UNC hospital is a referral center for patients all over North and South Carolina, as well as southern Virginia. We have a large volume of high risk pregnant patients with various disease processes. We commonly care for patients with severe pre-eclampsia, morbid obesity, cardiac disease, neurological disorders, scoliosis and prior spine surgery, coagulopathies, abnormal placentation, and patients having a trial of labor after cesarean delivery. We also care for pregnancies complicated by fetal conditions, such as severe prematurity, airway anomalies and masses, congenital defects, chromosomal abnormalities and CNS lesions. Our fellows have the opportunity to care for a large volume of both normal and high risk pregnancies, supervise and educate residents and be a part of a multidisciplinary team including neonatal ICU and maternal-fetal specialists.
1) Labor and Delivery: Primary clinical duties for the fellow take place on Labor and Delivery where we have 15 labor rooms, 3 operating rooms, 5 triage rooms and a post anesthesia care unit. Our unit has centralized fetal heart rate monitoring. We have state of the art equipment including that needed for advanced airway management, rapid transfusion and invasive monitoring. Anesthetic care is always provided under the direct supervision of a faculty anesthesiologist. As the fellow gains experience, he/she will be given the opportunity to assist the faculty in teaching clinical skills to residents and medical students. They will also function in a supervisory role with residents.
2) Neonatal ICU Rotation (2 weeks): Fellows spend 2 contiguous weeks in the NICU during their fellowship year. During this time, they learn the necessary skills for neonatal resuscitation in the delivery room, as well as become NRP certified.
3) Maternal Fetal Medicine Rotation (2 weeks): During the year, fellows will participate in a contiguous 2 week MFM rotation. This experience may be comprised of ultrasound clinic, high risk OB clinic, MFM consult clinic, genetic counseling and labor and delivery. Fellows will attend antepartum rounds every morning for a 2 week block. They will collaborate with Obstetric residents, MFM fellows and Obstetric attendings on the care of complicated pregnant patients during the antepartum period.
4) Research/QI Project: All fellows will participate in a scholarly project during their fellowship year. This project may be: original research, a quality improvement project or patient safety initiative. Three months of non-clinical time will be incorporated into the schedule (as per ACGME requirements) to allow for completion of this project. The project must result in presentation at a national meeting (preferably the Society of Obstetric Anesthesia and Perinatology (SOAP) annual meeting). Support for research projects is available through the department's research division. THe department has ample computer and technical support for database entry, management and statistical analysis. Two research nurses are on staff to assist with research protocol development, subject recruitment, and data collection for clinical studies. A modest departmental research fund is available to support projects deemed to be of sufficient merit. An educational fund is available for all fellows. This fund may be used to purchase texts, as well as to help pay for attendance at the annual SOAP meeting.