OB/GYN Hospitalist Fellowship Curriculum

Learning Objectives

Our curriculum will provide you the knowledge and expertise you need to successfully practice as an Ob/Gyn hospitalist. You will meet the following learning objectives in this program

Obstetrical and Gynecological Emergencies:

  • Obtain expert knowledge in the management of obstetrical and gynecological emergencies including but not limited to: antepartum and postpartum hemorrhage, shoulder dystocia, cord prolapse, uterine rupture, ectopic pregnancy, first trimester hemorrhage, ovarian torsion, amniotic fluid embolism and maternal critical care.
  • Placenta Accreta Spectrum (PAS) – Be a member of the Morbidly Adherent Placenta Team to obtain knowledge and surgical skills for the management of the morbidly adherent placenta.

Obstetrical Triage:

  • Identify patients with high-risk conditions requiring immediate care.

Labor Management: Obtain expert knowledge and skills in the following areas

  • Induction of labor
    • Indications for inductions
    • Methods of induction
  • Labor abnormalities
    • Disorders of Arrest and Protractionii
    • Management of abnormal FHTs
    • Management of the third stage of labor
  • Vaginal laceration and episiotomy repairs

 Operative Deliveries:

  • Forceps and Vacuum deliveries
    • Obtain expert knowledge and skills in forceps and vacuum deliveries
      1. Learn indications, contraindications, risks and benefits
      2. Demonstrate proper technique in the utilization of forceps and vacuums
  • Cesarean Delivery
    • Demonstrate proper technique for cesarean delivery and teach cesarean delivery to residents
    • Perform cesarean hysterectomy

Quality Initiatives and Patient Safety:

  • Participate in daily safety briefings and resident and nursing huddles
  • Attend and present at quality assurance meetings

Simulation

  • Participate in all obstetrical simulations
  • Complete simulation instructor course and lead obstetric simulations

Antepartum Care

  • Obtain expert knowledge in the management of maternal and fetal complications in pregnancy, including but not limited to PTL, PPROM, pre-eclampsia, abnormal placentation, fetal growth restriction, fetal anomalies, maternal co-morbidities
  • Learn to manage chronic hypertension, diabetes and other chronic medical conditions in pregnancy
  • Change to read obtain skills in ultrasound to complement the management of normal pregnancy and complications of pregnancy including cervical length measurement, Fetal Doppler analysis, identification of ectopic pregnancy and placenta accreta spectrum

Education

  • Lead labor and delivery board rounds
  • Participate in resident education
    • Journal club
    • Resident didactics
  • Lead Medical student triage rotation

Evaluation

The fellow will be assessed by faculty, nursing staff, residents, and students during their clinical and non-clinical rotations. The core competencies that will be evaluated include patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and systems-based practice. Additionally, learners will assess the fellow's teaching skills. The fellow will also evaluate the program and provide feedback for its improvement.

Certificate of Completion

A certificate of completion will be provided at the end of the fellowship if the program goal and learning objectives are met and there are no serious deficiencies in the core competencies.

Duties and Responsibilities

As a member of the hospitalist division, the fellow will participate in all aspects of clinical care under the supervision of the Hospitalist attending or Service attending.  The fellow will be required to work a minimum of twelve 12-hour shifts per month.  Weekend and holiday coverage are required.  Other call may be required based on the clinical service rotation.  You will be expected to provide clinical care at the highest level to patients in accordance with hospital and evidence-based care guidelines.  You are expected to promote a culture of patient safety. Your clinical responsibilities are assigned by the Hospitalist Division Director and may be altered in response to changing Departmental, Division or Hospital needs. Clinical duties include but are not limited to the following:

  • Evaluation and management of patients in triage
  • Participation in Emergency Response Teams  (rapid response, adult codes, delivery response and massive transfusion protocols) and management of unexpected emergencies on L&D, antepartum unit, postpartum unit and other areas of the hospital
  • Management and delivery of patients in L&D: unassigned patients and those of other attendings and services as requested
  • Acting as a surgical assistant when needed
  • Surveillance of labor progress and fetal heart rate tracing on patients on L&D
  • Perform or assist with emergent gynecologic surgery for cases such as ectopic pregnancies or incomplete abortion curettage as needed with gynecology attending
  • Participate in call coverage for Placenta Accreta Spectrum (PAS) team
  • Evaluation and management of all Obstetrical and gynecological transfer patients
  • After hours and weekend oversight of patients assigned to  the fetal intervention and maternal-fetal medicine service
  • Coverage of Fetal Intervention (FI) patients after hours and weekends
  • Coverage of Minimally Invasive Surgery (MIS) service patients after hours when requested
  • Participation and leading of L&D board rounds
  • Participate in daily safety briefings
  • Participation in Quality Initiatives within the hospital
  • Daily rounding on antepartum and postpartum patients
  • Participate in simulation

As a hospitalist fellow you are expected to participate in the education of residents, fellows, medical students, nursing staff etc. 

You will be expected to maintain medical staff privileges in good standing at Texas Children’s Pavilion for Women and you are bound by all policies and bylaws of the hospital.  You must complete documentation and billing of professional services provided in a timely manner.  You will participate in hospital and departmental committees as needed.  You must continue to hold and maintain a permanent, valid and unrestricted license to provide patient care in the State of Texas and comply with BCM credentialing criteria.  You are expected to maintain certification in Advanced Cardiovascular Life Support (ACLS).

You will be required to complete a research project during time in fellowship, but given the academic environment in which we work there is an expectation to participate in research within the department or hospital.  Participation as a primary or secondary investigator in a clinical research project or quality improvement project is highly supported.