Adapted from “DRAFT Program Requirements for Fellowship Education in Obstetric Anesthesiology” (http://soap.org/acgme.php)
The subspecialty fellow, upon completion of the program, will have achieved & demonstrated a consistent level of expertise & proficiency in:
- Providing & managing anesthetic care of women,
- at various degrees of risk, during labor & vaginal delivery;
- undergoing cesarean section, postpartum tubal ligation, dilation & curettage, removal of placenta, and similar procedures;
- undergoing interventions for conditions threatening maternal or fetal life (ante-/post-partum hemorrhage, placental abruption, cord prolapse, uterine rupture, etc.);
- with obstetric conditions of early pregnancy;
- undergoing non-obstetric surgery during pregnancy, non-operative diagnostic and interventional procedures requiring anesthesia, and assisted reproductive technology interventions;
- undergoing in utero fetal surgery, or ex-utero intrapartum treatment (EXIT) procedures with & without neonatal transfer to extracorporeal membrane oxygenation (ECMO).
- Antenatal evaluation & preparation of both high & low risk parturients, and their fetuses, prior to & after anesthesia. The fellow will demonstrate mastery of a wide variety of clinical problems that can occur in obstetric patients through appropriate & relevant clinical application, and through communication verbally (with obstetricians, anesthesiology faculty & residents, nurses, other consultants, and with patients) and in writing (consultation notes).
Performing, supervising, and teaching the full spectrum of obstetric anesthetic & analgesic interventions, including the relevant underlying context-specific rationale & decision-making, assessment of effectiveness, troubleshooting, and detection & management of complications. These interventions include, but are not limited to
- neuraxial labor analgesia (epidural, spinal, combined techniques, intrathecal catheter, patient controlled infusion modalities)
- non-neuraxial labor analgesia (intravenous and inahaltion [nitrous oxide]modalities),
- provision of analgesia & anesthesia for spontaneous & operative (e.g. forceps, vacuum) vaginal delivery,
- elective & emergent cesarean delivery,
- general anesthesia for cesarean delivery and other procedures,
- invasive monitors,
- ultrasound guidance (e.g. transversus abdominus plane block, neuraxial block)
- antenatal procedures (e.g. external cephalic version, cervical cerclage),
- epidural blood patch.
- Assessing & managing pregnant women with co-existing illness, including, but not limited to:
- hereditary or acquired hemostatic disorders: thrombophilias, coagulopathies, drug therapy;
- morbid obesity;
- moderate to severe cardiac, pulmonary, renal, endocrine and neurologic disease;
- infectious diseases (e.g. chorioamnionits, herpes, HIV, etc.).
- Assessing & managing common obstetric conditions (such as preeclampsia, multiple gestation, abnormal fetal presentation, obstetric hemorrhage, pre-term labor and/or delivery), and more broadly, pregnant women who are referred to maternal-fetal medicine specialists for any reason;
Teamwork, Communicating, & Collaborating
effectively & collegially with all members of the inter-professional care team (anesthesiology, obstetrics, midwifery, nursing, students, residents, faculty, ancillary staff, neonatologists, other relevant consultants, and most importantly, the patient),
- in a manner that promotes care that is as good as it can be (safe, effective, timely, efficient, equitable, and patient-centered), and
- in ways that unequivocally demonstrate the value added by the fellow’s contributions as a member of the inter-professional care team.
- Cognitive, affective, and verbal skills essential to learning & teaching, including
- continuing to develop advanced adult his/her own self-directed learning skills & behaviors,
- developing, practicing, &improving teaching skills (informal on-the-fly, small group facilitated, formal presentation, assessment, curriculum development, etc.), and
- demonstrating behaviors consistent with a commitment to inquiry, improvement, and discovery (active participation in teaching, clinical discussions, inter-professional rounds, journal clubs, quality improvement activities, etc.).
- Scholarship of discovery, dissemination, and/or application, in the form of
- participation in research;
- publication of review articles, chapters, or commentaries; and/or
- publication or presentation of case reports/series or medically challenging cases.