SCOPE OF PRACTICE PGY-5 PGY-7
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1 GENERAL: It is the goal of the Department that its Maternal Fetal Medicine Fellows will have a progressive increase in authority ultrasound interpretation, independence in providing consultative services, and operative independence in procedures specific to the subspecialty of Maternal Fetal Medicine. As fellows increase their knowledge base, clinical competence, and manual dexterity specifically with respect to ultrasound guided procedures, they will be given more independence in the clinical and operative arena. Individual competency will be monitored by a variety of means: 1) evaluations by attending physicians after each rotation, 2) performance monitoring through Maternal Fetal Medicine Fellow s Conference, 3) Annual resident evaluations, nursing and ancillary staff evaluations, 4) Semi-annual review by the Maternal Fetal Medicine Fellowship director, 5) Semiannual review by the clinical competency committee, and 9) thesis defense in PGY7. We have explicitly outlined clinical skill expectations and job descriptions for each PGY training year as follows: PGY-5 Develop core knowledge in MFM through ward rounds, evaluation and management of patients in an outpatient MFM office, supervision of Obstetrics/Gynecology residents on Labor Delivery, Antepartum, and postpartum services, and training in obstetric ultrasound. Develop core knowledge in management of critically ill pregnant patients through an inpatient rotation through the Medical Intensive Care Unit and supervised provision of consultative services to pregnant patients admitted to the ICU. Develop core knowledge through use of basic MFM and ultrasound text books, ob/gyn journals, weekly grand rounds, journal clubs, and weekly MFM Fellow s Conference which includes case discussions, faculty led discussions on topics germane to MFM and ultrasound, and research presentations Learn how to order appropriate genetics studies and become facile in family history taking in order to produce and interpret a pedigree. Learn how to formulate and design a clinical study including preparation of an IRB proposal, consent form, calculation of sample size, and development of a budget Updated on 02/20/2018 Page 1 of 6
2 Establish diagnosis and treatment plans under the supervision of attending physicians in the outpatient MFM office. Perform daily ward work including evaluation of triage patients, daily rounds on hospitalized patients, and preoperative evaluations. Assist in the operating room when appropriate Develop continuity of care for outpatients in the MFM Office. Perform specific procedures as follows: o Provide supervision and/or perform procedures within the scope of practice of Obstetrics and Gynecology medical staff o Perform Specialty Specific procedures Cesarean hysterectomy Cervical cerclage (after 16 weeks) Level II and Genetic ultrasound Comprehensive ultrasound evaluation of the fetus Fetal echocardiography Genetic amniocentesis o Outpatient MFM visits: All outpatients will be discussed with an attending physician prior to disposition. o Outpatient genetics counseling: All genetics visits will be discussed with an attending physician prior to disposition o Be responsible for resident and student teaching o Develop a fellowship thesis project Updated on 02/20/2018 Page 2 of 6
3 PGY-6 Continue to develop core knowledge in MFM through ward rounds, evaluation and management of patients in an outpatient MFM office, supervision of Obstetrics/Gynecology residents on Labor Delivery, Antepartum, and postpartum services, and training in obstetric ultrasound. Continue to develop core knowledge in management of critically ill pregnant patients through an inpatient rotation through the Medical Intensive Care Unit and supervised provision of consultative services to pregnant patients admitted to the ICU. Continue to develop core knowledge through use of basic MFM and ultrasound text books, ob/gyn journals, weekly grand rounds, journal clubs, and weekly MFM Fellow s Conference which includes case discussions, faculty led discussions on topics germane to MFM and ultrasound, and research presentations Contribute to the didactic curriculum for MFM Fellows by coordinating the weekly MFM fellowship conference to incorporate topics for discussion from the ABOG MFM Guide to learning. Learn how to order appropriate genetics studies and become facile in family history taking in order to produce and interpret a pedigree. Learn how to formulate and design a clinical study including preparation of an IRB proposal, consent form, calculation of sample size, and development of a budget Establish diagnosis and treatment plans under the supervision of attending physicians in the outpatient MFM office. Perform daily ward work including evaluation of triage patients, daily rounds on hospitalized patients, and preoperative evaluations. Assist in the operating room when appropriate Updated on 02/20/2018 Page 3 of 6
4 Develop continuity of care for outpatients in the MFM Office. Perform specific procedures as follows: o Provide supervision and/or perform procedures within the scope of practice of Obstetrics and Gynecology medical staff o Perform Specialty Specific procedures Cesarean hysterectomy Cervical cerclage (after 16 weeks) Level II and Genetic ultrasound Comprehensive ultrasound evaluation of the fetus Fetal echocardiography Genetic amniocentesis Assist with percutaneous umbilical sampling as appropriate o Outpatient MFM visits: All outpatients will be discussed with an attending physician prior to disposition. o Outpatient genetics counseling: All genetics visits will be discussed with an attending physician prior to disposition o Be responsible for resident and student teaching o Continue work on fellowship thesis project and other ongoing research PGY-7 Continue to develop core knowledge in MFM through ward rounds, evaluation and management of patients in an outpatient MFM office, supervision of Obstetrics/Gynecology residents on Labor Delivery, Antepartum, and postpartum services, and training in obstetric ultrasound. Continue to develop core knowledge in management of critically ill pregnant patients through an inpatient rotation through the Medical Intensive Care Unit and supervised provision of consultative services to pregnant patients admitted to the ICU. Updated on 02/20/2018 Page 4 of 6
5 Continue to develop core knowledge through use of basic MFM and ultrasound text books, ob/gyn journals, weekly grand rounds, journal clubs, and weekly MFM Fellow s Conference which includes case discussions, faculty led discussions on topics germane to MFM and ultrasound, and research presentations Learn more about the coordination of care of those patients with anomalous fetuses through as the presenter/moderator of the monthly fetal board Complete thesis and successfully defend Present research at a regional/national meeting. Present Grand Rounds or equivalent at a regional or national meeting Submit research for publication in a peer-reviewed journal Learn how to order appropriate genetics studies and become facile in family history taking in order to produce and interpret a pedigree. Learn how to formulate and design a clinical study including preparation of an IRB proposal, consent form, calculation of sample size, and development of a budget Establish diagnosis and treatment plans under the supervision of attending physicians in the outpatient MFM office. Perform daily ward work including evaluation of triage patients, daily rounds on hospitalized patients, and preoperative evaluations. Assist in the operating room when appropriate Develop continuity of care for outpatients in the MFM Office. Perform specific procedures as follows: Updated on 02/20/2018 Page 5 of 6
6 o Provide supervision and/or perform procedures within the scope of practice of Obstetrics and Gynecology medical staff o Perform Specialty Specific procedures Cesarean hysterectomy Cervical cerclage (after 16 weeks) Level II and Genetic ultrasound Comprehensive ultrasound evaluation of the fetus Fetal echocardiography Genetic amniocentesis Placement of fetal shunts as appropriate o Outpatient MFM visits: All outpatients will be discussed with an attending physician prior to disposition. o Outpatient genetics counseling: All genetics visits will be discussed with an attending physician prior to disposition o Be responsible for resident and student teaching Updated on 02/20/2018 Page 6 of 6
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