Labor and Delivery
The bulk of your time will be spent on labor and delivery, providing anesthesia services to those patients laboring and those needing surgical deliveries. In this context, the fellow is able to teach residents and work with CRNAs, as well as perform solo cases as desired. There is ample time to assist the attending with both formal lectures and informal teaching topics for the anesthesia students rotating on L&D. Every month, there is a formal introduction to neuraxial anesthesia for the new rotators that involves a lecture, hands-on work with epidural and spinal kits, and time in the cadaver lab. The fellow is encouraged to help lead these teaching sessions. We also see both inpatient and outpatient anesthesia consults, for high risk deliveries and cesarean sections to help coordinate care leading up to delivery.
At least 2 weeks, up to 4 weeks will be spent with the Neonatal Intensive Care Team in our level 3 NICU, including an attending, fellow, pediatric residents and nurse practitioners. The goal of this rotation is to gain exposure to neonatal care techniques and gain experience and confidence with newborn resuscitation, intubation, and line placement. During this time, you will attend the “pediatric codes” which are paged for high risk deliveries including emergent deliveries, fetal anomalies, meconium, preterm birth, multiple gestation, and non-reassuring fetal monitoring.
Maternal Fetal Medicine
For at least 2 weeks, the fellow will rotate with the Maternal Fetal Medicine department, working closely with their fellows and attendings. This rotation focuses on high risk maternal conditions and includes work in their subspecialty clinics (congenital heart disease, diabetes, and fetal care to name a few).
The clinical fellow will have privileges and badging at UCMC and CCHMC in order to take part in the complex process of managing fetal care patients. As patients are referred to the fetal care center for consult, they undergo extensive counseling by MFM, Neonatology, fetal surgery, and genetics based on the fetal condition and their options for delivery and potential in-utero interventions. Some of the conditions that present include a myriad of congenital heart lesions, congenital diaphragmatic hernia, neural tube defects, gastroschesis, omphalocele, cystic hygroma, and sacral coccygeal teratoma. The fellow is able to attend care conferences leading up to delivery, as well as help with the delivery management for deliveries at both UCMC and CCHMC. Location of delivery is dependent on maternal and fetal conditions.
Three months of research time are allotted to the research endeavor of choice. A block of time is given early in the year to solidify the project and continue working on it throughout the year. Prior projects have included simulation training in obstetric crisis, case series analysis of complex patient conditions, and quality improvement for postoperative pain control. The fellow is encouraged to submit and present at local and national meetings, with the knowledge that conferences costs are reimbursed if a presentation is given. We encourage fellows to attend the Ohio Society of Anesthesiologists Annual Meeting, ASA annual meeting, and SOAP annual meeting at a minimum.