Training & Certification
Diploma in fetal medicine
The practice of fetal medicine has major implications not only for the individual family, but for the society as a whole. There are training programs for subspecialization in fetal-maternal medicine in the USA, UK, Australia and Canada. However, the number is limited and these programs are not designed to meet the increasing world-wide demand for specialists.
In introducing the Diploma in fetal medicine we aim to build on the existing specialization programs and raise training standards internationally. We also intend to establish an international network of specialists undertaking collaborative research and promoting standards in clinical practice through the exchange of ideas and experiences.
The Diploma in Fetal Medicine will be awarded to candidates who have successfully undertaken the following:
- Specialist theoretical and practical training in a recognized fetal-maternal center for a minimum of 2 years. The trainees will need to complete a log-book to demonstrate the range of conditions managed and they will be required to obtain a recommendation from the program director of the center in which they received training.
- Research in fetal-maternal medicine leading to either a postgraduate qualification (PhD or MD) from the University of London or equivalent university, or a series of scientific publications in peer-reviewed journals.
The practical component of the Diploma in fetal medicine is a full-time structured training program designed to cover the diagnosis and management of the whole spectrum of fetal disorders and pregnancy complications.
Candidates will be expected to acquire a high standard of competence in the clinical management of high-risk pregnancies; ultrasound diagnosis and management of fetal anatomical and functional abnormalities; Doppler assessment of the uterine and fetal circulations; amniocentesis, chorion villus sampling and cordocentesis.
Candidates will also be expected to undertake a major clinical or laboratory-based research project and publish a thesis and/or scientific papers.
The International Educational Committee will consider applications for accreditation from departments of fetal-maternal medicine with active research programs and a clinical workload that is sufficiently broad for the trainee to be exposed to most fetal conditions and techniques for fetal diagnosis and therapy. Such centers must be either within hospitals or affiliated to institutions with an obstetric service with high proportion of high-risk perinatal patients as well as neonatal intensive care, neonatal surgery, perinatal pathology and genetic services. All subspecialist centers currently recognized by the Royal Colleges of Obstetricians and Gynecologists in Britain and Australia are also recognized by the International Educational Committee for the Diploma.
The candidates should have a good knowledge and understanding of the following:
Embryology, including normal and abnormal development, and sonoembryology of major systems. Teratogenicity, including mechanisms and agents.
Modes of inheritance, syndromology, molecular genetics and gene therapy, cytogenetics (conventional and molecular), pre-implantation diagnosis, genetic counselling.
Ultrasound features, prenatal and postnatal management, and prognosis for abnormalities of the brain and spinal cord, face, heart and great arteries, lungs, diaphragm, gastrointestinal and urogenital tracts, abdominal wall and skeletal system. Chromosomal defects, including epidemiology, implications and sonographic and biochemical screening.
The indications, risks and techniques of amniocentesis, chorion villus sampling and cordocentesis. Isolation and testing of fetal cells from the maternal circulation.
Animal models, medical treatment (transplacental and fetal), intrauterine surgery (open, laparoscopic and ultrasound-guided). Pathophysiology, assessment and management of red cell isoimmunization and alloimmune thrombocytopenia.
Maternal and fetal physiology
Maternal physiological adaptation to pregnancy, including cardiovascular, respiratory, renal, endocrinological, hematological and nutritional changes. Placental physiology in normal and pathological pregnancy, including developmental anatomy and structure, metabolic and endocrine function, and transfer. Amniotic fluid, including origin, composition and regulation. Fetal physiology in normal and pathological pregnancy, including fetal biochemistry, hematology, endocrinology and immunology, regulation of acid-base balance, fetal behavior and biophysical profile.
Perinatal death and placental pathological examination.
Basic assessment and resuscitation, intensive care, ventilation and nutrition, growth retardation, macrosomia, infection, brain hemorrhage, periventricular leukomalacia, enterocolitis, survival and handicap, prediction of handicap.
Uterine activity (to include anatomy, physiology, molecular biology), pathophysiology, implications, screening, prevention, diagnosis, assessment and management.
Fetal growth restriction, preeclampsia and fetal loss. Pathophysiology, implications, screening, prevention, diagnosis, assessment and management.
Diabetes mellitus, autoimmune disease including systemic lupus erythematosus and antiphospholipid antibodies, cardiovascular, pulmonary, renal, hepatic, hematological, neoplastic disorders. Pathophysiology, implications, screening, prevention, diagnosis, assessment and management.
Toxoplasmosis, cytomegalovirus, rubella, human immunodeficiency virus, hepatitis, varicella, Coxsackie, Parvovirus B19, Listeria. Pathophysiology, implications, screening, prevention, diagnosis, assessment and management.
Epidemiology, pathophysiology, chorionicity, discordancy for defects, growth or death, twin-to-twin transfusion syndrome, prenatal diagnosis, assessment and monitoring, multifetal pregnancy reduction.
Implications for the individual and society
Ethics, law, psychology, sociology, politics, economics.
Medical statistics and epidemiology. Undertaking a literature search and summarizing the findings, planning a research project, writing an application for a grant-giving body and research ethics committee, computerization, statistical analysis and interpretation of data and writing an audit report, scientific papers and a thesis. Teaching at postgraduate level.
Organization and administration of fetal medicine service
Structured training, clinical protocols, consent forms, research versus audit in clinical practice, patient notes, counselling, computerization.
Holders of the FMF Diploma in fetal medicine
To view the list of doctors who have obtained the FMF Diploma in fetal medicine please click here.
Application for obtaining the Diploma in fetal medicine
Please send your curriculum vitae, logbook and letter of recommendation from the director of training:
Diploma in fetal medicine
The Fetal Medicine Foundation
137 Harley Street
London, W1G 6BG