The Obstetric Anesthesiology Fellowship at Cedars-Sinai is a 12-month-long program designed to provide advanced experience and training in all aspects of obstetric anesthesiology, including research, administration and clinical management of the complex obstetrical and gynecological patient. Fellows will become experienced consultants in providing analgesia and anesthesia to the normal and high-risk obstetric patient.
The fellowship provides advanced obstetric anesthesia subspecialty training and is accredited by the Accreditation Council for Graduate Medical Education (ACGME). The program provides a very strong clinical and academic framework, with emphasis on future growth and development in obstetric anesthesiology, including committee skills and leadership skills in managing an obstetric anesthesiology service. The obstetric anesthesiology faculty assists in every way to make the educational experience memorable.
Departmental Educational Goals, Objectives and Evaluations
In addition to the requirements set forth by ACGME, the department has established its own goals and objectives to help guide its fellows through their training.
The fellow is expected, under the supervision of one of the obstetric anesthesiology attending physicians, to manage the labor and delivery suite. This requirement includes direct patient care and supervision of the residents. The fellow spends a total of eight months working on the labor floor.
Clinically, the fellow is expected to become proficient beyond the level of the non-obstetric anesthesiologist in providing anesthesia care for women during labor and vaginal delivery, and for women undergoing cesarean section, postpartum tubal ligation, dilation and curettage, obstetric hemorrhages and removal of the placenta. Training also includes experience with patients having anesthesia for non-obstetric surgery during pregnancy. During the labor-floor rotation, the fellow supervises and teaches the anesthesia residents during their core rotation.
Although not all fellows may seek a career in academic obstetric anesthesia, the fellows are strongly encouraged to participate in ongoing research projects and to initiate their own. Fellows are required to spend three months in research. After being exposed to all our clinical and basic science research projects at the beginning of the year, each fellow chooses a project in his or her area of interest to work on during the course of the fellowship.
The faculty and the program director provide academic guidance during research meetings to discuss the progress of the fellow's research projects. The goal is for the fellow to complete at least one of the projects initiated during fellowship training. After an appropriate mentor is assigned, the fellow and mentor develop a timeline that ensures the opportunity to present the results of the fellow's research at a national meeting. The project will likely lead to either an abstract presentation at a major meeting or a publication in a peer-reviewed journal.
The program's emphasis includes clinical sciences and scholarly activity designed to accomplish the following:
- Promote expertise necessary to deliver comprehensive peripartum care to the obstetric patient
- Promote the acquisition of new knowledge through clinical investigation and study
- Develop educational skills through supervision of residents and instruction by means of both didactic and case-oriented teaching
The objectives of the fellowship program include the following:
- Development of the required six core competencies needed to provide anesthesia services to pregnant patients undergoing obstetric procedures.
- Development of the knowledge, skills and judgment necessary for the safe conduct of obstetric anesthesiology. This conduct includes preoperative patient evaluation, interpretation of diagnostic data, hemodynamic monitoring and management of peripartum care.
- Development of the art of obstetric anesthesia in a moral, ethical and professional manner worthy of the Cedars-Sinai's model of lifelong professional excellence and learning.
The fellowship achieves these goals through a "learner-centered" program. The integration of educational methods is based on the following: clinical learning; didactic staff lectures; problem-based learning discussions; debates; learning projects including research, journal presentations and evidence-based reviews; multidisciplinary conferences; and exposure to a high volume of routine and high-risk obstetric cases.
These goals support the department's mission of graduating fellows who are experts in providing obstetric anesthesia, lifelong learners and models of professional excellence with unique skill sets that allow them to make significant contributions to the field of obstetric anesthesia.
While not all fellows will become chiefs of obstetric anesthesiology services, many do. An additional emphasis is placed on learning to run an obstetric anesthesiology service, including managerial areas: committee meeting management, practice and regulatory affairs, health system issues and providing value to the patient, obstetrician and hospital.
The opportunity exists to "moonlight" within the Department of Anesthesiology, in accordance with ACGME guidelines.