The Department of Obstetrics and Gynecology

The Division of Maternal Fetal Medicine of the Department of Obstetrics and Gynecology has provided advanced training in Maternal-Fetal Medicine to qualified physicians for more than two decades. An outstanding basic research faculty compliments an excellent clinical faculty and together they provide a superb environment in which to train. Every effort is made to balance the training in all aspects of high-risk obstetrics. The objectives of the fellowship are best summarized in two categories:

1.Educational Objectives

To provide didactic and practical advanced training in the understanding and management of obstetric, medical and surgical complications of pregnancy.
To provide advanced training in prenatal diagnosis and therapy.
To link problems of fetal physiology to their impact upon newborn morbidity.
To develop skills in prenatal diagnosis to include
- Genetic amniocentesis
- Umbilical vein sampling
- Chorion villus sampling
- Standard and Doppler ultrasound techniques
- To develop skills in special procedures including
  - Fetal transfusion
  - Abdominal cervicoisthmic cerclage
  - Critical care obstetrics
- To further skills as an academic OB/GYN educator

To expand the fellow's understanding of experimental design.
To broaden the fellow's competence in statistical design and evaluation.
To Design, implement and complete a research project suitable for a thesis.

The Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine is not recruiting for the 2010 start year. Applications for a 2011 start date will be accepted through ERAS. Please refer to the ERAS website later for information the July 2011 timeline.

The Department of Obstetrics and Gynecology invites applications from qualified individuals with strong academic credentials. Candidates must be eligible for certification in Obstetrics and Gynecology by the American Board of Obstetrics and Gynecology and should possess excellent skills in clinical Obstetrics. The University of Cincinnati is an equal opportunity employer. The Fellowship selection process employs the matching process of the National Board of Medical Examiners.

Reproductive Endocrinology and infertility Training Program

The major goal of our Fellowship Training Program in Reproductive Endocrinology and Infertility at the University of Cincinnati will be to provide advance training in both the physiology and pathophysiology of mammalian reproduction. Basic instruction in the physiologic principles of hormone action will be combined with clinical instruction involving the pathophysiology of disorders of human reproductive function. It is also our intent to provide clinical, surgical, and in vitro fertilization experience which will be of sufficient scope so as to ensure development of competent and complete endocrine and infertility specialists. Guided experience in conferences and in basic and clinical research activities will be aimed at initiating trainees into productive investigative careers in reproductive endocrinology.

A major portion of each trainee's time during the first year of the fellowship will be devoted to research. Early in the first year of training, the fellow will meet with each of the faculty preceptors individually to discuss possible research projects. In consultation with Dr. Thomas, each trainee will select a preceptor and design a research program. Each trainee will be required to develop a complete research project which includes a critical review of the pertinent literature, a statement of the problem and its significance, experimental aims, statistical analysis, and an outline of the proposed experimental design. Each fellow will present his or her proposal at the biweekly research conference prior to its inception. The research proposal will also be reviewed by the department of Ob/Gyn research committee which will provide additional scientific input and approve funding for the project. In addition, each trainee will be required to rotate and assist with performance of immunoassays in the hormone assay laboratories (under the direction of Dr. Thomas). Thus, trainees are encouraged to initiate a predominantly laboratory research endeavor early in the first year and also to design and implement a clinical research protocol later in the fellowship. All fellows must purchase a computer. Use of the computer for database and analysis will be supervised by Dr. LaBarbera.

During the first year, each fellow will become proficient in the pelvic ultrasound monitoring of follicle growth (under the direction of Dr. Thomas and Dr. Robins). Daily ultrasound monitoring for gonadotropin ovulation induction is carried out seven days/week by the first-year fellow. Each trainee will also be expected to spend one-half day each week attending the Pediatric Endocrine clinic directed by Dr. Handwerger. The required graduate course work (biostatistics) will be completed during the first year as well.

During the second year of training, clinical activities of the trainees will increase, but research endeavors will continue. Daily ultrasound monitoring of IVF patients and IVF oocyte retrievals (approximately 100 cycles/year) are performed by the second-year trainee. In collaboration with the designated preceptor, a research grant proposal similar to the NIH format will be initiated. On the basis of the numbers of patients seen by the five clinical faculty, there will be over 7,800 patient visits per year. Microsurgical cases will also be performed at The Christ Hospital with two board-certified REI private practice faculty. We anticipate a continuing increase in the number of patient visits. Fellows will also have the option of a rotation through the medical endocrine clinic for a two-month period under the direction of Dr. Robert Cohen. We believe that the clinical exposure afforded the fellows will be more than sufficient to permit them to develop into well trained consultants and specialists in this field. We are committed to the training of academic reproductive endocrinologists.

The major goal of the third year of fellowship training will be to provide an uninterrupted and intense research experience so that the trainee can design and carry out a detailed research project proposed during the second year. This research project proposal, presented in the NIH format, will be reviewed by the Research Committee of the Department of Obstetrics and Gynecology. After committee’s approval of the budget, the Department will provide sufficient funding for this endeavor. Trainees will also be expected to submit this proposal for funding from extramural sources such as the Mead Johnson/ACOG fellowship grants during their second year of fellowship. Over the past 3 years, trainees have received grants from the North American Menopausal Society and Merck/ACOG.

During this time, the trainee will have daily interaction with the preceptor and essentially be working on a 1:1 basis in the laboratory of the preceptor. This working relationship will be analogous to that of a postdoctoral candidate. The trainee will be required to hone his/her manuscript preparation and grant writing skills. It is expected that research from the previous two years will be presented at national meetings such as the Society for Gynecologic Investigation or the Endocrine Society and summarized in submitted manuscripts before completion of the third year.

The trainee will also be required to expand laboratory skills that would pertain to his/her research interest and projects. For example, the trainee may learn to carryout, troubleshoot, and interpret data from cell cultures, HPLC, Northern/Southern blots, or PCR techniques. Under the tutelage of the preceptor, the third-year trainee will devote 100% time to research.

The progress and efforts made by the trainee will be closely monitored by the preceptor, Dr. Thomas, and the Research Committee. This progress will be reviewed on an every week basis. The trainee will also be expected to present research findings at the REI Division meeting monthly, the Department research seminar (twice per year), combined Endocrine conferences (twice per year) and the Department Grand Rounds (once per year).

It is anticipated that preliminary data generated by research will serve as the foundation for extramural support during this individual's early academic career. This experience could be the basis for further research in the NIH-sponsored Women’s Heatlth Research Scholars program which this department was recently award. In this way, the trainee at the completion of the third year will have developed a credible curriculum vitae, suitable preliminary data, grant and manuscript writing skills, and experience to compete for independent extramural support during his/her academic career.

Throughout the fellowship, trainees will participate in conferences. Attendance at weekly departmental grand rounds, combined Endocrine conferences, research-in-progress seminars, and journal clubs will be expected. Each fellow will be given the rank of Instructor.

The required graduate level course in statistics and the ones in a related endocrine field which each trainee may select are described below (from the University of Cincinnati Bulletin):

Environmental Health 26-904-787 Introduction to Biostatistics. Descriptive statistics, probability distributions, estimation, types of error, significance level, test of hypotheses, sample size, correlation, linear regression, non-parametric methods. Emphasizes practical-applied aspects. 4 graduate credits. (This College of Medicine course is the one which Maternal/Fetal Medicine fellows also take).

Biochemistry and Molecular Biology 26-989-997 to 999. Molecular Biology of the Cell I-III. This three quarter sequence covers protein structure, enzymology, metabolism, basic molecular biology, excitable membranes, morphology of cells and organelle functions, the cell cycle, growth regulation, receptors, secondary messengers, and models of development. 3 graduate credits per quarter. (Dr. Sohaib Khan is one of the major instructors of this course series).

Physiology and Biophysics 26-968-942. Endocrinology. Selected topics of the endocrine system. Emphasis on molecular mechanisms of hormone action and regulation of hormone secretion. 3 graduate credits.

Physiology and Biophysics 26-968-996. Endocrine-Immunological Interactions. Endocrine regulation of the immune system, immunological interactions on the endocrine system. Certain autoimmune disorders will be discussed. 2 graduate credits.

Introduction to Molecular Genetics 26-950-871. Genetic concepts, DNA structure, replication and repair, recombination, transcription, translation, regulation, cloning methods.

Contact: Angel Hall
Deparment of Obstetrics and Gynecology
Medical Sciences Building, Room 4461
231 Albert B. Sabin Way
P.O. Box 670526
Cincinnati, OH 45267-0526
Telephone: (513) 558-6560
Fax: (513) 558-3558
Email: angel.hall@uc.edu

Postgraduate Fellowship Training

Maternal-Fetal Medicine

Reproductive Endocrinology and infertility Training Program