Where Am I Supposed to Be?
Question: What days of the week are fellows ordinarily expected to participate in their assigned clinical rotations?
Answer: Monday through Friday.
Question: Approximately how frequently should each fellow expect to provide MFM call?
Answer: Approximately one week per month.
Question: How often should fellows enter or review their work hours?
Answer: Weekly.
Where must fellows record required MFM cases and procedures?
Answer: In the ACGME Case Log System.
Question: What should a fellow do when uncertain whether a patient can be managed independently?
Answer: Contact the supervising attending and ask for guidance.
Question: Who approves fellow PTO?
Answer: The Program Director through the established fellowship process.
Question: What is the fellow’s first responsibility when receiving a maternal transport request?
Answer: Obtain the essential clinical information, clarify the reason for transfer, and promptly involve the supervising attending.
Question: What is the fellow’s first priority when outside employment or moonlighting opportunities conflict with fellowship responsibilities?
Answer: The fellowship and the fellow’s education.
Question: What are the usual weeknight home-call hours?
Answer: 5:00 PM through 7:00 AM the following morning.
Question: Even when the Program Manager helps prepopulate work hours, what must the fellow do?
Answer: Review and verify the hours for accuracy.
Question: Name three procedures or clinical experiences that should be captured in the fellow’s case logs.
Answer: Any three appropriate examples, such as:
Question: Is progressive responsibility the same as independent practice without attending involvement?
Answer: No. Autonomy increases with demonstrated competence, but appropriate supervision, communication, and escalation remain required.
Question: For a planned absence, which individuals should receive written notification?
Answer: The Program Director, Program Manager, responsible attending, and physician scheduling lead or other designated scheduling personnel via QGenda.
Question: Who makes or confirms the final attending-level decision regarding transfer acceptance and the appropriate destination?
Answer: The responsible supervising or accepting attending, following the applicable hospital and transfer-center process.
Question: Name the two principal hospitals that serve as the fellowship’s major inpatient training sites.
Answer: St. Joseph’s Hospital and Medical Center and Valleywise Health.
Question: What are the usual weekend call hours?
Answer: 7:00 PM Friday through 7:00 AM Monday.
Question: By when must prepopulated work hours be formally verified?
Answer: By the end of each month.
Question: What should faculty review with the fellow at the beginning of a rotation?
Answer: The rotation learning objectives, expectations, supervision structure, and the evaluation that will be used.
Question: What factors determine the required level of supervision?
Answer: The fellow’s demonstrated competence, the clinical circumstances, the complexity and risk of the task, and the fellow’s assigned level of responsibility.
Question: What should a fellow do if illness or an emergency prevents attendance?
Answer: Notify the required individuals promptly through the established written absence process and ensure that the absence is acknowledged.
Question: What must be clarified before transport regarding the patient’s destination?
Answer: The appropriate hospital, level of care, accepting service, and specific location or unit.
Question: Erik is scheduled for outpatient MFM, but a clinical need develops elsewhere. Who determines whether his assignment changes?
Answer: Fellowship leadership in coordination with the responsible faculty and clinical teams. The fellow should not independently change the rotation assignment.
Question: A fellow receives a significant overnight call. With whom should the fellow communicate or complete handoff?
Answer: The supervising or oncoming attending and any other responsible clinical team members.
Question: Does work performed from home while on call count toward ACGME work hours?
Answer: Yes, when the fellow is performing clinical work or other required duties. Time spent returning to the hospital also counts.
Question: What is the purpose of the end-of-rotation Faculty Competency Assessment and Coaching conversation?
Answer: To review observed performance, reinforce strengths, identify development opportunities, and establish forward-looking goals appropriate to the fellow’s stage of training.
Name at least three people or resources a fellow may contact with a program concern.
Answer: Appropriate responses include:
Question: Is a fellow personally responsible for finding another fellow to cover an illness-related absence or rescheduling affected patients?
Answer: No. The fellow must communicate promptly, but program and clinical leadership coordinate coverage and patient rescheduling.
Question: What communication must occur after a maternal transport is accepted?
Answer: Closed-loop communication with the referring team, transfer center, accepting attending, receiving service, and other appropriate clinical personnel.
Question: A fellow receives conflicting instructions from two clinical teams. What should the fellow do?
Answer: Clarify the assignment and chain of responsibility with the supervising attending and escalate to the Program Director or Associate Program Director when needed.
Question: A fellow evaluates a patient or returns to the hospital while on home call. What additional obligation does the fellow have?
Answer: Record the time as work hours in New Innovations and complete the appropriate clinical documentation and handoff.
Question: Does moonlighting count toward the fellow’s total ACGME work-hour limits?
Answer: Yes. Moonlighting must be approved and cannot interfere with fellowship responsibilities or cause a work-hour violation.
Question: What group reviews fellow performance and recommends progression using Milestones and multiple sources of assessment?
Answer: The Clinical Competency Committee, or CCC.
Question: What should a fellow do if a clinical situation is worsening, exceeds their competence, or creates concern for patient safety?
Answer: Recognize the limitation, immediately involve the supervising attending, clearly communicate the concern, and continue escalating through the appropriate chain until the concern is addressed.
Question: A fellow has approved PTO but remains listed for clinic or call. What should the fellow do?
Answer: Notify the Program Director, Program Manager, responsible attending, and scheduling team and obtain confirmation that the clinical assignment has been closed or covered.
Question: What must the fellow complete after participating in a maternal transport?
Answer: Appropriate documentation, attending communication, clinical handoff, follow-up of time-sensitive issues, and any required case or work-hour logging.