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Fellowship: Maternal Fetal Medicine

Dr. Morais instructing how to do an amnio using the simulation model with residents, Stephanie Ayre and Jessica Liauw.

The Maternal Fetal Medicine division at McMaster University includes 8 faculty working at one site - the McMaster site of Hamilton Health Sciences. Our health region includes approximately ​30,000 deliveries. Having all clinical experiences focused at one site allows the group to be close knit and enables constant encounters with all levels of learners. The site is also a Children’s Hospital so that all Pediatric sub-specialists are readily available for consultation and education. We have sessions several times per month between various Pediatric groups and our division. Our division is well supported by the generalist obstetricians.

The fellowship program is a two-year program fully certified by the Royal College of Physicians and Surgeons of Canada. We have the capability of accepting up to two fellows per year. Fellows have intensive time in clinical MFM, prenatal diagnosis, as well as neonatology, pathology and obstetrical medicine. There are also blocks of elective time which occur in both first and second year. Commonly this is used to join the Toronto fetal therapy group but other experiences would also be encouraged. Another key element to any MFM fellowship program is ultrasound. McMaster Ultrasound provides obstetrical ultrasound services to a large number and wide variety of healthy and complex, high risk obstetrical patients from LHINs 3 and 4. We see a high volume of fetal anomalies. Techniques provided in the unit include two dimensional (grayscale, Doppler) and 3D/4D dimensional scanning/reconstruction and invasive procedure guidance (amniocentesis and CVS). Fetal and maternal pelvic MRI is available for selected cases.

The ultrasound unit also provides educational opportunities for trainees in Obstetrics, Radiology, Family Medicine, Pathology, Ultrasound Technology (Mohawk College), Midwifery, Maternal Fetal Medicine and Undergraduate Medicine. These opportunities are diverse including hands on scanning, reviewing images on a digital image archiving system, manipulation of 3D teaching volumes, amniocentesis simulator, ultrasound team rounds, as well as local digital and internet resources. An MFM-sonographer is in the unit daily to facilitate this teaching.

There are six months for research during the Fellowship. Each resident meets with the MFM Research Coordinator, and a Clinician-Scientist in the department, upon their arrival to discuss their previous research experiences, potential areas of interest, and career goals. Opportunities with various MFM faculty are discussed as there are a number of different opportunities. Once the resident has selected a research topic, there are specific modules set up by the MFM Research Coordinator. These modules are taught by various faculty and are meant to guide the resident through key steps in developing a research project. The goal is to ensure the resident’s efficient progress towards contributing in a meaningful way to the literature.

Setting up multicenter research projects is also possible within the time span of the fellowship. For instance, a recent graduate from the fellowship established a multicenter collaboration with University of Toronto, and published results in the British Journal of Obstetrics and Gynecology all within the time span of her two-year fellowship, and also received an award for best MFM poster at the University of Toronto/McMaster MFM – Neonatology Research Day.

Our program has the flexibility to enable fellows’ career goals. Recently, one of our fellows undertook a Master’s degree in Health Research Methodology through the Department of Clinical Epidemiology and Biostatistics during her fellowship. Dr. McDonald has graduate faculty status with CE&B and is the Department’s representative on the Clinician Investigator Program. This enables graduate studies (Masters or PhD) and she would be delighted to discuss these opportunities further.

Another of the strengths of our program, as noted by the fellows, is that there is a clinic specifically for patients to be managed by the fellow. New consultations are done as well as follow up visits. The fellow chooses what types of patients are booked. The program director supervises the clinic and there is increasing autonomy over the course of the program. This is a horizontal experience that continues as a commitment throughout rotations (other than elective). Residents have consistently praised this experience feeling that it gives them a degree of independence and allows them to mature in their clinical judgment.

Lastly, Hamilton itself offers some advantages as a city. It is central with respect to liaising with other MFM units. There is ease of access to Toronto and London for not only MFM-related issues but cultural, travel and other activities. There is a large amount of green space and since it is on the Bruce Trail excellent hiking and other outdoor activities are possible.

We are proud of our program and our MFM graduates. We work well together. We receive very positive feedback from our fellows. Our division would welcome interested applicants to apply, click here  for the Postgrad application form.

​For more information Contact:

Fellowship Program Coordinator, 905-521-2100 ext. 76204

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