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Assessment of critical care education in the obstetric anesthesiology fellowship curriculum
Abstract Number: SAT-22
Abstract Type: Original Research
Currently, the Accreditation Council for Graduate Medical Education (ACGME) does not require a formal intensive care unit (ICU) rotation during the OB anesthesiology fellowship year.1 Given the increasing rate of severe obstetric morbidity in the US, there may be a need for formal ICU training to be incorporated into OB anesthesiology fellowship curricula.2 We sought to identify whether formal ICU training exists among current US and Canadian OB anesthesiology fellowship programs.
In order to ascertain whether a gap in critical care education and training exists in the obstetrical anesthesiology fellowship curriculum, a survey of critical care curriculums was developed by an expert panel. After IRB approval, the electronic survey was emailed to the 49 ACGME (31) and non-ACGME (16) accredited OB anesthesiology fellowship program directors in the US and Canada. Responses were collected in an anonymous fashion. Univariate statistics were used to evaluate survey responses as percentages.
The survey response rate was 49% (24 out of a total of 49 programs). The percentage of responding programs that require a formal ICU rotation was 12%. More than half of responding program directors (58%) felt that fellows would acquire critical care knowledge more easily if they rotated through a formal critical care setting that focused on care in the postpartum period. The majority (83%) of programs did not have a specific protocol to identify high-risk patients who may require peripartum ICU admission.
Despite increasing emphasis on ICU expertise in OB, our study reveals a heterogeneity and deficiency in standardized critical care curriculum among OB anesthesia fellowship programs. In our survey, only a minority of OB anesthesia fellowships include a specific ICU rotation. However, over half of respondents indicated that an ICU rotation would be of educational benefit to the fellow. The training process for OB anesthesiologists should be periodically reviewed.3 Our survey highlights OB critical care as a potential area of improvement in the OB anesthesiology fellowship curriculum. Efforts to enhance and standardize critical care curriculum in OB anesthesiology fellowship programs may be warranted.
1.ACGME Program Requirements for Graduate Medical Education in Obstetric Anesthesiology. (2016). Retrieved from https://www.acgme.org website
2.Kuklina EV et al. 2009
3.Zwart et al. 2010