdominal cerclage, breech extraction and cesarean hysterectomy).
- 3 months covering Prenatal Diagnostic Center (ultrasound unit). Fellows at Tufts MC have comprehensive ultrasound training. By the end of the first year, the fellow becomes confident in most areas of diagnostic ultrasound (interpreting images, capturing images, counseling patients and communicating with referring providers). First year fellows also become proficient in amniocentesis, and have an introduction to fetal echocardiography.
- Weekly half-day of continuity clinic. Fellows function with autonomy, seeing their own panel of consultations and prenatal care, while under the supervision of an MFM attending. Clinical topics include diabetes, Rh isoimmunization, multifetal gestations, medical conditions, cervical insufficiency/preterm birth, fetal anomalies, etc.
- 2.5 months at Boston Medical Center for specific outpatient experience in managing opioid addiction in pregnancy, HIV in pregnancy and complicated diabetes in pregnancy. In addition, during this rotation, fellows rotate on BMC Labor & Delivery as L&D Supervisor for OB/GYN generalists, Family Medicine physicians and midwives.
- 1 month in Surgical ICU
- 1 month of research. During this time, fellows identify a mentor, work on identifying topics/projects of interest, and perform background literature reviews and preparatory reading.
- 1 month of genetics. Fellows gain experience in the cytogenetics lab to understand the different testing strategies for laboratory diagnosis, and learn to interpret the results of a cytogenetic report. In addition, fellows work with prenatal genetic counselors become confident in creating pedigrees and identify a patient's risk for a genetic disorder and mode of inheritance. They become proficient in counseling patients on options of screening/diagnostic/predictive genetic testing strategies, and gain confidence in counseling patients on the results of their genetic/biochemical tests. Throughout the month, fellows gain clinical experience with neonatal genetics evaluations by working one-on-one with a clinical geneticist on neonatal consultations, and determining management and surveillance of the identified disorder.
Second year
- 2 months covering MFM patients on Inpatient MFM service.
- 3 months covering Prenatal Diagnostic Center. By the end of the second year, the fellow becomes confident in their skills in diagnostic ultrasound and fetal echocardiography.
- Weekly half-day of continuity clinic (as above)
- 5 months of research
- 1 month of genetics. Fellows gain experience on follow-up evaluations in Clinical Genetics. In addition, they become proficient with neonatal genetics consultations. Fellows are also expected to complete an SMFM prenatal genetics course.
- 1 month of elective. Electives can be individualized to each fellow’s academic interests (potential rotations include, but are not limited to, additional ultrasound experience, fetal echocardiography, critical care, additional research time, additional statistics/clinical research study design, and genetics)
Third year
- 1 month covering Prenatal Diagnostic Center. In the third year, they are capable to independently interpret, diagnose and counsel on common fetal anomalies. By the end of the third year, the fellow has gained proficiency in CVS and clinical experience in fetal blood sampling.
- Weekly half-day of continuity clinic (as above)
- 10 months of research.
- 1 month of elective (individualized to each fellow's academic interests)