Obstetric Anesthesiology Fellowship

Overview

Our one-year, ACGME-accredited program trains fellows in all aspects of obstetric anesthesiology, with a focus on clinical excellence, scholarship, data-driven models of care, and leadership. In addition to taking care of a range of parturients with complex medical problems, fellows participate in activities that promote high-reliability culture, such as simulations around administering general anesthesia for emergent cesarean deliveries and managing post-partum hemorrhage. Fellows also lead sessions of multi-disciplinary teams to plan for complex deliveries and provide guidance and supervision for junior residents.

Clinical Experience

NewYork-Presbyterian/Weill Cornell Medical Center has over 7,300 deliveries per year, including a significant number of high-risk deliveries. Fellows complete 13 four-week block rotations, spending eight rotations on the labor and delivery anesthesia team and three rotations fully dedicated to a variety of teaching and research projects. During the labor and delivery rotations, one day a week will also be dedicated to teaching and research. An additional eight weeks are spent on four two-week rotations: maternal-fetal medicine, neonatal ICU, transfusion medicine, and simulation design. There is also an opportunity to participate in a research-focused global health elective with four weeks of travel abroad.

Curriculum

The program will expose fellows to complex scenarios with maternal and fetal co-morbidities, including congenital and acquired cardiac lesions, abnormal placentation, coagulopathies, and difficult airways. Fellows participate in a large number of neuraxial blocks, as well as difficult IV and arterial line placements. In addition, they will use ROTEM to assess coagulopathy and point of care ultrasound (POCUS) to assess anatomy in appropriate clinical scenarios.

Fellows achieve certification in the Neonatal Resuscitation Program upon start of the program, and Fetal Heart Rate Monitoring Certification by the end of the first three months of the program. Through journal clubs and analysis of research, as well as mentored IRB-approved projects, they use rigorous methodology to study current clinical and public health problems in obstetric anesthesiology. The Department of Anesthesiology provides access to the MPOG database, and additional research time is made available as dictated by ongoing project needs.

Through access real-time operational data, the fellow learns to separate signal from noise and make data driven conclusions and decisions. Fellows participate with obstetric anesthesiology leadership in implementing performance improvement projects based on need determined by analysis of adverse events and near misses, and also coordinate the multidisciplinary planning for the care of complex patients.

More broadly, fellows play a leadership role not only in the daily activities of the obstetric anesthesia team, but of the entire multi-disciplinary labor and delivery team. A monthly conference with anesthesia, OB, and cardiology updates the plan of care for pregnant patients with complex cardiac disease. Knowledge and skill in this domain builds on use of data-driven decisions and leadership principles to build buy-in and lead change. Fellows learn effective communication and feedback to lead high-performance teams. Mobile Heartbeat, a technology platform for real-time communication, facilitates daily teamwork in the clinical setting.

Conferences