The effect of board-imposed changes on maternal-fetal medicine fellowships

A 1996 survey of Maternal-Fetal Medicine fellows revealed that there was cause for serious concern over fellow experience. In 1997, Maternal-Fetal Medicine fellowships underwent significant changes, including a lengthening of the program and more stringent requirements for protected research performance. We investigated whether the changes imposed in Maternal-Fetal Medicine fellowships in 1997 have improved fellow experience.

Fellows were identified through the Society of Maternal-Fetal Medicine. An identical survey to a 1996 survey using the Likert scale, ordinal- and categorical-scale questions were used. The results of the 1996 survey were compared with the results of the 2000 survey. chi2, Mann-Whitney U test, Fisher exact test, and analysis of variance were used where appropriate.

Sixty-five of 100 fellows returned the survey (return rate, 65%). Overall, there has been improvement in many areas of fellow experience. Significant changes include an increase in research time (7 months versus 18 months; P <.001), number of research projects (2.9 versus 4.3 projects/fellow; P <.001), fellows rating research time as adequate (66.4% versus 85.6%; P=.003), fellows receiving grant training (20.2% versus 37.1%; P=.012), 2 or more research presentations (36.2% versus 47.1%; P=.028), pursuit of a postgraduate degree (5.7% versus 32.9%; P <.001), presence of a mentor (68.1% versus 80.8%; P=.049), and the rating of mentorship as strong (59.4% versus 77.9%; P=.039). Of concern, 24.3% of current fellows did not believe they would receive their full-protected research time.

The changes imposed in Maternal-Fetal Medicine fellowships in 1997 appear to have had a positive impact on fellows' experience, especially the ability to perform and present research.