Mission

To provide a primary source of Maternal-Fetal Medicine subspecialty trained teaching faculty to our Department of Defense teaching medical centers and Obstetrics and Gynecology residency programs and who can deliver world-class compassionate care in support of U.S. military operations at home and abroad.

Vision

Our program aims to graduate highly competent, well-rounded MFM subspecialists capable of providing excellent clinical care to pregnant patients in the Military Health System. Our MFM graduates will be the leaders in all medical environments in the military including at academic centers, community MTFs and while deployed. The quality of our program will be second to none, with excellent outpatient and inpatient clinical experiences. Our MFM graduates will be expert sonographers, competent in performing MFM procedures including amniocentesis and chorionic villus sampling. They will be the subject matter expert for all high risk Obstetric complications. Finally, they will have a robust education in clinical and basic science research, and will graduate with multiple completed research projects ready for publication.

Aims

Our program believes in providing a well-rounded training experience, with significant outpatient and inpatient clinical exposure, hands-on ultrasound training, and a robust research experience. The aims of the MFM Program are the following:

• Provide an environment with robust clinical experience, both inpatient and outpatient, so that MFM fellows will be experts at diagnosing and managing MFM complications.
• Enable MFM fellows to have significant hands-on training in Obstetric ultrasound, so that they will be able to complete detailed fetal anatomic surveys and fetal echocardiography.
• Provide significant exposure to MFM procedures including amniocentesis, chorionic villus sampling, cerclage, breech delivery, management of multiple pregnancies.
• Provide significant research training including mentorship with a Ph.D. research scientist, formal research courses at MAMC as well as advanced research courses including the Society for Academic Specialists in General Obstetrics and Gynecology PROGRESS course (Program for Researchers in Obstetrics and Gynecology and Reproductive ScienceS). MFM Fellows will also have 12 months of dedicated research time to complete their thesis and additional projects.
• MFM Fellows will also have dedicated weekly academics and didactics.

Every Thursday  8 a.m. – 12 p.m.

Multiple activities including:

• Journal Club
• Quarterly Pediatrics and Obstetrics Academics
• Quarterly Morbidity and Mortality conference
• Visiting lecturers including Genetics, Pediatric Cardiology, Palliative Care, etc.
• Quarterly research conference
• Quarterly Perinatal Pathology Conference with University of Washington

Rotations include:

• MFM Consult: our fellows read normal and abnormal Obstetric ultrasounds in the hospital, see Complicated Obstetric clinic, and also provide consultation to admitted Obstetric patients.
• Intensive Care Unit
• Labor and Delivery: our fellows function as an OBGYN attending.
• Genetics/Genomics course: Basic Training, A Course in Reproductive Medical Genetics for two months. Course taken as a third year fellow.
• Research: 12 months dedicated time, scattered throughout the three years of fellowship.
• Electives: including an MFM consult rotation at St. Joseph Medical Center in Tacoma, Washington where fellows can get CVS experience.

• MFM consult rotation at St. Joseph Medical Center in Tacoma, where fellows can get CVS experience
• Anesthesia
• Developmental Pediatrics clinical rotation

• Labor & Delivery call – two 12-14 hour blocks per month.
• MFM pager backup – typically the MFM consult fellow will be on pager call during the week and all fellows will split the weekends.

Our program is the sole MFM fellowship program in the DOD. Our fellows participate in academics with the OBGYN residency program that does have quarterly military unique curriculum.

• Dept of Clinical Investigations Molecular Short course
• DCI Applied Research Course
• SMFM New Fellows Conference
• Critical Care Obstetrics Conference, Mesa, Arizona
• Annual Fetal Echocardiography: Normal and Abnormal Hearts
• Fetal and Women’s Imaging Conference
• Gottesfeld Hohler Memorial Foundation MFM Fellowship Retreat
• SASGOG PROGRESS course
• Basic Training, A Course in Reproductive Medical Genetics
• Fellows are also required to present their research at national conferences including American College of Obstetrics and Gynecology Armed Forces District, Society of Maternal Fetal Medicine, Society for Reproductive Investigation

• Amniocentesis simulator training
• Andersen Simulation Center – MFM fellows participate in Emergencies in Obstetrics Course training – real life mannequins are used in critical care Obstetric simulations
• MFM fellows lead quarterly TeamSTEPPS training involving critical care in Obstetrics

Madigan Faculty Development Course

Fellows have 12 months of dedicated research time (spread out through the three years of fellowship). Our fellows are heavily involved in research, and we have two well-established basic science models including a model of preterm labor and placenta perfusion, with robust research mentorship both in basic science and clinical research. We have a dedicated Basic Science laboratory including a dedicated Molecular Biology PhD for the MFM Research platform. We have significant funding including two NIH R01 grants totaling more than 12 million dollars, as well as three CRADAs with other major research institutions including the University of Washington, University of Pittsburgh and University of Arkansas, as well as one patent granted in 2020. Our fellows are expected to present at national conferences including Society for Maternal Fetal Medicine, American College of Obstetrics and Gynecology Armed Forces Districts and Society of Reproductive Investigation. They are required to develop and complete a thesis with publishable manuscript by the time they graduate.

Required research training:

• DCI Molecular Short course
• DCI Applied Research Course
• SASGOG PROGRESS course

Each of the fellows are authors of at least one quality improvement project. All faculty are trained in TeamSTEPPS and participate in I-PASS and quarterly Morbidity and Mortality conferences.

MFM Fellows attend a Faculty Development course. They attend national Society for MFM and Society for Reproductive Investigation conferences as well as American College of Obstetrics and Gynecology Armed Forces District meetings.

• Madigan Army Medical Center (primary site)
• St. Joseph Medical Center in Tacoma

We do not offer MFM rotations for OBGYN residents or for OBGYN staff. We welcome requests for interviews for MFM fellowship.

Interested applicants should apply through the appropriate military (if active duty) or civilian matches. Applications will be reviewed and qualified applicants will be offered an interview as part of the match process. The fellowship conducts virtual or in-person interview. Applicants will have the opportunity to meet with faculty members, current fellows, and other vital members of the fellowship. Our team evaluates the entire applicant package with emphasis during the interview on emotional intelligence and maturity.

Program graduates take the Maternal-Fetal Medicine examinations (written and oral). The written and oral exam are offered annually. To become fully board certified, applicants are eligible to take the oral board certification exam >12 months following graduation, after 12 months of case collection. To be eligible to take specialty written board exams, graduates must complete all pre-requisites required by the American Board Obstetrics and Gynecology by September of their graduating year. Written board exams occur at the end of July of the graduating year. Oral board exams occur in the Spring, following at least 12 months of post-fellowship surgical case collection.

Fellows are expected to teach the on-service OB/GYN resident(s) and rotating medical students in the clinic and on Labor and Delivery.

Fellows experience meaningful teaching opportunities as instructors for small group didactic sessions, combined OB/Pediatric and Morbidity and Mortality conferences, and research mentors to OB/GYN residents and medical students.

All faculty are MFM subspecialists.

We have a well-established basic science clinical researcher who is a Ph.D. They mentor the fellows in basic science research. The MFM faculty mentor the fellows on clinical research topics. MFM fellows are free to select the focus of their thesis. They do begin work soon after starting their fellowship on a basic science project that is already Institutional Review Board approved.

There are multiple opportunities for Wellness Initiatives at the Fellowship, OB/GYN Department, GME, and hospital-levels. The MFM Division hosts regularly scheduled family activities, such as picnics, zoo outings, and nature hikes. We also include the SMFM Thrive wellness program into the curriculum. The fellows and faculty have access to embedded behavior health, as well as virtual and in-person non-institutional behavior healthcare at no cost. There is also a peer support program at our institution that fellows, and faculty/staff have access to at any time. Mentorship opportunities within military MFM are planned at least twice annually at regional/national conferences.