MFM Fellowship Application - Downloadable .pdf format. Please print out the application, complete it and mail it to the address below.

University of Iowa House Staff Training Program Policies and Procedures

Director: Jerome Yankowitz, MD

The University of Iowa Hospitals and Clinics is the sole tertiary health care center for the State of Iowa, and referrals also come from out of state. The Staff consists of full-time faculty in the College of Medicine, and so the complete patient population is available for teaching and clinical research.

The Division of Maternal-Fetal Medicine presently includes five board certified maternal-fetal specialists. They are: Jennifer R. Niebyl, MD (Department Head), Asha Rijhsinghani, MD, Jerome Yankowitz, MD, Janet I. Andrews, MD, and Stephen K. Hunter, MD, PhD. Dr. Roger A. Williamson, double boarded in Genetics and Obstetrics, is also a member of the Division. Dr. Yankowitz is also board certified in clinical genetics.

Over 800 of the deliveries resulted from maternal transports. Roughly 70% of the patients delivered at the University of Iowa have clear cut medical, surgical, or obstetrical complications of pregnancy. There are almost 500 antepartum admissions per year. If demographic factors such as marital status, age, and socioeconomic status are included in the definition of high risk, at least 80% of the population is easily classified as high risk.

The patients are cared for in a series of clinics. The High Risk Obstetric Clinic meets three days a week. Typically, three to four new and 25-30 return patients are evaluated per session. Approximately 20 insulin dependent and 50 gestationally diabetic women receive care through the High Risk Service annually. In addition, there is a representative sample of nearly all other complications of pregnancy.

Genetic care in the state is regionalized, and when indicated, the patient is referred to the University. The section of Obstetrical Genetics consists of Dr. Roger A. Williamson (Director) and Dr. Jerome Yankowitz. A statewide maternal serum-screening program is regionalized by the central State Hygienic Laboratory by statute. Dr. Williamson is the physician coordinator for the program. Triple hormone screening began in June 1990, and some 14,000 women are screened each year. Last year, 400 women were referred to the University of Iowa because of an abnormal MSAFP level. The Genetics Section encounters approximately 1,300 patients annually. Of these, approximately 1,000 undergo amniocentesis or CVS. During five half-day sessions per week, evaluation and counseling of patients of known or presumed risk for genetic disorders is carried out. The Genetics Clinic is a part of the Department of Obstetrics and Gynecology and it enjoys a close working relationship with the Division of Medical Genetics in the Department of Pediatrics. Two former M-F-M fellows have combined their third year with a Genetics fellowship.

The University of Iowa has a well-established multidisciplinary Fetal Diagnosis and Treatment Unit under the direction of Dr. Yankowitz. Scheduled office hours are presently held 2 days per week during which 20 to 30 patients are seen per day. The majority of level II scans, anomaly consultations, and interventional fetal procedures in the state are performed by this unit. Many cordocenteses and intravascular transfusions are performed each year. The major interest of the team is the development of fetal medicine. The Obstetrics and Gynecology Ultrasound Program is certified by American Institute of Ultrasound in Medicine (AIUM).

The fellowship at Iowa is designed to permit maximum growth of clinical and research skills. We adhere to a basic philosophy: the fellow is here for academic pursuit and development of world-class clinical skills.

The first two years are similar in sequence. The fellow spends three months each year staffing the High Risk Service in conjunction with one of the members of the Division of Maternal-Fetal Medicine and one more in the Surgical Intensive Care Unit. Throughout the fellowship, the fellow will help supervise the High Risk Obstetric Clinic and participate in both the Genetics and Fetal Diagnosis and Treatment Units where advanced diagnostic ultrasound and invasive fetal medicine will be taught. It is recommended that the fellow complete formal course work during the first year in such areas as Biostatistics, Epidemiology, or Genetics. The remainder of the year is for research.

A research stipend is supplied by the Department when justified by a budget. Databases are maintained by the Fetal Diagnosis and Treatment and Genetics Units. Examples of previous clinical studies include the use of tocolysis in women with PROM, low dose aspirin for multiple gestation, dose of oxytocin for induction and augmentation of labor, and placebo-controlled trials of the terbutaline pump and the home uterine monitor. Currently studies are being carried out on fetal fibronectin and early versus later umbilical cord clamping (NIH supported).

Laboratory opportunities are extensive and all fellows are encouraged to participate. There is sufficient time, laboratory space, and financial support for research endeavors by fellows. Perinatal research is being conducted by members of the Division and the Departments of Medicine, Pediatrics, and Anesthesia. Most laboratories on campus are open to fellow participation. A large number of university-wide "core" facilities have been established. The Division maintains active laboratories in biochemical and molecular biological studies. In addition, Dr. Williamson is the Director of the Gene Targeting Core Facility.

Most former fellows are in academic medicine. Seventy-five percent are funded investigators.

Applicants must have passed the written Part I of the general obstetric and gynecology examination administered by the American Board of Obstetrics and Gynecology prior to entering training. The Division participates in the Fellow Match Program. Fellows in special circumstances will be considered.

Further information may be obtained from Dr. Jerome Yankowitz, Director, Division of Maternal-Fetal Medicine and Fetal Diagnosis and Therapy Unit by telephone at (319) 356-2574 or by fax at (319) 353-6759.

Department of Obstetrics and Gynecology
Division of Maternal-Fetal Medicine
University of Iowa Hospitals and Clinics
200 Hawkins Drive
Iowa City, IA. 52242-1080