Fellowship in Complex Family Planning

The Icahn School of Medicine at Mount Sinai (ISMMS) Fellowship in Complex Family Planning (CFP) is committed to training future leaders in the field of family planning. Our accredited fellowship offers obstetrician/gynecologists training in advanced sexual and reproductive health clinical care and fosters development of medical education, research, and advocacy skills.  Fellows care for patients from a wide variety of socioeconomic backgrounds with a diverse and complex constellation of family planning needs, often requiring an interdisciplinary approach to management.

Unique aspects of the program include:

  • Training in abortion care and management of pregnancy loss, including medical management and D&E beyond 24 weeks with maternal or fetal indications.
  • Well-rounded training in both hospital and outpatient settings with high volume consolidated Complex Family Planning service at Mount Sinai Beth Israel and high acuity Main OR-based care at Mount Sinai Hospital and Mount Sinai Morningside.
  • Productive and diverse research program supported by unique opportunities for multidisciplinary collaboration and extensive institutional research resources at the Icahn School of Medicine at Mount Sinai.
  • Strong departmental support and regular collaboration between Complex Family Planning and our Gynecology, Maternal Fetal Medicine and Genetics Divisions.

The Complex Family Planning Fellowship at The Mount Sinai Health System started in July of 2014. In 2020, our fellowship in CFP became accredited with The Accreditation Council for Graduate Medical Education (ACGME) upon formal recognition of CFP as a sub-specialty. Our program leaders and core faculty actively mentor fellows throughout their two-year program. We strive to find the right mix of clinical and public health training, research and advocacy to align with each trainee’s goals. As part of the largest Graduate Medical Education consortium in the country, we continue to expand upon the already formidable portfolio of resources available to adapt to fellows’ unique strengths, interests, and career paths.

Fellowship Aims: 

The program aims of the Complex Family Planning Fellowship at Mount Sinai are: 

  1. Develop physicians committed to using evidence-based practice and delivering patient-centered, high-quality care.
  2. Advance the field of complex family planning through fellow scholarly activity. 
  3. Develop national and community leaders in abortion, contraception, and sexual reproductive health.

Trainees per year: one

Fellowship length: two years

Salary:  GME PGY5 level salary first year with annual increases based upon PGY6 

Call: CFP home call; No Gyn call; No Obstetrics call, moonlighting is available

Benefits: Four weeks of vacation per year. Mount Sinai benefits package, including medical and dental insurance along with retirement funding and malpractice coverage can be found here:

Learn more about GME benefits at the Mount Sinai Health System

In light of the Supreme Court Decision to reverse 50 years of federal protection to the right to abortion for all people, New York State reaffirmed their commitment to recognizing abortion as an essential health service. In June 2022, Governor Hochul and the New York State legislature created a number of laws that protect patients, patient allies, physicians, clinicians and others from prosecution related to abortion care provided in our state, positioning New York as a medical sanctuary.

The Mount Sinai Health System and the Raquel and Jaime Gilinski Department of Obstetrics, Gynecology, and Reproductive Science will continue to provide the full range of health care services to any patient who seeks our care. We are also fully committed to our staff and faculty who provide abortions, to protecting access to these services for all our employees and their covered dependents, and to continuing our research and education programs related to these services.

 

 

Fellows train in surgical and medical abortion, management of unintended, failed, and abnormal pregnancy, and provision of reversible and permanent contraception for patients from diverse backgrounds with various characteristics and medical conditions. Our expert faculty provide supportive supervision with graded-responsibility as fellows advance through the program.

Our fellows learn to provide D&E in locations throughout the Mount Sinai Health System. In collaboration with the Division of Maternal-Fetal Medicine, fellows train to provide D&E and medical abortion (labor induction) beyond 24 weeks’ gestation for pregnancies complicated by fetal or maternal conditions.

Mount Sinai offers all FDA-approved contraceptive options for initiation in the context of shared decision-making with patients across the health system. Fellows also train with complex family planning faculty in dedicated clinical sessions at the Mount Sinai Hospital specializing in comprehensive contraceptive counseling and provision, including LARC, for medically- or procedurally- complicated patients.

In addition to regularly scheduled clinical activities during the week, fellows participate in Complex Family Planning afterhours and weekend home call throughout fellowship. There are no general obstetrics or gynecology clinical service requirements; however, moonlighting on Labor and Delivery is available. The majority of fellows choose to complete oral board examination for generalist certification during their two years of training.

With the education and experience from the Complex Family Planning Fellowship, our well-trained fellows can practice independently and confidently across a variety of contexts. They are well-equipped to lead evidence-based, patient-centered clinical care and skillfully perform advanced procedures safely and effectively.

Fellows’ School

Fellows participate in regularly scheduled complex family planning fellowship didactics, typically one to two hours per week led by CFP faculty. We implemented a two-year curriculum covering core clinical topics, research skills, advocacy training and other professional development. Activities include lectures, journal clubs, research workshops, and interactive learning sessions focused on case review for peer learning and ongoing quality improvement.

We regularly invite speakers from across the institution and outside academic and other reproductive health organizations to participate in Fellows’ School. This structure fosters knowledge-sharing about best practices and updates in research as well as create opportunities for community and collaboration. Fellows also attend weekly departmental peer learning sessions and Grand Rounds.   

Cultivating the Next Generation of Medical Educators

Our fellows develop and strengthen their skills as medical educators throughout their training. They provide lectures and facilitate journal clubs with faculty, peers, residents and medical students as well as provide clinical instruction to residents and medical students in real time during all aspects of patient care. Fellows also present a lecture or update on their research to the Department of Obstetrics, Gynecology and Reproductive Science each year and have opportunities to present to other departments or service lines, if desired.

Our model includes a “train the trainer” approach. The CFP Fellows work closely with a dedicated PGY 2 or PGY-3 during the residents’ dedicated family planning clinical rotations and mentor them in all aspects of complex family planning.

We balance surgical opportunities so that the Fellow has dedicated OR time alone with core CFP faculty, and with progressive responsibility, also have OR days in which the fellow functions as a primary surgical trainer for rotating residents with supportive faculty supervision.

Given the breadth and depth of the training programs across the Mount Sinai Health System, our Graduate Medical Education (GME) office provides robust programming throughout the year to strengthen all aspects of medical education for our faculty and fellows. Each year, GME sponsors an annual conference highlighting best practices in medical education methodology and innovations, including strategies to provide effective evaluation and feedback, create a culture of wellness and meaningfully address issues of diversity, equity and inclusion across programs. Fellows and faculty participate.

Collaboration and Mentorship

Our department and institution are home to world-class expertise and exciting initiatives to advance the science and practice of medicine. Our fellows benefit from a wealth of resources and opportunity to collaborate not only with our complex family faculty team but with faculty from other divisions in the department as well as other clinical departments within the Icahn School of Medicine. In the past, we have successfully collaborated with the Divisions of Maternal-Fetal Medicine, Global Health, Department of Pediatrics - Division of Adolescent Medicine, Department of Medicine - Immunology Institute, Department of Family Medicine and Community Health, and Department of Population Health Science and Policy. Our faculty also teach MPH courses in the graduate school of Public Health at ISMMS at Mount Sinai.

Our location in New York City gives fellows geographic access to many national organizations dedicated to family planning. These include the Population Council, United Nations Population Fund, Planned Parenthood Federation of America, Physicians for Reproductive Health, Global Doctors for Choice, and the Guttmacher Institute. Fellows may have the opportunity for collaboration with and exposure to the family planning research and advocacy conducted by these organizations, depending on the fellow’s areas of interest and the ongoing activities at these organizations. 

Fellows’ design and execute a research project with faculty mentorship. They are supported throughout the process to design, implement, analyze, and disseminate their research. Fellows and mentors meet regularly to assess study progress, troubleshoot, and ensure accountability. Fellows also have access to expertise beyond our division and may conduct research in collaboration with other members of the Mount Sinai network faculty in partnership with complex family planning faculty. Pending project approval, research may be conducted on a wide range of topics, including abortion, contraception, adolescent health, sexuality education, and global health.

Fellows have protected time for research and must complete a thesis requirement for graduation. We have a designated research coordinator for CFP research, departmental biostatisticians available, and recently expanded departmental research infrastructure under the leadership of Leslie Shaw, PhD, the Vice Chair of Research for the Department of Obstetrics and Gynecology.

The CFP fellows choose from among various structured educational resources to advance their research skills. Fellows may take courses offered through the Graduate School of Biomedical Sciences at the Icahn School of Medicine at Mount Sinai. Fellows may also access institutional subscriptions to Coursera for research-related coursework. The department provides an educational allowance of $1500 per fellow during fellowship for course work.The GME office offers competitive scholarship opportunities for an MPH or other related Master’s level degree and certificate programs through the Icahn Mount Sinai Graduate Program in Public Health for all incoming fellows across specialties as well; we encourage interested fellows to apply.

Core CFP faculty work with fellows on manuscript writing and critical review and other dissemination activities while reinforcing knowledge of epidemiology, biostatistics, study design and data analysis when working with fellows on research projects.

Prior Fellows’ Research Projects:

  • Geetha Fink, 2015-17: Emergency contraception use in school-based health centers before and after implementation of long-acting reversible contraception services: A mixed methods study
    Fink G, Dean G, Nucci-Sack A, Arden M, Lunde B. Emergency contraception use in school-based health centers: A qualitative study. J Pediatr Adolesc Gynecol 2019;32(2)175-181
  • Sharon Gerber, 2016- 18: HPV vaccination at the time of surgical abortion: a missed opportunity?
    Gerber S, Porsch L, Markowitz J, Dayananda I, Lunde B, Dean G. Acceptance of HPV vaccination at the abortion visit at a clinic in New York City in 2017 to 2018. Contraception. 2021 Oct;104(4):426-431. doi: 10.1016/j.contraception.2021.07.005. Epub 2021 Jul 14. PMID: 34270978.
  • Chi Son Kim, 2017-2019: Cost-effectiveness of the contraceptive implant in school based health centers
    Kim CS, Lunde B, MacIsaac L, Arden M, Garney WR, Wilson KL, Li Y. Provision of contraceptive implants in school-based health centers: A cost-effectiveness analysis. Contraception. 2021 Feb;103(2):107-112. doi: 10.1016/j.contraception.2020.11.009. Epub 2020 Nov 20. PMID: 33221276.

Comparing two cervical preparation strategies between 16 and 19 6/7 weeks
Kim CS, Dragoman M, Porsch L, Markowitz J, Lunde B, Stoffels G, Dayananda I. Same-Day Compared With Overnight Cervical Preparation Before Dilation and Evacuation Between 16 and 19 6/7 Weeks of Gestation: A Randomized Controlled Trial. Obstet Gynecol. 2022 Jun 1;139(6):1141-1144. doi: 10.1097/AOG.0000000000004790. Epub 2022 May 2. Erratum in: Obstet Gynecol. 2022 Aug 1;140(2):344-345. PMID: 35675611.

  • Ariella Goldman, 2018-20: A randomized, controlled trial of transcutaneous electrical nerve stimulation (TENS) for pain management with medical abortion through 70 days gestation: a feasibility study
    Goldman AR, Porsch L, Hintermeister A, Dragoman M. Transcutaneous Electrical Nerve Stimulation to Reduce Pain With Medication Abortion: A Randomized Controlled Trial. Obstet Gynecol. 2021 Jan 1;137(1):100-107. doi: 10.1097/AOG.0000000000004208. PMID: 33278292.
  • Stephanie Lambert, 2019-21: Osmotic dilators plus mifepristone or misoprostol for cervical preparation before dilation and evacuation: a retrospective cohort study
  • Ann Frisse, 2020- 2022: Evaluation of post-partum tubal ligation via mini-laparotomy proficiency among graduating Ob/Gyn residents

Our location within New York City offers many opportunities for advocacy, policy, and service work. Fellows are encouraged to pursue their interests in these areas.

Current and past fellows’ advocacy, policy, and service work has included:

  • Physicians for Reproductive Health Leadership Training Academy
  • ACOG Congressional Leadership Conference
  • Icahn School Medical Students For Choice (MSFC) program panelists
  • Volunteer attending of the day for the GYN clinic at the Mount Sinai free student run clinic East Harlem Health Outreach Partnership (EHOP)