Obstetric Anesthesiology

About the Program:

Our OB Anesthesia Fellowship, established in 1996, attained ACGME accreditation in 2013. Currently, we offer two fellowship positions in OB Anesthesia. Our primary hospital site is Parkland Memorial Hospital, a bustling county hospital that caters to a vibrant and diverse patient population. With an average annual delivery volume of approximately 14,000, Parkland boasts an impressive neuraxial rate of 80%. Additionally, we have a strong affiliation with Clements University Hospital, which sees around 2,500 deliveries annually and maintains an exceptional neuraxial rate of 90%. Both hospitals cater to a wide range of patients, from low to high-risk, and have earned the esteemed SOAP Center of Excellence certification.

Objective of the Fellowship:

Upon completion of the fellowship year, our aim is for the fellow to emerge as a proficient physician consultant and a recognized authority in the field of anesthesiology, particularly in the context of obstetric anesthesiology. By fostering personal, professional, and interprofessional growth and establishing meaningful relationships, the fellow will serve as a dedicated representative of obstetric anesthesiology throughout their future career, whether it be in private or academic practice. The fellowship is designed to accomplish the following specific goals: 

• Foster meaningful connections with patients, demonstrating empathy, respect, and cultural sensitivity. 
• Conduct comprehensive evaluations to identify potential risks or medical considerations, ensuring appropriate preoperative management. 
• Employ appropriate anesthesia techniques tailored to individual patient needs, aiming for safe and successful delivery experiences. 
• Articulate pertinent patient information, anesthesia plans, and potential considerations in a succinct and organized manner. 
• Collaborate with various healthcare providers to develop comprehensive care plans that address the unique needs of complex obstetric cases. 
• Share knowledge and expertise through effective teaching and mentoring, ensuring the dissemination of best practices in obstetric anesthesia. 
• Stay informed about the latest research and advancements in obstetric anesthesia, engaging in evidence-based discussions and continuous learning. 
• Embrace evidence-based practice and integrate new knowledge and technologies to enhance patient care and outcomes. 
• Actively listen to patients, colleagues, and other healthcare team members, fostering effective communication and understanding. 
• Provide constructive feedback to colleagues, learners, and oneself, while also being open to receiving feedback for personal and professional growth. 
• Showcase expertise by creating and delivering presentations on important topics in obstetric anesthesia, promoting academic and professional development. 
• Uphold high ethical standards, treating patients and colleagues with empathy, compassion, and respect. 
• Harness the power of technology to assess patient data, stay updated with medical literature, and enhance evidence-based decision-making.

Our People:

Leadership rosters: 

Roster of Current/Past Fellows: 

2022-2023 

Nguyen Nguyen, DO 

New Role: Assistant Professor, OB Anesthesia Faculty at Yale  

2021-2022 

Hannah Burcham, MD  

New Role: Assistant Professor, OB anesthesia faculty at UTSW 

Sannoor Surani, MD  

Anesthesiologist, Metro Anesthesia Group, Dallas, TX 

2019-2020 

Miakka Jalloh, MD 

Assistant Professor, UTSW 

Katherine Duncan, MD 

Anesthesiologist, Fairfax Anesthesiologist Assoc, VA 

2018-2019

Kelechi Brenda Anyaehia, MD 

Co-Director Obstetric Anesthesiology Parkland Memorial Hospital 

Assistant Professor, UTSW 

Tristyn St. Thomas-Achoja 

Anesthesiologist, Kaiser Permanente, CA 

2016-2017

Michelle Eddins, MD 

Anesthesiologist, John Peter Smith Hospital, Fort Worth, TX 

Olutoyosi Ogunkua, MD  

Anesthesiologist, Novant Health Presbyterian, Charlotte NC 

Curriculum and Rotations:

• L&D Parkland: 4 months  

At Parkland, the fellowship offers a diverse experience, exposing fellows to a wide range of peripartum cases, from routine to complex, including high-risk, fetal, non-OR, and non-obstetric surgeries. Fellows take on leadership roles, supervising residents, collaborating with multidisciplinary teams, and acting as the anesthesiologist in charge on L&D. Additionally, they lead the obstetric anesthesia preoperative complex clinic for high-risk parturients, working closely with MFM colleagues to ensure optimal care. 

The fellowship also includes exposure to specialized areas, such as percutaneous fetal procedures and placenta accreta spectrum procedures. Fellows have the opportunity to gain valuable experience in these complex and cutting-edge techniques, further enhancing their expertise in managing unique obstetric cases. 

• L&D CUH: 2 months  

During the fellowship at Clements University Hospital (CUH), the fellow will have the opportunity to seamlessly integrate into a close-knit team comprised of faculty members, CRNAs (Certified Registered Nurse Anesthetists), nurses, midwives, and OB providers. This collaborative environment is dedicated to delivering exceptional, multidisciplinary care to a diverse range of parturients, including those with varying levels of risk. The scope of care extends not only to obstetric procedures but also encompasses non-obstetric surgeries and procedures. The emphasis is on providing high-quality healthcare and ensuring the well-being of patients across the board. 

• Maternal-Fetal-Medicine: 2 weeks 

During this two-week rotation, fellows have the invaluable opportunity to forge connections with MFM (Maternal-Fetal Medicine) attendings and fellows, as well as OB/GYN residents. These relationships will be instrumental as they continue to work collaboratively throughout the duration of the fellowship. The fellow's involvement in this rotation extends to various facets of high-risk antepartum care, encompassing conditions such as addiction, diabetes, placenta accreta spectrum, and preeclampsia. This hands-on experience allows fellows to develop expertise in managing complex cases and acquire comprehensive knowledge in the management of diverse high-risk obstetric conditions. (HB) 

• NICU: 2 weeks  

The Neonatology Division features national and world leaders in evidence-based newborn resuscitation. The fellows participate in structured didactics and attend to all neonatal emergencies. Fellows are required to be certified by the Neonatal Resuscitation Program. 

• Research: 3 months  

The Obstetric Anesthesia Service has carried on a long tradition of conducting clinical research, often in collaboration with members from Obstetrics and Neonatology. Research projects vary from randomized trials, observational cohort studies, and case series/reports. A research team is available to help with the IRB application and the patient enrollment process. The large volume and rich variety of cases provide a unique opportunity for fellows and aspiring faculty to complete clinical trials.  

• Transfusion Medicine:  

The transfusion medicine rotation within the fellowship program provides fellows with a comprehensive and in-depth understanding of the principles and practices of transfusion medicine. This rotation is designed to develop expertise in the field of blood banking, blood transfusion, and the management of various transfusion-related issues. 

• POCUS and Lumbar Ultrasound: 1 month 

During their fellowship, fellows will have the opportunity to collaborate with ICU fellowship-trained faculty to gain expertise in the principles of transthoracic echocardiography (TTE) and Point-of-Care Ultrasound (POCUS) exams. This valuable experience will enable fellows to develop proficiency in performing and interpreting TTE and POCUS exams, enhancing their skills in assessing cardiac function and diagnosing relevant conditions in critically ill patients. 

Additionally, fellows will work closely with fellowship-trained faculty on labor and delivery (L&D) to learn the principles and techniques of lumbar and truncal block ultrasounds. This hands-on experience will equip fellows with the necessary skills to perform and refine ultrasound-guided lumbar and truncal blocks, ensuring optimal anesthesia delivery and patient comfort during obstetric procedures. (JG) 

• Regional Anesthesia: 1 month 

The regional anesthesia component of the fellowship program provides fellows with focused and intensive training in the principles and techniques of regional anesthesia. This specialized area of anesthesia involves the targeted numbing of specific nerves or nerve groups to achieve pain relief and anesthesia for surgical procedures. 

During the regional anesthesia rotation, fellows work closely with experienced faculty members who are experts in this field. They receive comprehensive instruction and hands-on training in various regional anesthesia techniques, including peripheral nerve blocks, epidurals, spinal anesthesia, and continuous catheter techniques. 

• QI: 

The quality improvement course offered as part of the fellowship program provides fellows with a comprehensive understanding of principles and techniques in healthcare quality improvement. Through this course, fellows gain the knowledge and skills necessary to identify, analyze, and address areas for improvement in patient care and safety. 

• Simulation: 

As part of the fellowship program, fellows will participate in monthly simulation sessions led by fellowship-trained Obstetric Anesthesiologists. During these sessions, fellows will actively engage in various simulation scenarios, taking on roles and actively participating in the simulations. In addition to their involvement in the scenarios, fellows will also have the opportunity to instruct and provide feedback on essential aspects such as teamwork, interpersonal communication, technical skills, and general medical knowledge. 

The simulation sessions serve as a valuable platform for fellows to enhance their practical skills, critical thinking abilities, and decision-making in a controlled and realistic environment. By actively participating in and instructing these simulations, fellows can develop their leadership skills and gain proficiency in providing constructive feedback to their peers. This regular exposure to simulation-based training ensures that fellows are well-prepared for real-life clinical situations and fosters continuous improvement in their overall clinical competence.  

• Conferences: Journal Club, didactics, Joint OB and Anesthesia Parkland Conference, MFM Cardio-Obstetrics Multidisciplinary Conference, Departmental Grand Rounds, M&M, and SOAP Webinar Series