Fellowship training: the ever-changing subspecialty of maternal-fetal medicine

To estimate the current scope of practice and evaluate the experience in training of maternal-fetal medicine specialists in the United States.

We administered an Internet-based, 16-question survey of 1,764 members of the Society for Maternal-Fetal Medicine, inquiring about aspects of fellowship training and scope of practice after completion of training.

Approximately 36% (n=643) of surveys were returned. Most respondents were between 40 and 49 (230/640, 35.9%) and 50 and 59 (199/640, 31.1%) years old, and 411 were men (64.1%). Nearly all respondents (590/636, 92.8%) were certified in obstetrics and gynecology, and 80.1% (530/628) were certified in maternal-fetal medicine. The majority were in small-group practices of two to seven partners (359/634, 56.6%). Forty-nine percent (306/630) were in university-based practices, 26.8% (169/630) in university-affiliated practices, and 24.6% (155/630) in community-based or hospital-based practices. Most respondents work full time (40 hours per week or more), and the weekly practice profile consists primarily of ultrasonography (33.5%), consultation for high-risk patients (17.1%), and total obstetrical care for high-risk patients (15.4%).Training in most aspects of maternal-fetal medicine practice was felt to be adequate, with the exception of practice management. Time spent in training was spent primarily in high-risk pregnancy management (41%), ultrasonography (22%), and research (18%).

The current scope of maternal-fetal medicine practice incorporates more ambulatory care than hospital-based care. Training programs rate highly in adequacy for high-risk pregnancy management and ultrasonography but lower in other aspects.

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