Clinical Experience

Clinical Exposure

We work with our fellows to customize their educational curriculum and meet their unique needs. If you have a particular area of interest that is not covered in-depth by our current curriculum, talk to us about how we can better tailor your educational experience. We offer well-rounded clinical and procedural training.

Advanced Procedural Training

With the unique patient population, we have a high volume of intrauterine tranfusions (IUTs) and cesarean hysterectomies relative to other centers.

Our fellows are trained to perform these types of maternal-fetal medicine procedures:

Amniocentesis
Breech extraction of the second twin
Cerclage (including Shirodkar and MacDonald procedures)
Percutaneous umbilical cord sampling / intrauterine transfusion (IUT)
Dilation and evacuation (first and second trimester)
Cesarean hysterectomy for placenta accreta spectrum and obstetric hemorrhage
Operative vaginal delivery (vacuum and forceps)

Clinical Autonomy

Our fellows function as independent obstetriticians for activities within the scope of a general OB/GYN. Our fellows are not ‘PGY-5’ residents or super-chief-residents; rather, they enjoy well-deserved autonomy in procedures and patient management that they have already mastered. They have direct supervision for MFM consultations, management, and procedures.

Experiential Learning

We focus on hands-on ultrasound training and have ultrasound and genetic case conferences moderated by experts. As a referral center for the Intermountain West, our fellows are exposed to a high volume of fetal anomalies and fetal/maternal genetic disorders. Our fellows are mainly based at two large tertiary-care hospitals, both with large regional NICUs. The University of Utah and Intermountain Medical Center both have busy labor and delivery units, active diagnostic centers, and ample opportunities for education.

Clinical Rotation

Research

One month of MSCI coursework (Year 1)
Protected time for research

Clinical Outpatient

Hands-on ultrasound training (Year 1)
Continuity, consults, & ultrasound (All years)
Fetal center (Years 2–3)
Genetics (2) & Cardiology (1) (Year 2)
Electives* (4) (Years 2–3)

Inpatient

L&D/Antepartum
ICU rotation (Year 1)

Over all three years, fellows have inpatient in-house call. Rotations split between Intermountain and University of Utah Health sites.

*Elective options: family planning, diagnostic procedures, advanced imaging, and fetal diagnosis and others.

Types of Clinical Rotations

Ultrasound

Three months of the first-year ultrasound experience is dedicated to scanning in addition to routinely scheduled didactic lectures. Experience with reading ultrasound begins in the second year and continues throughout the fellowship with six months of dedicated clinical time. Additional time in our diagnostic center can be scheduled to pursue individual educational goals. Fellows have graduated autonomy across fellowship with their learning goals progressing from performing and interpreting ultrasounds to serving as an MFM consultant.

Critical Care

Fellows complete a one-month rotation in the Shock-Trauma ICU at Intermountain Medical Center during the first year of fellowship. Our fellows complete the SMFM critical care course and have the opportunity to attend the SMFM critical care conference as well.

Our fellows become familiar with the principles of critical care and are able to apply these skills and knowledge to the obstetric population. They will also be involved in caring for critically ill pregnant/postpartum patients during their obstetric rotations.

Genetics

Our fellows complete The National Basic Training in Reproductive Genetics curriculum during their second year of fellowship and work closely with genetic counselors throughout their clinical rotations. These include participation in pediatric genetics clinic and case conference, neonatal genetic consultations and perinatal autopsies, exposure to genetic counseling, and firsthand observation of relevant laboratory assays. We have a board-certified OB MFM geneticist on our primary MFM faculty (Dr. Byrne) who our fellows have the opportunity to learn from and work with clinically.

Cardiology: Fetal and Maternal Congenital Cardiac Disease

During the second year of fellowship, our fellows complete a one-month cardiology rotation. Fellows will gain experience in fetal cardiology and maternal congenital heart disease.

This rotation provides additional training in sonographic evaluation of the fetal heart and is designed to improve diagnostic skills for fetal congenital cardiac disorders. Fellows will participate in adult clinics to improve knowledge and competence in the obstetric care of women with congenital heart disease.

Fellows also have the opportunity to obtain their fetal echo certification.

Education

Didactics

A favorable education to service ratio is top priority. Our fellows have protected time for all educational activities.

We have a highly structured didactic schedule that emphasizes faculty participation and highlights several guest speakers annually. Many of our faculty are international experts on particular topics and are actively involved in fellow education.

Some examples of recent didactics include: