Introduction: A Career in Maternal-Fetal Medicine
Sub-specialization within Obstetrics and Gynecology has developed over the last two decades. With increasing sophistication in fetal imaging and the ability to observe the intrauterine environment, the concept of the fetus as a patient was born. Concomitant with the explosion in technologies for prenatal diagnosis and medical and surgical fetal therapy came the need for an obstetric perinatologist or fetal physician. Such an individual, by definition, would require a firm grounding in physiology and pathophysiology of the fetus and would be prepared to address, through scientific enquiry, some of the unresolved dilemmas in perinatal medicine. The role of the Maternal-Fetal Medicine (MFM) specialist, or perinatologist, has developed as complementary to that of the obstetrician and in current practice the job description also encompasses the tasks of administration, education and fetal advocate. In this country, where regionalization perinatal care has been shown advantageous, with improved outcome and lowered health acre costs, the obstetric perinatologist will be found in academic tertiary level centers. These individuals have clinical practices limited to care of the high-risk mother and her fetus.
In 1986, the Royal College of Physicians and Surgeons of Canada approved the first sub-specialty training program in Maternal-Fetal Medicine. Currently there are 10 Royal College accredited programs in Canada (accreditation without certification). Graduates of two-year Canadian program may receive a diploma stating that they have successfully completed a program accredited by the Royal College of Physicians and Surgeons of Canada - RCPSC. They can expect to gain experience in a wide variety of medical complications of pregnancy, detailed sonographic fetal diagnosis, prenatal genetic diagnosis and screening, and fetal, maternal and neonatal intensive care. The MFM fellow is expected to make an original contribution to the perinatal literature during his/her training, developing an appropriate research question and methodological approach and gather the relevant data to answer it. Within the University based practice the MFM sub-specialists, in addition to fulfilling clinical commitments, plays a role of educator to the community and other members of the health care team, health policy advisor, auditor of ongoing health practices and researcher. The distribution of time spent in these activities may vary widely.
Patterns of clinical practice within Canada also range from an exclusively consultative service to primary care physician for regional perinatal transfer. The ultimate lifestyle of the perinatologist will be predicated by the pattern of practice and the fiscal arrangements (fee-for-service or salaried positions), the size of the regional center and number of practice partners.
In 1990 the Maternal-Fetal Medicine Committee of the Society of Obstetricians and Gynecologists of Canada published a prospectus on manpower needs in MFM suggesting an excess demand for MFM sub-specialists for 1990's in excess of the anticipated supply with the current number of trainees. The demand in Canada for trained MFM specialists, though less well defined, favor continued growth in order to meet the target ratio of 6 Maternal-Fetal Medicine specialists per 10,000 birth in each region.
The vocation of an academic career in Maternal-Fetal Medicine awaits the candidate seeking personal fulfilment, financial security and intellectual challenge with the desire to explore the concept of the fetus as a patient.
The Ottawa Hospital, General Campus
501 Smyth Road
Ottawa, ON K1H 8L6
Dr. Darine El-Chaar, Fellowship Program Director
For information on MFM Clinical Fellowship, please contact:
Postgraduate Clinical Fellowship Programs
Department of Obstetrics and Gynecology
Phone: 613-737-8899 ext. 73254
MFM Clinical Fellowship Program Application Process:
All applicants to the Maternal Fetal Medicine Fellowship Program must contact the Postgraduate Medical Education Office at the University of Ottawa when applyining to the Maternal Fetal Medicine Program our University.
The University of Ottawa will require the following information to complete your application:
- Curriculum Vitae
- Proof of Medical Degree
- Proof of Specialty Degree
- 3 Current Original Reference Letters (dated and signed)
- Confirmation of Sponsorship
Applications will be reviewed by the Fellowship Committee in Maternal Fetal Medicine and candidates will be contacted for interviews in October /November for positions beginning July 1st, start date.
For information on Post-Doctoral Research Fellowship, please contact:
Research Administrative Assistant
OMNI Research Group
Phone: (613) 739-6655