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Fellowship Training: The Ever-Changing Subspecialty of Maternal–Fetal Medicine

Wing, Deborah A. MD; Quilligan, Edward J. MD

doi: 10.1097/AOG.0b013e31818d8e9e
Original Research

OBJECTIVE: To estimate the current scope of practice and evaluate the experience in training of maternal–fetal medicine specialists in the United States.

METHODS: We administered an Internet-based, 16-question survey of 1,764 members of the Society for Maternal–Fetal Medicine, inquiring about aspects of fellowship training and scope of practice after completion of training.

RESULTS: Approximately 36% (n=643) of surveys were returned. Most respondents were between 40 and 49 (230/640, 35.9%) and 50 and 59 (199/640, 31.1%) years old, and 411 were men (64.1%). Nearly all respondents (590/636, 92.8%) were certified in obstetrics and gynecology, and 80.1% (530/628) were certified in maternal–fetal medicine. The majority were in small-group practices of two to seven partners (359/634, 56.6%). Forty-nine percent (306/630) were in university-based practices, 26.8% (169/630) in university-affiliated practices, and 24.6% (155/630) in community-based or hospital-based practices. Most respondents work full time (40 hours per week or more), and the weekly practice profile consists primarily of ultrasonography (33.5%), consultation for high-risk patients (17.1%), and total obstetrical care for high-risk patients (15.4%).Training in most aspects of maternal–fetal medicine practice was felt to be adequate, with the exception of practice management. Time spent in training was spent primarily in high-risk pregnancy management (41%), ultrasonography (22%), and research (18%).

CONCLUSION: The current scope of maternal–fetal medicine practice incorporates more ambulatory care than hospital-based care. Training programs rate highly in adequacy for high-risk pregnancy management and ultrasonography but lower in other aspects.

LEVEL OF EVIDENCE: II

Results from a nationwide survey of maternal–fetal medicine practitioners provide insights to guide additional changes for the future.

From the University of California, Irvine, Department of Obstetrics and Gynecology, Irvine, California.

The authors thank Robert Newcomb, PhD, and Rita Peterson, MS, for their assistance with statistical analysis for this article.

Corresponding author: Deborah A. Wing, MD, University of California, Irvine, Department of Obstetrics and Gynecology, 101 The City Drive South, Building 56, Suite 800, Orange, CA 92868; e-mail: mfm@uci.edu.

Financial Disclosure The authors have no potential conflicts of interest to disclose.

© 2008 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.