Center for Fetal Research: Fetal Diagnosis and Therapy Fellowship
- About the Center for Fetal Research
- Fetal Diagnosis and Therapy Fellowship description
- Requirements
- Resources
- Education
- Research
- Evaluation
- Contact
About the Center for Fetal Research
The Children's Hospital of Philadelphia established the Center for Fetal Research for the Center for Fetal Diagnosis and Treatment in 1995 under the leadership of N. Scott Adzick,MD. The Center for Fetal Research is one of only a handful in the world where open fetal surgery is performed. This Center provides integrated, multidisciplinary care for mothers carrying a fetus with a known anatomic or genetic birth defect that requires therapy before and/or after birth. Comprehensive services range from prenatal evaluation and diagnosis to treatment, including invasive fetal therapy and open fetal surgery. By considering the fetus as a separate patient, the Center for Fetal Diagnosis and Treatment brings a new perspective to the care of pregnant women. The collaboration of numerous specialists enables us to provide high-quality, state-of-the-art care to treat both patients — mother and child — together at one center.
The perception of the fetus as a patient is gaining momentum and the number of successful interventions applicable to the fetus has increased rapidly. At the present time, these interventions are performed by either maternal fetal medicine specialists or pediatric surgeons or by a combination of the two. In neither specialty, however, is specific training focused on the fetus readily available. This has led to recognition of the need for additional training opportunities in this area.
Fetal Diagnosis and Therapy Fellowship description
This new program trains maternal-fetal medicine specialists in prenatal assessment, counseling and management of pregnancies with complex anomalies.
The goal of the fellowship is to foster the development of a new generation of fetal specialists focused on the investigation and management of fetal disease. Fellows should also be capable of developing patient-oriented and/or basic research careers directed toward fetal biology and therapy.
Training emphasizes a rigorous, programmatic, multidisciplinary approach to the scientific analysis of fetal treatment within the maternal-fetal unit. Fetal therapy is by necessity a multidisciplinary endeavor with contributions from a variety of fields. This is reflected in the faculty that participates in the fetal therapy program. The program focuses on developing and teaching unifying concepts as they apply to the fetus and fetal treatment.
Requirements
The training program is one year in duration. Candidates can enter the program from training programs in either obstetrics and gynecology or genetics. Candidates must possess certification in either primary discipline. They must also be enrolled in or have completed a subspecialty fellowship program in maternal-fetal medicine or prenatal/reproductive genetics.
Resources
Center for Fetal Diagnosis and Treatment
The Center for Fetal Diagnosis and Treatment is the largest and most comprehensive center of its kind in the world. The Center offers comprehensive, multidisciplinary, state-of-the-art diagnostic services, as well as counseling and care for pregnant mothers and families. In addition, the Center offers a broad array of fetal intervention options, ranging from amniocentesis to open fetal surgery. The staff has extensive clinical experience in maternal-fetal medicine, neonatology, pediatric surgical subspecialties, genetics, prenatal diagnosis, fetal imaging and anesthesia.
Through our emphasis on the fetus as a patient, the Center prioritizes fetal diagnosis and care in the context of the maternal-fetal unit. Since 1995, the Center has received more than 10,000 referrals from all 50 states and 46 countries. More than 500 fetal procedures have been performed, in addition to 80 EXIT procedures. There are four full-time obstetrical faculty. Dr. Mark Johnson is trained both in obstetrics and gynecology and reproductive genetics. Drs. Michael Bebbington and Stephanie Mann are trained in obstetrics and gynecology, and maternal-fetal medicine. Dr. Bebbington also has a master’s degree in epidemiology and biostatistics. There currently are three full-time pediatric surgeons on faculty -- Drs. N. Scott Adzick, Alan Flake, and Holly Hedrick, all of whom completed fellowships in fetal surgery.
Fetal Heart Program
The Fetal Heart Program directed by Dr. Jack Rychik uses state-of-the-art technology to provide detailed anatomic and functional evaluation of the fetal heart as a core consultation service. It is one of the largest fetal heart programs in the United States.
Imaging services
World-class imaging services are supplied by the Radiology Department of the Hospital of the University of Pennsylvania (HUP) under the direction of Dr. Beverly Coleman, and fetal MRI services are readily available at Children's Hospital under the leadership of Dr. Anne Johnson for body MRI and Larissa Bilaniuk for neuro MRI.
Labor and delivery facilities
The Center involves the participation of medical and surgical specialists from CHOP and the University of Pennsylvania community who have a special interest in fetal therapy. The newly opened Garbose Family Special Delivery Unit provides labor and delivery facilities within the Children's Hospital of Philadelphia. The Center also includes a medical ethics panel review, social services and financial counseling as well as psychological support for families involved in our programs.
The Center for Fetal Research
The Center for Fetal Research, under the direction of Dr. Alan Flake, functions as the research arm for the Center for Fetal Diagnosis and Treatment and is focused on basic science and translational research questions related to fetal biology and treatment. The Center is located in the Abramson Research Center adjacent to Children's Hospital. The Center currently has the only NIH funded grant to train future medical specialists in fetal biology. Investigators have a history of training numerous research fellows from a variety of specialties at different levels of career development who are interested in fetal treatment.
Visit the Fetal Therapy Research site
Education
Imaging
Our one-year program trains fellows to provide high quality clinical care with an emphasis on prenatal evaluation using a variety of imaging and testing techniques. The ultrasound service of the fetal surgery program has the most up-to-date equipment with both 2D and 3D capabilities. Fellows are expected to develop advanced scanning skills and to learn management skills to supervise and support the technical staff.
Counseling
Fellows participate in management counseling and in-utero intervention in select cases that meet specific indications. Training gives the physician fellow a concentrated exposure to a wide range of congenital anomalies, allowing him or her to:
- Develop expertise in prenatal assessment
- Learn appropriate counseling for each type of anomaly
- Understand and be able to counsel families about management options, including in utero therapy
- Develop and recommend appropriate follow-up obstetrical care and delivery planning to optimize outcomes for the infant
The focus is on training MFMs to develop expertise in prenatal assessment, counseling and management of pregnancies with complex anomalies.
Clinical and research rounds
Clinical and research rounds are held on a regular basis. There is a weekly multidisciplinary fetal conference where formal discussion of new referrals and ongoing cases from the previous week (including review of all imaging studies) takes place. Staff also present follow up information on previous patients, covering various points in time, particularly neonatal outcomes.
There is a weekly seminar of scientific presentations by faculty members, invited speakers and research fellows on a rotating basis. This provides a forum for program faculty to present their research in detail, for fellows to present projects to an audience of colleagues, and for internal and external speakers to present current research issues in fetal therapy. In addition, various special interest groups sponsor small group seminars on a regular basis. This may include groups such as the Stem Cell group and the Institute for Human Gene Therapy.
Grand rounds
The departments of General Surgery and Pediatrics at Children's Hospital have weekly grand rounds as does the Department of Obstetrics and Gynecology at the Hospital of the University of Pennsylvania (HUP). The maternal-fetal medicine group at HUP also sponsors a weekly journal club and seminar series.
Graduate courses, conferences and workshops
Fellows are encouraged to take one or more graduate courses at the medical school or the university to extend their level of scientific sophistication. The biomedical graduate studies groups have courses ranging from immunology and molecular biology through epidemiology and biostatistics. The office for faculty development at the University of Pennsylvania also offers conferences, workshops and e-based learning courses on subjects such as grantsmanship, writing for scientific journals, time management and others.
Research
Fellows will choose a research training experience that will be primarily a patient-oriented research project carried out in conjunction with the Center for Fetal Diagnosis and Treatment. Training faculty have been chosen based on their proven ability to direct a patient-oriented research program. It will be the responsibility of the research mentor to direct the trainee in the selection of an important scientific question, analysis of the research area, development of hypotheses, and design of experiments to address these hypotheses and the analysis of the experimental results.
Evaluation
The fellow will be assigned a primary mentor during the program whose job it will be to monitor progress and solicit evaluation input from the faculty. Every three months, fellows will meet with their mentors and a formal written assessment will be compiled to document progress towards the formal objectives. Fellows will be required to present the results of their research project at a national meeting and to write up the results for submission for publication.
Contact
Michael Bebbington MD, MHSc, program director
The Children’s Hospital of Philadelphia
Center for Fetal Diagnosis and Treatment
5th Floor, Wood Center
34th Street and Civic Center Blvd
Philadelphia, PA 19104
E-mail: bebbington@email.chop.edu
Phone: 267-426-7187
Fax: 215-590-2447
Contact Us
- 1-800-468-8376
- (1-800-IN-UTERO)
