Overview of the Recurrent Pregnancy Loss Fellowship
Approximately 5% of couples trying to establish a family encounter recurrent pregnancy loss.
Advanced clinical and research training in RPL is thus needed given the high prevalence of this reproductive disorder
and the limited evidence-based evaluation and treatment protocols which exist today.
The Department of Obstetrics & Gynecology at the University of Illinois Hospital & Health Sciences System leads in patient care and education. The RPL Fellowship Training is enhanced by our comprehensive women’s health program, which includes all OB/GYN subspecialties.
The purpose of this program is to provide advanced training in the diagnosis and treatment of early and recurrent pregnancy loss, with the ultimate goal of developing successful academic clinician-scientists in the field. Diagnosis and treatment of RPL comprise a skill set beyond what is taught in Obstetrics & Gynecology residency or in Reproductive Endocrinology & Infertility or Maternal Fetal Medicine fellowships. The program thus seeks to integrate clinical work with mentored research in basic, clinical, or translational research.
Mentored Research. Fellows will spend 50% of their time on research, with the goal of completing an original research project (or a systematic review). This research will be completed with a research mentor, and may be clinical or translational research, or may invovle basic science. Research mentors are selected based on their areas of expertise and interests, achievement in extramural funding, and a proven record of mentorship, as well as a match to the fellow’s research area. The fellow will have protected time to carry out her/his research activities and career development. During the mentored research time, the fellow will have minimal clinical responsibilities. It is expected that at the culmination of the fellowship, fellows will have at least one manuscript submitted for publication and for presentation at a national meeting.
Clinical Work. In addition to developing the fellow’s fundamental understanding of the etiology and sequelae of recurrent pregnancy loss, the fellow will also hone her/his clinical skills in patient consultation, physical examination, outpatient procedures, performance/interpretation of ultrasound and diagnostic tests, and patient management. Fellows will spend 50% of their time in clinical activities. A sample schedule can be found on the curriculum page.
Education. The Department of Obstetrics & Gynecology has a wealth of educational activities from Grand Rounds, fellow conferences, journal clubs, to hands-on trainings. Fellows may also supplement our educational offerings with a clinical or research elective or with coursework. The University of Illinois at Chicago has 7 Health Sciences Colleges with robust and diverse educational offerings.
Electives. Fellows may choose to do clinical or research electives, locally or abroad, related to RPL. Options include, but are not limited to: early pregnancy, genetics of early pregnancy, rheumatic disease and pregnancy, thrombotic disease and pregnancy, mental health and pregnancy, pathology of implantation or early pregnancy, laboratory medicine for evaluation of RPL, endocrine disorders and pregnancy. Fellows will choose an elective through discussions with the RPL Fellowship Director. Read about our current fellow’s international electives here.
Coursework. The fellow may choose to supplement their training through coursework. The School of Public Health offers a variety of certificate programs in clinical research. It also offers stand alone courses in biostats, research methods, reproductive health epidemiology, etc. The fellow may also choose to attend seminars and classes offered through the Center for Clinical and Translational Science (CCTS) or other programs. Completion of the CCTS’ intensive Clinical and Translational 3-day training at the beginning of their training is recommended. The department will also support the fellow’s attendance at the Exxcellence in Clinical Research training offered annually in Late Spring/Early Fall. The Exxcellence course curriculum provides an intensive introduction to epidemiology, research methods and data analysis.
Teaching. The development of teaching and presentation skills are a significant focus of this fellowship. Fellows will assist the RPL teaching faculty with supervision of OB/GYN residents rotating in the Reproductive Endocrinology & Infertility service. The fellow will lead at least two educational sessions targeted at OB/GYN residents (one for the interns; PGY-1) and one for the residents (PGY-2, 3 and 4). The fellow will present at least once in the REI Interactive Rounds, in the OB/GYN Grand Rounds on a RPL-related topic and/or will present her/his research project or systematic review. The fellow will organize and lead the Recurrent Pregnancy Loss Rounds, which involves presenting patients for review and discussion of management plan, discussing her/his research/systematic review, a published article(s) and/or controversial topics in RPL.
Who Should Apply?
The Recurrent Pregnancy Loss fellowship is aimed at medical doctors who are board-eligible or board-certified in obstetrics and gynecology, and who have completed an ACGME certified residency, or equivalency. The program will provide one year of training for individuals interested in a clinician-scientist career. One fellow will be accepted at any given time. Preference will be given to applicants who are pre- or post-REI or MFM fellowship.
Goals of the Fellowship
The overarching goal of the RPL fellowship is to develop academic clinician-scientists in recurrent pregnancy loss through clinical education and mentored research. The program promotes professionalism, medical knowledge, practice-based learning, and communication.
- To build consultative skills to thoroughly assess patients’ reproductive, medical, social and family history, to elucidate factors which may impact prior and subsequent pregnancy outcomes, and their mental well-being.
- To develop examination skills that may elucidate underlying medical disease which may be associated with a history of recurrent pregnancy loss.
- To formulate appropriate differential diagnoses based on clinical history and examination.
- To order and interpret appropriate laboratory tests and procedures for evaluation of recurrent pregnancy loss and associated medical diseases/disorders.
- To perform and interpret transvaginal and abdominal ultrasound evaluations.
- To formulate evidence-based management plans, for patients with a history of recurrent pregnancy loss.
- To develop patient counseling skills to be able to discuss the recommended management plan and options, and to listen and respond to patients’ concerns in a caring and safe environment.
- To develop teaching skills specific to recurrent pregnancy loss, and to apply these skills when instructing residents and talking with patients.
- To critically appraise the literature related to recurrent pregnancy loss.
- To develop research skills to successfully complete a mentored research project during the fellowship.
Following completion of the RPL fellowship, the fellow will:
- Be able to perform a thorough and timely evaluation, and formulate an evidence-based management plan for patients with recurrent pregnancy loss.
- Have developed expertise in outpatient procedures appropriate for patients with recurrent pregnancy loss.
- Be able to perform and interpret gynecologic and first trimester ultrasound, and offer close first trimester monitoring for patients with recurrent pregnancy loss.
- Be able to assess the mental well-being of the RPL patient, and refer appropriately when required.
- Have prepared at least two didactic or problem-based sessions for residents and/or medical students.
- Have attended at least one national/international scholarly meeting in which RPL research is presented, such as ASRM, SGI or ESHRE.
- Have completed a research project and submitted it for publication.