BWH Maternal Fetal Medicine Fellowship Program

Overview

The Maternal-Fetal Medicine (MFM) Fellowship Program at Brigham and Women’s Hospital (BWH) combines the resources of the largest obstetrical service in the New England region with the research and teaching expertise of the Harvard medical complex. Annually, there are approximately 8,000 deliveries, 600 admissions to the high-risk antepartum service, and over 300 maternal transports.

Facilities include a 74-bed high-risk antepartum/postpartum unit, 24 labor-delivery-recovery rooms, 4 dedicated operating rooms, a neonatal intensive care unit with 66 beds, and an ambulatory high-risk floor containing the Center for Fetal Medicine and Prenatal Genetics with ultrasound equipment, electronic fetal heart-rate monitoring capabilities, genetic counseling, and high-risk consultative services. In the outpatient setting, approximately 400 high-risk consultations are conducted annually, many of which derive from recently diagnosed fetal conditions such as anomalies, arrhythmias, isoimmunization, and nonimmune hydrops. Additionally, over 1,400 women are seen per year by the genetic counselors for a range of concerns including aneuploidy risk, carrier screening, teratogen exposure or a significant family history.

Close multidisciplinary relationships exist among neonatology, obstetric anesthesia, genetics, pathology, medicine, and surgery departments within BWH and at Boston Children's Hospital. Division faculty and other selected subspecialists closely supervise all services in which fellows are involved.

Requirements

Applicants must have completed training in an accredited Obstetrics and Gynecology residency program and meet eligibility requirements for fellowship training in maternal-fetal medicine.

Curriculum

During the majority of the first year, the fellow provides care for patients on the inpatient unit. Most of these patients are antepartum, although an in-depth experience in critically ill postpartum patients is also obtained during this rotation. The first year additionally includes time to initiate training in ultrasound and perinatal consultation as well as a dedicated research block. Each fellow begins longitudinal continuity outpatient care in our Special Obstetrics Clinic.

Second- and third-year fellows enhance their ambulatory training through a dedicated outpatient ultrasound and consultation blocks provided in the Center for Fetal Medicine. Fellows participate in consultations for fetal anomalies, arrhythmias, isoimmunization, and other complex conditions. Fellows perform procedures including chorionic villus sampling, amniocentesis, PUBS, multifetal pregnancy reduction, and intrauterine transfusions. Additionally, they have elective and research blocks.

First-Year Training

• Fellows primarily provide care on the inpatient unit, focusing on antepartum patients and critically ill postpartum patients
• Exposure includes antepartum complications (e.g., preterm premature rupture of membranes, preterm labor, third-trimester bleeding, hypertension/preeclampsia) and maternal/fetal conditions (e.g., cardiac, rheumatologic, neurologic, oncologic diseases, fetal growth restriction, multifetal gestations)
• Initiation of ultrasound and perinatal consultation training
• Dedicated research block
• Continuity outpatient care begins at the Special Obstetrics Clinic, managing patients with diverse medical and obstetrical complications

Second/Third-Year Training

• Dedicated outpatient ultrasound and consultation blocks in the Center for Fetal Medicine (CFM), where fellows see patients with current or anticipated pregnancy complications under MFM staff supervision
• Participation in genetic counseling of high-risk screening results, diagnosis of ultrasound anomalies, and availability of advanced genetic testing options
• Counseling and management of diagnostic and therapeutic needle-based procedures including chorionic villus sampling, amniocentesis, multifetal pregnancy reduction, and PUBS with intrauterine transfusion
• Critical care rotations through the surgical ICU and with teams in obstetric anesthesia and cardiac anesthesia
• Lead clinician on labor and delivery in two-week intervals
• Clinical electives include, but are not limited to: NICU, maternal subspecialty clinics, genetics, fetal echo, and advanced ultrasound rotations
• Minimum 12 months of protected research time

Learning Opportunities

• Daily formal rounds with a board-certified or board-eligible MFM subspecialist
• Weekly multidisciplinary conferences with obstetricians, neonatologists, geneticists, sonographers, and other adult and pediatric subspecialists
• Weekly Special Obstetrics Clinic conference supervised by MFM faculty
• Weekly Ob/Gyn Grand Rounds throughout the academic year
• Annual postgraduate course in MFM sponsored by BWH Department of Obstetrics and Gynecology and Harvard Medical School
• Weekly didactic lecture series covering MFM concepts on a three-year repeating cycle

Combined Maternal-Fetal Medicine and Genetics Fellowship

• Accredited 4-year program through Boston Children’s Hospital and Brigham and Women’s Hospital. This program recruits every other year.
• Graduates are eligible for both MFM and clinical genetics boards.

Training structure

Year 1: MFM inpatient care, three months in clinical genetics, outpatient continuity MFM clinic

Years 2-3: Alternating six-month blocks of clinical genetics (at Boston Children’s Hospital, Massachusetts General Hospital, and DFCI) and maternal fetal medicine, including outpatient and ICU experiences

Year 4: Laboratory rotations in cytogenetics, molecular genetics, biochemical genetics, and continued research; outpatient continuity MFM-genetics clinic

• Participation in core didactic program required
• Program goal: develop expertise in the interface of MFM and clinical genetics, including leadership in research and clinical care

Participation in core didactic program required.

Program goal: develop expertise in the interface of MFM and clinical genetics, including leadership in research and clinical care.

Combined Maternal-Fetal Medicine and Addiction Medicine Fellowship

Accredited 4-year program at Brigham and Women’s Hospital and affiliated sites (BWFH, Highpoint Brockton OTP, Spectrum Health, etc.).

Graduates are eligible for both MFM and ABPM Addiction Medicine boards

Training structure:

• Year 1: 6 months of MFM (mostly inpatient care, along with year-long continuity clinic in MFM); 6 months of Addiction Medicine (5 months inpatient consults, 1-month elective time)
• Years 2-3: 9 months of MFM (mostly outpatient procedures/ultrasound/genetics and research); 3 months of outpatient Addiction Medicine. *Year 2 longitudinal clinic in BWH Bridge Clinic; Year 3 longitudinal clinic in MFM with focus on Perinatal SUDs/Psychiatric Disease*
• Year 4: 12 months of MFM (mostly elective/research); continuity MFM/Addiction clinic. Sit for Addiction Medicine board exam. Opportunities (inpatient and outpatient) to practice as an independent addiction provider.

Program goal: To train the next leaders in perinatal substance use disorders, both as clinicians and researchers

Fellows have 12 months of research time distributed across training to support the development of an individualized research experience.
Additional training in research methodology, study design, statistical analysis, and scientific writing is available through the Harvard School of Public Health. Fellows also have access to large clinical datasets and specimen databases within the division.

Combined Maternal-Fetal Medicine and Critical Care Medicine Fellowship

• Accredited 4-year program at Brigham and Women’s Hospital (Critical Care Medicine Fellowship through the Department of Anesthesia)
• Graduates are eligible for both MFM and Critical Care Medicine boards
• This training pathway is flexible with individuals combining their critical care training throughout the MFM fellowship vs individuals adding a 4th year after completion of the MFM fellowship
• Fellows complete comprehensive rigorous training in both MFM and the full spectrum of critical care medicine- which combines core rotations through a range of specialties in critical care. Fellows obtain experience in the care of general critically ill adult patients in the ICU setting (not limited to obstetric populations) alongside advanced training in high-risk pregnancy and complex maternal conditions. Fellows gain experience in point of care ultrasound, care for patients on ECMO and those requiring mechanical circulatory support. They also gain experience in the contemporary care of patients suffering from trauma or burn injuries.
• This pathway prepares physicians to bridge obstetrics and critical care, equipping them to lead multidisciplinary teams and care for the most medically complex patients across the spectrum of pregnancy and critical illness.
• Program goal: To train the next leaders in high-acuity medically complex patients, both as clinicians and researchers.

How to Apply

Applicants should submit application materials according to fellowship program guidelines. Required materials typically include a curriculum vitae, personal statement, letters of recommendation, and documentation of residency training must be submitted by April 27, 2026. If you have any questions, please contact the Fellowship Coordinator, Margie Ruiz at mruiz@bwh.harvard.edu or 617-732-5452

Fellowships and Faculty Contacts

• MFM Fellowship Program Director: Katherine Economy, MD
• MFM Fellowship Associate Director: Carolina Bibbo, MD
• MFM/Genetics Fellowship Associate Director: Stephanie Guseh, MD
• ACGME Program ID: 2302422003
• Fellowship Coordinator Contact: Margie Ruiz – mruiz@partners.org | 617-732-5452

Name /Research Interest

• Lysa Auguste, MD MFM / Health equities, hypertensive disorders, structural racism impact, quality improvement.
• Kira Bromwich, MD MFM / Labor management, fetal monitoring, quality improvement.
• Megan Bunnell, MD MFM-Genetics / Genetic counseling, prenatal screening, first trimester ultrasound.
• Sarah Miller, MD MFM / Placenta accreta spectrum, surgical obstetrics, medical education.
• Briana O’Leary, MD MFM-Genetics / Prenatal genetic screening/diagnosis, fetal imaging, quality improvement.
• Gregory Woods, MD MFM-Addiction/ Addiction medicine, complex psychiatric care, ultrasound.