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UCSF

ObGyn&RS

Fellowship Training Programs

Training and Curriculm

EDUCATIONAL PROGRAM

Inpatient and outpatient teaching of maternal fetal medicine occurs at both the main UCSF campus and at Zuckerberg San Francisco General Hospital (ZSFG). Inpatient high-risk obstetrics rotations occur at both hospitals. The UCSF Mission Bay site provides “quaternary” care, with a range and depth of subspecialty care available, including the Fetal Therapy program. The OB program recently moved to the UCSF Mission Bay Campus in February 2015 for both inpatient and outpatient OB, including prenatal diagnosis, fetal echo, etc. The inpatient high-risk obstetrics unit at ZSFG provides care to indigent and underserved women of San Francisco County. ZSFG is the only Level 1 trauma center in San Francisco and northern San Mateo counties, and thus all pregnant trauma patients are routed to ZSFG. ZSFG is home to Bay Area Perinatal AIDS Center (BAPAC), the obstetric HIV service that coordinates comprehensive prenatal and delivery care for HIV positive pregnant women. The county population is generally underserved, and patients frequently have multiple medical and social co-morbidities complicating their pregnancies.

The OB/GYN residency program at UCSF is an ACGME accredited program and has 9 residents per year, for a total of 36 residents. UCSF’s Department of Obstetrics, Gynecology, and Reproductive Sciences offers ABOG-certified fellowships in Reproductive Endocrinology-Infertility (2 fellows/year for a total of 6) and Gynecologic Oncology (1 fellow/year for a total of 3). The department also offers non-accredited fellowships in Family Planning (1-2 fellows/year for a total of 3-5 fellows), and Women’s Health at the Veteran’s Administration (in combination with Internal Medicine).

RESEARCH TRAINING

Fellows have 12 months of protected research time during the three years of fellowship. This time is distributed roughly throughout the three years.

The Fellowship Director works with each fellow to identify research mentors both inside and outside of the division. Although our fellows work with many research faculty throughout the MFM division, our department, and institution, there are five main MFM faculty that provide research mentorship.

Mary Norton, MD is board-certified in MFM and Genetics. She is Interim Division Chief of MFM and Vice Chair for Clinical and Translational Genetics.

Miriam Kuppermann, PhD, MPH, Vice Chair for Clinical Research, Director of the Program in Clinical Perinatal and Comparative Effectiveness Research, also the Director for the CTSI Resident Research Program, and serves as a research advisor to all of the MFM fellows and is primary mentor for many. She has a long track record of NIH, AHRQ, and March of Dimes funding.

Susan Fisher, PhD, leads the Translational Research Program in Perinatal Biology and Medicine in the MFM division and is the Director of the UCSF Human Embryonic Stem Cell Program and Faculty Director of the Sandler-Moore Mass Spectrometry Facility. Her work as been supported by the NIH for over 30 years, and she has trained numerous graduate students and clinical and postdoctoral fellows.

Tracey Woodruff, PhD, MPH is the Director of the Program on Reproductive Health and the Environment and the Pregnancy Exposure to Environmental Contaminants Research and Prevention Center. Her funding comes from NIEHS, the Wellness Foundation, and USEPA.

Melissa Rosenstein, MD, MPH, is a UCSF Women’s Reproductive Health Research (WRHR) career development scholar and graduate of the MFM fellowship studying cesarean delivery and VBAC. She maintains the long-standing UCSF Perinatal Research database.

ACTIVITIES OF FELLOWS

Call: Fellow call is in-house OB-only at UCSF (3 calls/month), and this call time counts towards the 80-hour work week. When fellows are on the inpatient antepartum/L+D supervisor rotation or on night call they are supervised by faculty who are in-house and immediately available.

RECENT RESEARCH PROJECTS OF OUR FELLOWS:

Betsy O’Donnell (Recent Graduate of June 2016):

Papers published:
1. O'Donnell BE, Lewkowitz AK, Vargas JE, Zlatnik MG. Examining Pregnancy-Specific SmartPhone Applications: What Are Patients Being Told? J Perinatol. 2016 May 19. doi: 10.1038/jp.2016.77. PMID: 27195980

2. Shah AD, Hsiao EC, O'Donnell B, Salmeen K, Nussbaum R, Krebs M, Baumgartner-Parzer S, Kaufmann M, Jones G, Bikle DD, Wang Y, Mathew AS, Shoback D, Block-Kurbisch I. Maternal Hypercalcemia Due to Failure of 1,25-Dihydroxyvitamin-D3 Catabolism in a Patient With CYP24A1 Mutations. J Clin Endocrinol Metab. 2015 Aug;100(8):2832-6.

Posters presented:

1. B.E. O'Donnell, G. Delapiana, S.R. Wiener, N.E. Stotland, S. Gregorich, M. Kuppermann. Centering Pregnancy® prenatal care: a tool to decrease the risk of excess gestational weight gain? àPresented at the Society for Reproductive Investigation Annual Meeting, Montreal, Canada, March 2016.

2. B.E. O'Donnell, A.K. Lewkowitz, N. Stotland, J.E. Vargas. Is a “trial of induction of labor” a safe and effective alternative to diagnosing failed induction of labor? àPresented at the Society for Reproductive Investigation Annual Meeting, Montreal, Canada, March 2016.

3. S.G. Valderramos, B.E. O'Donnell, J. Gonzalez, K. Tabsh. Cerclages in twin pregnancies to reduce the preterm birth rate before 32 weeks.
• Presented at the Society of Maternal Fetal Medicine, The Pregnancy Meeting, Atlanta, GA, February 2016.

4. Betsy E. O’Donnell, Adam K. Lewkowitz, Naomi Stotland, Juan E. Vargas. A “Trial of Induction of Labor”: A Means to Avoid Cesarean Delivery for A Failed Induction of Labor?
• Presented at the Pacific Coast Obstetrical and Gynecological Society Annual Meeting, Oahu, Hawaii, September 2015.

Teresa Sparks (MFM/Genetics Combined Fellow, 4th year of 4):

Papers published:

1. Sparks TN, Norton ME, Flessel M, Goldman S, Currier RJ. Actual rate of Down syndrome observed in twin pregnancies. In press, Obstet Gynecol.

2. Sparks TN, Shaffer B, Page J, Caughey AB. Gastroschisis: perinatal mortality risks with each additional week of expectant management. In press, Am J Obstet Gynecol.

3. Henry D, Gonzalez JM, Harris IS, Sparks TN, Killion M, Thiet MP, Bianco K. Maternal arrhythmia and perinatal outcomes. In press, J Perinatol.

4. Sparks TN, Griffin E, Page J, Pilliod R, Shaffer B, Caughey AB. Down syndrome: perinatal mortality risks with each additional week of expectant management. Prenat Diagn 2016; 36(4):368-374. PMID: 26891366

5. Sparks TN, Nakagawa S, Gonzalez JM. Hypertension in dichorionic twin gestations: how is birthweight affected? J Matern Fetal Neonatal Med 2016 Apr 28:1-6. [Epub ahead of print] PMID: 27046743

6. Sparks TN, Yeaton-Massey A, Granados JM, Handler SJ, Meyer M, Caughey AB. How do maternal views of delivery outcomes vary by demographics and preferred mode of delivery? Am J Perinatol. 2015 Jul;32(8):741-6.

Abstracts Presented:

1. Sparks TN, Nakagawa S, Gonzalez JM. Hypertension in dichorionic twin gestations: How is birth weight affected?
• Presented at: Pacific Coast Obstetrical and Gynecological Society (PCOGS); Kahuku, Oahu, Hawaii. September 2-6, 2015.

2. Sparks TN, Thao K, Pelagio J, Norton ME. Mosaic Trisomy 16: What are the obstetric and long-term childhood outcomes?
• Presented at: Annual Meeting of the Society for Maternal-Fetal Medicine (SMFM); Atlanta, GA. February 1-6, 2016.

3. Sparks TN, Caughey AB, Cheng YW. Perinatal outcomes of pregnancies with fetal Down syndrome.
• Presented at: Annual Meeting of the Society for Maternal-Fetal Medicine (SMFM); Atlanta, GA. February 1-6, 2016.

Victoria Berger (MFM/Genetics Combined Fellow, 2nd year of 4):
Paper Published:
1. Davis AS, Berger VK, Chock VY. Perinatal Neuroprotection for Extremely Preterm Infants. Am J Perinatol. 2016 Feb;33(3):290-6. doi: 10.1055/s-0035-1571148. Epub 2016 Jan 22.PMID: 26799965

Abstracts Presented:

1. Victoria Berger, E. Werner, P. Hosseinzadeh1, A. Ness, B. Salmanian1, Z. Heidari-Bateni1, M. A. Belfort, J. Espinoza, A. Shamshirsaz. Natural history and outcome of non-immune hydrops. 1. Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA. 2. Obstetrics and Gynecology, Stanford University Medical Center, Stanford, CA, USA
• Presented at: ISUOG, Montreal 10/2015

2. A. Ness, E. Werner, Victoria Berger, P. Hosseinzadeh1, Z. Heidari-Bateni1, B. Salmanian, M. A. Belfort, J. Espinoza1, A. Shamshirsaz1 Postnatal survival according to gestational age at delivery in non-immune hydrops fetalis. 1. Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA. 2. Obstetrics and Gynecology, Stanford University Medical Center, Stanford, CA, USA
• Presented at: ISUOG, Montreal 10/2015

3. Victoria Berger, Joseph T.C. Shieh Utility of broad sequencing to reveal mtm1 gene mutation carriers with history of recurrent neonatal death1 Medical Genetics, Dept Pediatrics, Dept Obstetrics and Gynecology, Institute for Human Genetics, University of California San Francisco, San Francisco, CA 94143, USA.
• Presented at: WSPR, Carmel Jan 2016

Erin Washburn (MFM Fellow, 2nd year of 3):
Abstracts Presented:
1. Washburn E, Sparks T, Gosnell K, Lee H, Feldstein V, Rand L, Gonzalez J. Isolated polyhydramnios in one of a monochorionic-diamniotic twin pair and the risk of progression to twin-twin transfusion syndrome
• Poster presentation at SMFM on Feb 4, 2016.

2. Washburn, E, Connors S, Little S, Robinson J. Risk factors for rehospitalization in the puerperium.
• Poster presentation at ACOG on May 16, 2016.

3. Lim S, Washburn E, Harris I, Gonzalez J, Lucero J. Mode of delivery and anesthetic management outcomes in Patients with congenital and acquired cardiac disease (CACD).
• Poster presentation at SOAP on May 20, 2016

Rachel Shulman (MFM Fellow, 1st year of 3):
Paper Published:
Shulman R1, Kottke M2. Impact of maternal knowledge of recommended weight gain in pregnancy on gestational weight gain. Am J Obstet Gynecol. 2016 Jun;214(6):754.e1-7. Epub 2016 Mar 21. PMID: 27012961

Jeffrey Sperling (MFM Fellow, 1st year of 3):
Paper Published:
1. Sperling JD, Dahlke JD, Sibai BM. Am J Obstet Gynecol. 2016 Jun 24. pii: S0002-9378(16)30374-X. [Epub ahead of print] PMID: 27349295

2. Sperling JD, Dahlke JD, Sibai BM. Restriction of oral intake during labor: whither are we bound? Obstet Gynecol. 2016 May;127(5):934-40. PMID: 27054940

3. Dahlke JD1, Sperling JD, Chauhan SP, Berghella V. Cervical Cerclage During Periviability: Can We Stabilize a Moving Target? Obstet Gynecol. 2016 May;127(5):934-40. PMID: 27054940

DIDACTIC LECTURE/CONFERENCE SCHEDULE:

The main didactics occur weekly for MFM fellows, Wednesdays, from 8–9am. These lectures cover requirements from the ABOG Guide to Learning in Maternal-Fetal Medicine. Meetings schedule include:

  1. Maternal-Fetal Medicine Fellowship Didactics (every, Wednesdays, 8–9am)
  2. SMFM lecture (monthly, 1st and 3rd Wednesday, 9–10am)
  3. OB-Neonatology conference (every, Tuesdays, 12–1pm)
  4. Fetal Treatment Interdisciplinary Meeting (every, Tuesdays, 1–2:30pm)
  5. Grand Rounds (every, Tuesdays, 9–10am)
  6. Obstetrical Ultrasound, Jointly with Radiology (monthly, 1st Wednesday, 7:45–8:45am)
  7. MFM Research Works-in-Progress meeting (monthly, 3rd Tuesday, 10–11am)
  8. PACT (Pregnancy & Cardiac Treatment Program) meeting (monthly, 4th Wednesday, 12:30–1:30pm)
  9. Journal Club with OB Residents (monthly, 4th Tuesdays, 11am–12pm)
  10. MFM Research (monthly, 1st Tuesday, 10–11am)

ROTATIONS:

L&D supervisor
i. MB: 1 months (in 3 years)
ii. ZSFG (UCSF requirement): 1 month (in 3 years)

Outpatient (MB/ZSFG): 3 months per year

PDC/Procedures: minimum 1 month per year

PACT (pregnancy and cardiovascular treatment clinic)/fetal echo: 2 months (in 3 years)

Antepartum/Procedures: 2-3 months per year

ICU Parnassus: 1 month (in 3 years)

Research: 1–5 months a year (at least 12 months in 3 years)
i. TICR/ATCR coursework – at least 6 week summer course in designing clinical research, introductory biostats, database management

FTC/genetics (UCSF requirement) – at least one 1-month rotation in 3 years

Electives
i. Any of the above required rotations can be done as elective
ii. Women’s option
iii. Neonatology
iv. OB/Anesthesia
v. Reproductive environmental health
vi. Additional research