At Columbia University Medical Center, we have two L&D suites. The one at our main campus is responsible for 4500 deliveries annually and deals with many high-risk cases, in part because we are the major children's hospital for the New York City area (a catchment area of 16 million). For example, we have become a referral center for patients with abnormal placental implantation (accreta/percreta), and care for 1-2 such patients a month. The low-risk suite at the Allen Hospital of NewYork-Presbyterian/Columbia University Medical Center, about 3 miles north of the main campus, is responsible for about 2500 deliveries annually.
We have a group of 10 OB Anesthesia faculty who cover our main L&D 24/7, providing daytime and some night coverage at the Allen Hospital. This relatively small group results in consistency in practice and education for residents and Fellows. Among our faculty are the Director of Precision Medicine, The Director of the Margaret Wood Simulation Center and the Vice Chair for Compliance and Regulatory Affairs.
Our fellows spend the majority of their time at our main campus each day helping to care for our patients, organizing and supervising residents and seeing most of the medically complicated patients in antepartum consultation. We have a well-developed outpatient consultation service where fellows, along with a faculty member, meet patients individually who are referred to our division by their primary obstetrician in recognition of significant prior medical problems. Fellows are usually assigned two night calls every four weeks, exclusively in the Labor and Delivery Suite. Our fellows spend 2-3 days during their year with us at the Allen Hospital, mainly to learn in a different hospital setting that provides obstetric anesthesia to low-risk patients.
Our fellows participate in a research project with a mentor who guides them through study design, data analysis, scientific writing and presentation. The goal is for all of our fellows to present their work at a national meeting.
This 2-week required rotation in Maternal Fetal Medicine allows our fellows to see what our colleagues are seeing in early pregnancy and get to know the physicians on the MFM service. Fellows rotate to the perinatal clinic, ultrasonography, and MFM physician offices and learn antepartum care and assessment as well as fetal heart rate analysis.
This 2-week required rotation allows our fellows to spend time in the NICU and transitional nursery, assist with neonatal resuscitation at vaginal and cesarean births, consult with neonatologists, and obtain neonatal resuscitation certification.
Depending on the interest and expertise of the fellow, we have had previous fellows spend time in transfusion medicine as well as cardiac anesthesiology/TEE with one of our faculty who has completed both OB and cardiac anesthesiology fellowships.