The Obstetric Anesthesiology Fellowship is accredited by the ACGME for four fellows. The Section of Obstetric Anesthesiology in the Department of Anesthesiology at the Northwestern University Feinberg School of Medicine is actively involved in the care of obstetric patients at the Prentice Women’s Hospital of Northwestern Memorial Hospital. Located in the heart of downtown Chicago, the Labor & Delivery Unit at Prentice Women’s Hospital is designated a Level 3, high-risk obstetrical unit. The physical facility contains state-of-the-art facilities for providing care to obstetric patients and their babies.
Prentice Women’s Hospital performs the largest number of deliveries in the state of Illinois, over 13,000 per year. The patient population is a mix of private and service patients, routine and high-risk. The Anesthesiology Service is involved in the care of approximately 90% of obstetric patients. The Division of Maternal Fetal Medicine in the Department of Obstetrics and Gynecology is nationally recognized and is part of the NICHD Maternal Fetal Medicine Network Units Network. Many patients are enrolled in clinical obstetric trials or clinical anesthesiology trials.
The Fellowship in Obstetric Anesthesiology at Northwestern University Feinberg School of Medicine is a 12-month program that commences on July 1. There are four available fellow positions.
Fourteen dedicated obstetric anesthesiologists are the primary educators in the fellowship program. In addition, faculty members in the Medical School’s Department of Obstetrics/Gynecology, Division of Maternal-Fetal Medicine (MFM), Neonatology and Critical Care Medicine are integral to the fellows’ education experience.
The Section of Obstetric Anesthesiology in the Department of Anesthesiology has primary clinical responsibilities on the Labor & Delivery Unit. Faculty members in the Department of Anesthesiology, whose primary subspecialty interest is Obstetric Anesthesiology, are dedicated to providing a well-rounded educational experience for anesthesiologists interested in a career in obstetric anesthesiology. The OB Anesthesiology Fellows are expected to gain experience in advanced clinical care, including the care of healthy and high-risk parturients and pregnant women undergoing nonobstetric surgery (7 months total clinical rotation). Fellows are also required to participate in the management of patients scheduled for fetal surgery procedures.
Fellows will be expected to participate in at least one research project, with the goal of one abstract and publication (3-month research rotation). Additionally, fellows rotate to the MFM and Neonatology services for 2-week rotations and participate in a formal simulation curriculum. Fellows meet for a weekly didactic session with one of the faculty members. One meeting per month is held jointly with the MFM fellows, usually a journal club. Fellows participate in regular patient care conferences and other multidisciplinary conferences. Our goal is for fellows to complete the program as well-rounded anesthesiologists whose primary interest and expertise is obstetric anesthesiology.
The modern anesthetic management of parturients requires an in-depth knowledge of not only anesthesiology, but also knowledge of obstetrics and the issues facing physicians involved in the care of high risk parturients..
- Successful completion of an ACGME- or Royal College of Physicians and Surgeons of Canada- accredited program in anesthesiology is a prerequisite.
Northwestern Memorial Hospital, Prentice Women’s Hospital, delivers over 12,500 babies per year. The cesarean delivery rate is 27% (3500 cases/year) and labor neuraxial analgesia rate is 90% (11,000 procedures). Anesthesiology residents in the core program average approximately 175-200 cases in their 2-month obstetric anesthesiology rotation. There is no competition between residents and fellows for cases. Case assignment is based on level of trainee experience and competency and anticipated difficulty of patient care, as well as learning needs.
The obstetric anesthesiology fellowship will enable the fellow to acquire an advanced body of knowledge and level of skill in the management of parturients, particularly of high-risk parturients. This should allow the fellow to assume a future leadership role in academic or private practice in the field of obstetric anesthesiology. The objectives include:
- understanding the obstetric management of high-risk parturients.
- understanding fetal heart rate measurement and interpretation.
- understanding the anesthetic management and the interdisciplinary approach to the management of the high-risk parturient.
- understanding neonatal resuscitation (American Academy of Pediatrics Neonatal Resuscitation Certification).
- understanding the moral and ethical issues in the care of the parturient, including maternal vs. fetal well-being.
- understanding the economic issues in obstetric anesthesiology.
- organizing a functioning obstetric anesthesiology service.
- critically evaluating the clinical literature in obstetric anesthesiology.
- teaching obstetric anesthesiology to others.
- carrying-out a scholarly project, including study design, recruitment of patients, carrying out of a study, analyzing and publishing the results.
Learn and Demonstrate Competencies in Patient Care and Medical Knowledge
|Labor & Delivery||7-8 months|
|Maternal Fetal Medicine||2 weeks|
|Blood Bank||1 week|
Labor & Delivery Rotation
Fellows will complete a total of seven months in a clinical rotation that includes the Labor & Delivery Unit and the obstetric operation rooms. Northwestern Memorial Hospital, Prentice Women’s Hospital, delivers over 12,500 babies per year. The cesarean delivery rate is 27% (3500 cases/year) and labor neuraxial analgesia rate is 90% (11,000 procedures). Fellows will provide care for high risk patients, organize and supervise residents and other health care providers, and provide antepartum consultations for patients referred by Maternal Fetal Medicine or their obstetrician.
Fellows will complete a total of three months in a research rotation, the rotation will consist of 13 weeks scheduled in 1-week increments approximately every four weeks throughout the year. A faculty mentor will guide fellows through study design, data analysis, scientific writing and presentation. Fellows will be expected to participate in at least one research project, with the goal of one abstract and publication.
This two week rotation in Neonatology during which fellows provide evaluation and resuscitation of neonates with the NICU team on the labor and delivery unit. At the end of this rotation Fellows will receive their certification in neonatal resuscitation.
Maternal Fetal Medicine Rotation
This two week rotation in Maternal Fetal medicine allows fellows to become familiar with the early stages of pregnancy and build relationships with the physicians and staff on the MFM service. Fellows rotate to the MFM clinics and physician offices and gain experience in antepartum fetal testing and high-risk antepartum care.
Blood Bank Rotation
This one week rotation in the blood bank allows fellows exposure to transfusion medicine. Fellows work with a transfusion medicine attending and gain experience in blood component therapy, perioperative blood management, antibody evaluations and transfusion reaction evaluations.
Fetal Surgery Program
Fellows are actively involved with the care of patients with fetal complications through the Chicago Institute for Fetal Health, a multidisciplinary collaboration with the Ann & Robert H. Lurie Children's Hospital of Chicago. Procedures that fellows will participate in include twin to twin transfusion syndrome laser treatments and myelomeningocele repairs in utero.
Fellows are evaluated quarterly. The Program Director and Clinical Competency Committee Chair will meet to review the fellow’s evaluation with him or her.
Successful completion of the program will be contingent upon meeting curricular and skills requirements as judged by evaluations. In addition, the trainee must 1) complete at least one scholarly project suitable for publication, 2) make one local presentation and 3) show evidence of teaching medical students and residents.
Participate in quality improvement activity
Fellows will participate in at least one of a number of quality improvement projects. A current project is to choreograph a multidisciplinary team approach to emergency cesarean delivery. A fellow has scripted a team approach for the anesthesia team, including describing specific roles of team members. The roles were then simulated and modified as needed. Finally, the roles are practiced by the anesthesia team, particularly at the beginning of a new resident rotation. The fellow leads these role simulations. A number of other quality improvement projects are ongoing on the Labor & Delivery Unit and fellows are invited to participate in these projects. Examples include: postpartum hemorrhage protocol, escalation of care protocol (for parturients requiring obstetric and critical care), and roll-out of the electronic medical labor analgesic record.
Complete a project with at least one of the following goals:
- Enhancing the fellow’s engagement in multidisciplinary care of obstetric patients, or
- Improving patient safety as it applies to the fellow’s practice of obstetric anesthesiology
Participate in a system improvement project based on the literature, quality improvement data and patient and family satisfaction data
Relationship to Anesthesiology Residency and Obstetric Anesthesiology Resident Rotation
Anesthesiology residents are integral members of the anesthesiology team that cares for obstetric patients. Fellows frequently directly supervise the residents in providing care to low risk patients. They may also provide care to patients during times when residents are busy with didactic educational activities. Additionally, fellows will either assist the residents or provide direct care to high risk obstetric patients.
Residents, fellows and attendings participate in twice-daily sign-out rounds. These rounds often include discussions of evidenced-based care in the context of the patients on the unit. Fellows participate in the daily resident didactic lectures. The lectures are based on a 2-month obstetric anesthesiology rotation and the fellows are expected to prepared and present each lecture topic at least once during the fellowship year. These lectures are directly supervised by at least one attending anesthesiologist. Additionally, fellows, in conjunction with an attending anesthesiologist, are assigned approximately one journal club each month. The journal club is attended by obstetric anesthesiology faculty members, students and residents rotating on the service and fellows.
Both residents and fellows help care for patients enrolled in clinical studies; however, this is primarily the responsibility of the fellows. In particular, fellow are expected to have knowledge of the enrollment criteria for all of the current clinical studies and help alert the research nurses with patient enrollment, study procedures and data collection. The core program director and the fellowship program director meet regularly to assess the quality of interactions between the fellows and residents.
Weekly Obstetric Anesthesiology Fellow Lectures
Fellows will have weekly didactic sessions covering a range of in-depth topics in obstetric anesthesiology. The format may vary and may include lectures and problem-based learning. Some of these didactic sessions will be joint sessions with the maternal-fetal medicine fellows. All sessions will be supervised by at least one core obstetrical anesthesiology faculty member.
Weekly Obstetric Anesthesiology Journal Club
Fellows will participate in a weekly journal club every Friday morning with the obstetric anesthesiology faculty members and anesthesiology residents. At least once a month, a fellow will primarily lead the journal club. Faculty will assist in selection, appraisal and assimilation of evidence from scientific studies relevant to obstetric patients. In addition, fellows will participate in interdisciplinary education with maternal fetal medicine fellows by participating in their journal clubs.
Daily Obstetric Anesthesiology Morning Conferences
Fellows will participate in the daily morning obstetrical anesthesiology conference lecture series for the residents on their obstetrical anesthesiology rotation. The lectures cover a broad range of topics in obstetrical anesthesiology based on Chestnut's Obstetric Anesthesia: Principles and Practice. Fellows will develop their didactic skills by participating as the lead educators one or two times each month.
Anesthesiology Grand Rounds
Fellows will attend the Department of Anesthesiology Grand Rounds every Friday morning. Fellows will also be required to present at the grand rounds once during the year. The presentation will be on a topic in obstetric anesthesiology of their choice such as controversies in obstetric anesthesiology or updates on the most current obstetric anesthesiology practices. Each fellow will be assigned a mentor from the obstetric anesthesiology faculty to assist in the preparation of the presentation. This will allow the opportunity to locate, appraise and assimilate evidence from scientific studies related to their patient population and obstetric anesthesia practice. Additionally, fellows will demonstrate their ability to be an educator in the field of obstetric anesthesiology.
Ultrasound Workshop for Obstetric Anesthesiology Fellows
Fellows will participate in an ultrasound workshop at the beginning of the year that will review the basics of ultrasound techniques and equipment. Emphasis will be placed on use of ultrasound for focused transthoracic echocardiography (TTE), transversus abdominus plane (TAP) blocks and neuraxial techniques in patients with back pathology or morbid obesity. By the end of the workshop, the fellows should be able to decide which patients would benefit from ultrasound guided regional anesthetic techniques, obtain optimal images, interpret the images, perform the regional technique and assess the results. There will be additional follow-up lectures throughout the year to cover more in-depth topics with TTE and ultrasound as well.
Simulation has been recognized as a strategy to provide a safe environment for deliberate practice in both clinical and behavioral skills. The Anesthesiology RRC requires that trainees participate at least once yearly in a simulation experience. Furthermore, the ABA requires that diplomates participate in a 6-8 hour simulation course in Part IV of its Maintenance of Certification (MOCA) program. The proposed simulation education curriculum for the obstetric anesthesiology fellowship provides a bridging experience from trainee to practicing anesthesiologist through a dual strategy: 1) learning through participation in simulation and 2) learning about using simulation as a life-long teaching and learning platform.
1) To practice and expand clinical management skills in challenging and/or rare clinical events; 2) To practice and expand team management skills in challenging teamwork events; 3) To reflect on upon individual, team and systems performance for practice improvement; and 4) To learn the basics of scenario design and debriefing.
1) Participate in an introductory 2-hour workshop to learn about scenario design and debriefing basics; 2) Participate in at least 2 simulations + debriefing sessions during the course of the fellowship year. Each session will be 90-minutes in duration; 3) Provide a brief written practice improvement plan (PIP) and follow-up in response to each simulation experience. The PIP will be similar to the PIP completed by MOCA participants; and 4) Design and deploy at least one simulated scenario during the year in cooperation with the simulation curriculum director. Potential arenas include resident simulation sessions, fellow simulation sessions, multi-disciplinary events, or simulation for practicing physicians.
Monthly 90-minute simulation seminars attended by 2 or more obstetric anesthesiology fellows. Other trainees, including obstetric and anesthesiology residents and nursing staff, will also be invited to participate as appropriate and available.
Sample Topics by Competency Area
- Patient care scenario: Emergency cesarean delivery in the Emergency Department.
- Medical Knowledge scenario: Recognition of post-partum diabetes insipidus after placental abruption.
- Practice-based Learning and Improvement: Design, deployment, debriefing and refinement of own scenario.
- Interpersonal and Communication Skills scenario: Severe post-partum hemorrhage with a positive antibody screen, difficult family members present with language barrier.
- Professionalism scenario: Managing confrontation/disagreement and demonstrating effective basic debriefing techniques.
- Systems-based practice scenario: Transport of unstable patient between hospital buildings and testing of a systems solution using simulation
- Facilitated debriefings after each simulation session with input from both attendings and peers.
- Self-evaluation of written practice improvement plans (PIP) following each simulation session.
- Evaluation by participants in the scenario designed and deployed by the fellow.
- A single, year-end assessment (did not meet goals, met goals, exceeded goals) by those attendings participating in the simulation curriculum based on achievement of the goals as stated above.
- The modern anesthetic management of parturients requires an in-depth knowledge of not only anesthesiology, but also knowledge of obstetrics and the issues facing physicians involved in the care of high risk parturients.
- Successful completion of a 4 year accredited program in anesthesiology is a prerequisite. The candidate must be American Board of Anesthesiology eligible or accredited.
Feyce M. Peralta, MD: Program Director
Nicole Higgins, MD: Section Chief and Medical Director, Obstetric Anesthesiology
Paloma Toledo, MD, MPH: Fellow Research Director
Jennifer Banayan, MD
Brad Bavaro, MD, MS
Alina Brodskaia, MD
Alex DeLeon, MD
Jason Farrer, MD
Matthew Hire, MD
Elizabeth Lange, MD
Chia-yang Jeffrey Lu, MD
Naveen Nathan, MD
Helen Pappas, MD
Samir K. Patel, MD
Meghan Rodes, MD
Mahesh Vaidyanathan, MD, MBA
Maternal Fetal Medicine Faculty
William Grobman, MD, MBA: MFM Program Director
Susan Gerber, MD: L&D Medical Director
Janine Khan, MD
In addition to McGaw Medical Center benefits, Obstetrical Anesthesiology fellows receive:
- $700 educational expense account
- Funding for one national society meeting: ASA or SOAP
- Additional funding for a second Academic/research meeting: Fellows who present an abstract at a national meeting will receive funding for a second meeting, based on the Program Director's approval.
- Dedicated office space with desktop computer
To be considered for an Obstetrical Anesthesiology fellowship position, candidates must be eligible for certification or fully certified by the American Board of Anesthesiology before fellowship training begins. In addition, candidates must obtain an Illinois Temporary or Permanent License and have taken USMLE Step 3 prior to training.
Applicants will be considered throughout the training year, so there is no application deadline. Please send the following application materials to Caroline Simpson.
- Common Application for Fellowship in Obstetric Anesthesiology
- Curriculum Vitae
- Evaluations from OB Anesthesia rotation
- Professional Photo
Illinois Department of Financial & Professional Regulations (IDFPR)
Applicants must obtain a Temporary or Permanent Illinois Medical License before starting their fellowship training. Licensing information and application can be found at www.idfpr.com. In order to apply for a permanent license, the applicant must already have taken the USMLE Step III. Please be aware that it may take up to 60 days for IDFPR to process and grant an Illinois license.
Contact Northwestern's Office of Graduate Medical Education:
McGaw Medical Center of Northwestern University
420 East Superior Street
Rubloff Building, 12th Floor
Chicago, IL 60611
- McGaw Benefits (McGaw Medical Center of Northwestern University)
Access the handbook to review benefits available to all residents at Northwestern Medicine
Check out the many external resources on the Student Housing section of the Augusta Webster, MD, Office of Medical Education website; the Off-Campus Life housing section of the Northwestern University Division of Student Affairs has additional resources to assist you with your housing search
Feyce Peralta, MD
Housestaff Research Portal
Feinberg has the infrastructure and resources to assist McGaw trainees interested in conducting scientific research. Visit our Housestaff Research Portal to learn more.