The fellowship in obstetrical anesthesia is a program in the Division of Obstetrical Anesthesia in the Department of Anesthesiology at University Hospitals of Cleveland, on the campus of Case Western University. The directors of the Division of Obstetrical Anesthesia are Dr. Susan Dumas and Dr Evan Goodman, and the director of the Department of Anesthesiology is Dr. Howard Nearman. Our fax number is (216) 844-3815, and our email addresses are as follows:
Obstetrical Anesthesia Applications:
Although the fellowship has been in existence for fifteen years, we have not had a fellow complete the program each year. Among the several people who did elect to stay for the year was Dr. McCallum Hoyt. She became the director of the division shortly after the end of her fellowship (in the 1980s), and she remained in that position until several years ago.
The goals of the fellowship in obstetrical anesthesia are threefold:
- To provide intense training in all aspects of anesthesia care for labor and delivery, including high-risk pregnancies, teen and the older pregnancies, multiple birth pregnancies, and anesthesia for infertility procedures.
- To be involved in obstetrical anesthesia research, with the goal to present the results at the annual meeting of the Society for Obstetric Anesthesia and Perinatology.
- To be involved in the teaching of those just beginning their experience in obstetrical anesthesia. Teaching responsibilities include supervising and guiding the first year anesthesia residents and the anesthesia assistant students. Fellows are also expected to lecture to these beginning clinicians as we give them a cycle of twelve lectures each month.
In the past, this entire fellowship has taken place at the University Hospitals of Cleveland. Our Labor and Delivery unit delivers approximately 5000 women each year. We are involved with many high-risk deliveries, and we are backed up by a neonatal intensive care unit, located close to the Labor and Delivery area. The high-risk clinic sees women with disorders ranging from severe preecplampsia to a myriad of cardiac and neurologic abnormalities. Some of our patients have interesting concerns because of their young age or their drug abuse. We also have an active infertility service, whose work generates many more multiple birth pregnancies than we would otherwise have.
As anesthesia providers, we are involved in the care of a majority of patients who come to Labor and Delivery. Most procedures require the participation of the anesthesia team, and 80-90% of laboring patients elect to have epidural analgesia.
An obstetric anesthesia fellow in our program benefits from the input and teaching from many different attending anesthesiologists. Members of our group who frequent the Labor and Delivery floor, besides Dr. Dumas and Dr. Goodman, include Dr. Barbara Dabb, Dr. Victoria Eskinazi, Dr. Carl Forrest, Dr. Raymond Graber, Dr. Adam Haas, Dr. Gareth Kantor, Dr. Jana Kirilcuk, Dr. Lora Levin, Dr. Agnes Lina, Dr. Peter Matgouranis, Dr. Anne Meyers, Dr. Girish Mulgaokar, Dr. Annemarie Norenberg, Dr. Margaret Sedensky, Dr. Subhalakshmi Sivashankaran and Dr. David Wallace.
This year we have arranged for our fellow to spend a month at Metro Health Center, which is affiliated with the Cleveland Clinic. We have been working with the head of the Division of Obstetrical Anesthesia at Metro, Dr. Norman Bolden, to make the final arrangements. Seeing other methods of practicing obstetrical anesthesia will greatly broaden the experience of the fellow.
The obstetrical anesthesia fellow will participate in patient care as part of the anesthesia team on Labor and Delivery. He will also take 24 hour calls each month and have the following day off.
In three-month intervals, the fellow’s progress will be assessed at the Obstetric Anesthesia Task Force meeting. Suggestions for change and recommendations for improvement will entertained at that time.