Maternal-Fetal Medicine Fellowship

Our three-year fellowship program provides both strong clinical and basic science experience to prepare individuals for an academic career and clinical practice.

The fellows rotate between two major teaching hospitals: Hermann Hospital and Lyndon Baines Johnson General Hospital. Hermann Hospital, which is located in the Texas Medical Center, delivers 3,200 patients annually (40% of which are high risk) and receives approximately 300 maternal transports annually. The service is comprised of approximately one-third teaching clinic patients, 10% faculty private practice patients, one-third HMO patients, and the rest are patients of private physicians in the community. There is a 12-bed Maternal Fetal Special Care Unit for antepartum and critically ill patients, and an in-hospital Antepartum Testing Unit that provides a full range of ultrasound, heart rate monitoring, prenatal diagnostic and invasive procedures.

The outpatient clinics at the Medical Center include a resident clinic, private faculty, and ultrasound clinics. The resident clinic includes a high-risk clinic, which is staffed by Maternal-Fetal Medicine fellows and faculty. The ultrasound and prenatal genetics clinics are part of a busy prenatal diagnosis service. We perform chorionic villus sampling, early and regular amniocenteses, basic and targeted ultrasound exams, invasive fetal procedures and genetic counseling.

The Lyndon Baines Johnson (LBJ)/Harris County Hospital District delivers approximately 5,500 patients annually, 50% of whom are high-risk. The LBJ Hospital has an 8-bed Special Care Unit for critically ill gravidas, and also houses a full service Antepartum Testing Unit with capabilities for both basic and targeted ultrasound examinations, as well as fetal echocardiography, color doppler flow studies, and prenatal diagnostic services including invasive fetal procedures.

Most of the divisional faculty members spend some time at each hospital site, but are primarily assigned to one institution. The Hermann Hospital site faculty includes Drs. Susan Ramin, Joan Mastrobattista, Manju Monga, Mildred Ramirez, and Alex Vidaeff.

• Dr. Sean Blackwell joined our faculty in July of 2007. He is an Associate Professor and Principal Investigator of the NICHD MFMU Network. He completed his residency and Maternal-Fetal Medicine Fellowship at Wayne Station University. His areas of interest are fetal brain injury, stillbirth, shoulder dystocia, intrauterine infection, informatics, clinical trials, fetal diagnosis and therapy, CVS, fetal blood sampling, fetal anemia, medical complications, thrombophilia.
• Dr. Susan Ramin joined our faculty in August 1998 as the Director of the Division of Maternal-Fetal Medicine and Maternal-Fetal Medicine Fellowship Program. She completed her residency and Maternal-Fetal Medicine Fellowship at the University of Texas Southwestern Medical Center at Dallas. She joined their faculty in 1990 and served two years (1996-1998) as Director of the Maternal-Fetal Medicine Fellowship Program. Her areas of interest include medical complications of pregnancy, labor analgesia, and clinical obstetrics. In September 2006, Dr. Ramin became our Department's Chairman.
• Dr. Joan Mastrobattista completed her Maternal-Fetal Medicine fellowship in our Department in June 1994 and immediately joined the faculty as Director of Prenatal Genetics. She was promoted to Associate Professor in 2001. She is also Director of the Hermann Hospital Antepartum Testing Center. Her areas of interest include ultrasound, diabetes mellitus, and prenatal diagnosis.
• Dr. Manju Monga completed her Maternal-Fetal Medicine fellowship in our Department in 1993 and immediately joined our faculty. Her research interests are in myometrial contractility and preterm labor. Her work has been in collaboration with the Department of Biochemistry. In 2000, she became the Residency Program Director for the Hermann Hospital Program. She was promoted to Associate Professor in 1999 and full Professor in 2006.  In September 2006 Dr. Monga became the Maternal-Fetal Medicine Division Director and Director of the Maternal-Fetal Medicine fellowship.
• Dr. Mildred Ramirez completed her Maternal-Fetal Medicine fellowship in our Department in June 1993. She worked for MacGregor Health Care System after completing her fellowship. She joined the faculty as Associate Professor in September 2001. Her areas of interest include placental hormones, preterm labor, and biochemical markers of preterm labor.
• Dr. Jerrie Refuerzo joined our faculty in July of 2007 as an Assistant Professor. She completed her residency and Maternal-Fetal Medicine Fellowship at Wayne State University. Her areas of interest are medications in pregnancy, critical care obstetrics, maternal medical conditions
• Dr. Alex Vidaeff completed his MPH Degree and Maternal-Fetal Medicine fellowship in our Department in 2003 and immediately joined our faculty as Assistant Professor.  He has particular interest in research on corticosteroids and fetal maturation.  He also has expertise in working with H-441 adenocarcinoma lung cells.  Dr. Vidaeff also has an interest in medical complications of pregnancy and clinical obstetrics.

The faculty members at the Lyndon Baines Johnson Hospital include Drs. Edward Yeomans, Lisa Hollier and Michael Lucas.

• Dr. Edward Yeomans completed his Maternal-Fetal Medicine fellowship at the University of Texas Southwestern Medical Center in Dallas. After five years as Chief of Obstetrics at Wilford Hall Air Force Hospital in San Antonio and 2½ years as Director of Maternal-Fetal Medicine at the University of Texas Medical Branch at Galveston, he joined us as an Associate Professor in March 1995. He is a nationally recognized educator whose interests are clinical obstetrics and medical complications in pregnancy.
• Dr. Lisa Hollier completed her Maternal-Fetal Medicine fellowship at the University of Texas Southwestern Medical Center at Dallas in 1997 and immediately joined the faculty for one year. She joined our faculty as an Assistant Professor in August 1998. Her areas of interest include clinical obstetrics, multifetal gestations, and medical complications of pregnancy.
• Dr. Michael Lucas completed his Maternal-Fetal Medicine fellowship at the University of Texas Southwestern Medical Center in Dallas and then immediately joined their faculty in 1987. In April of 1999 he became Director of the Division of Maternal-Fetal Medicine at LSU Health Sciences Center in Shreveport, Louisiana. He joined our faculty as a Professor and Director of Sonography at LBJ Hospital Antepartum Clinic on July 1, 2002. Dr. Lucas' areas of interest include diabetes, ultrasound, and medical complications of pregnancy.

The fellowship program encompasses three years. During that time, 12 months are required on clinical Maternal-Fetal Medicine rotations, 6 months of elective rotation (clinical or research), and 18 months are spent on research/didactic rotations. Clinical months are spent on the inpatient obstetrical service at each hospital (Hermann and LBJ), outpatient Maternal-Fetal Medicine consultation services, and various off-service rotations. The off-service rotations include genetics, infectious diseases, obstetrical anesthesia, neonatology, and critical care. The clinical rotations in the Neonatal Intensive Care Unit may be done at either Hermann Hospital or LBJ, depending on the fellow's preference. The critical care rotation is a one-month rotation in the 45-bed Surgical Intensive Care Unit at Hermann Hospital, which is a major Shock/Trauma Unit for the city of Houston. The Critical Care faculty of the Department of Anesthesiology and General Surgery supervises this rotation.

At least 18 months of the three-year fellowship will be spent in a comprehensive research program under the direction of one of the faculty members. It will be the fellow's choice as to whether the research program will be clinically or basic science oriented. The physical site of the fellow's research program may be at either Hermann Hospital or LBJ, again dependent on the fellow's preference and faculty advisor.

We have developed focused training programs in infectious disease, critical care, genetics, public health, and maternal physiology. These programs may be tailored to provide a Masters of Public Health or Masters of Science in Clinical Research during the three-year fellowship. A combined Critical Care/Maternal-Fetal Medicine Fellowship program is also available, which provides the opportunity for the fellow to meet the requirements to sit for both the critical care and Maternal-Fetal Medicine board exams. At least two courses in the Graduate School of Biological Sciences (GSBS) - including biostatistics - are required for completion of the fellowship. The fellow's rotation and research schedule can be flexible and is usually tailored to his/her particular needs and interests.

The graduates of our fellowship program have done extremely well in their pursuit of academic careers. We feel that they have become outstanding Maternal-Fetal Medicine clinicians, as well as getting a good start to their basic science and/or clinical research careers. Several of our past fellows won prestigious awards.  For example, Dr. Tracy Cowles won the 1992 SPO Foundation Fellowship to pursue a third year of training in genetics, and both Dr. Bruce Feinberg (1990) and Dr. Manju Monga (1993) won the prestigious American Gynecologic and Obstetric Society Foundation Fellowship award, which funded two further years of full-time basic science laboratory training.  Our recent graduates have pursued academic careers; Nora Doyle (2005) at Emory University, Mary Ann Carroll (2006) at University of Wisconsin, and Linda Fonseca (2006) at Northwestern University.

Also, the University of Texas-Houston Medical School is one of the 14 centers that participate in the National Institutes of Health Maternal-Fetal Medicine Units Network. This is a five year grant that was awarded for the time period of April 2001-2006.  Participating in this network allows us the opportunity to do randomized clinical trials to further learn about conditions complicating pregnancy and improving the outcome of mothers and their infants.

APPLICATION PROCESS

We require a curriculum vitae, a personal statement, a 2 x 2 photo of yourself, and three letters of recommendation, including one from your current Department Chairman. Upon review of these materials, we will contact you to arrange a mutually convenient time for an interview here in Houston. The deadline for receipt of application materials is August 1. We would like to complete our interview process and make our rank order list by the last week in September. We participate in the Fellowship Matching Program and require that all applicants participate as well.

If we can be of further assistance to you with the application process, please do not hesitate to contact Dr. Manju Monga's office at:

email:  Lana.Kubena@uth.tmc.edu