Maternal Health Track

Overview

UC San Diego-San Diego State University General Preventive Medicine residency is the recipient of a HRSA grant that aims to train physicians already boarded in family medicine or internal medicine in maternal population health, with an emphasis on maternal health disparities. Our residency is frequently used by those boarded in another specialty as a “fellowship” to enhance their preventive medicine and population health skills while earning a master's of public health degree.

The Maternal Health curriculum includes robust clinical and public health experiences that focus on improving maternal health and decreasing morbidity and mortality in pregnancy with a specific emphasis on successful management of high risk pregnancies.

Maternal Health rotations occur at the San Diego County Public Health department, throughout UC San Diego Health System, and in the community—in both urban and rural settings. Residents gain skills for addressing addiction, lifestyle, obesity, and cardiometabolic issues in maternal health and work with experts in obstetrical quality improvement and research focused on improving pregnancy outcomes.

Requirements

Maternal Health rotations are available for all residents in the residency program. Residents may choose from the following rotations to apply toward satisfying residency program requirements in public health, clinical preventive medicine, research, and/or quality improvement.

San Diego County Public Health

The Maternal, Child, and Family Health Services (MCFHS) branch of the San Diego County Public Health Department has multiple programs dedicated to promoting maternal and child health within the community, all through the lens of health equity. Activities by residents working with the branch include conducting needs assessments and quality assurance reviews of programs providing comprehensive perinatal services from conception to 60 days post-partum for low-income pregnant women. Residents may also assist with formal reviews of fetal, infant and maternal deaths occurring in the county, with the goal of developing more effective prevention programs.

Rural Health

Disparities in maternal-health related outcomes have been widening for women living in rural communities compared with non-rural communities. Lack of access to care, decreased economic opportunities, and other social determinants of health have contributed to worsened outcomes for those living in these settings. Within two hours of central San Diego, residents can rotate through an area that is called the “Inland Empire” including in public health settings (Imperial County Public Health Department) and clinical settings (Borrego Health, Riverside County). These opportunities position residents in different contexts to increase understanding of the barriers facing rural women, especially in the prenatal timeframe. Residents are equipped at the end of these experiences to better apply epidemiologic methods, provide direct care, and advocate for women and maternal health related disparities.

Borrego Health: Residents rotating through Borrego Health will have the opportunity to directly work with and observe rural health providers working with women in rural settings. They will also have the ability to conduct quality improvement projects.
Imperial County (public health): Residents will be able to complete projects at Imperial County public health. Working in a rural public health department allows residents exposure to the full breadth and scope of public health work while at once understanding the challenges unique to rural areas.

Clinical Preventive Medicine

Maternal Health track residents will have the opportunity to work with faculty mentors in maternal fetal medicine. Residents will be able to gain experience providing care to complex pregnancies, diabetes in pregnancy care, and providing care to women using medication assisted therapy (MAT) using buprenorphine. Residents also may, on a case by case basis UC San Diego Diabetes and Pregnancy specialist interdisciplinary clinic serving patients with gestational diabetes, type 1 and type 2 diabetes during their pregnancy.

On a case-by-case basis, and with the specialized obesity care provided to patients in pregnancy. Residents also have the opportunity to work with Scripps Chula Vista Family Medicine program in their Centering Pregnancy program. In addition to this, residents have the opportunity to tailor the clinical experience to their interest. We will work collaboratively with our partners at UC San Diego Obstetrics, UC San Diego Family Medicine, Borrego Health, and Scripps Chula Vista Family Medicine for residents to gain experience in obstetrics, women's health procedures, and rural and urban underserved women’s health. For example, residents have the ability to take night-call in Hillcrest Medical Center in order to get opportunities to evaluate OB patients, do OB Triage with MFM faculty and participate in deliveries.

Quality Improvement

Residents have the opportunity to attend the monthly meetings of UC San Diego Department of Obstetrics, Gynecology, and Reproductive Sciences quality review committee. In addition to learning about the Department’s priorities and key initiatives for improving maternal health, residents can choose to conduct their own quality improvement projects under the mentorship of Department faculty. Residents may also interface with the statewide California Maternal Quality Care Collaborative, including data collection and quality improvement initiatives.

Maternal Mental Health

Residents have the ability to work with Postpartum Health Alliance, which is an organization that focuses on the diagnosis, treatment and stigma around perinatal mood and anxiety disorders. Residents are able to gain education around perinatal mood and anxiety disorders and to participate in educating local healthcare providers about this important topic.

Teaching/Medical Education

Residents in our program are uniquely equipped to disseminate clinically relevant information to appropriate audiences surrounding maternal health, given the skillset and experiential learning throughout the track. These opportunities enable residents to bridge across disciplines and medical specialities to improve the understanding of maternal health related topics. Residents also gain expertise in public speaking in a variety of settings, including community-facing events, undergraduate education through UC San Diego, graduate education through San Diego State University, and graduate medical education (GME) internal medicine and family medicine settings. These efforts aim to improve the care gaps for maternal health populations by increasing awareness in relevant topics surrounding prenatal and postnatal care.

Potential Research Partnerships

Preventive Medicine residents at UC San Diego-San Diego State University General Preventive Medicine residency program have the advantage of being able to choose research mentors from both institutions, which provides the opportunity to work on a variety of community based and clinical research projects. In addition to those opportunities, for the purposes of this track we have partnered with leading epidemiologists at the California MothertoBaby program and the Scripps Research Translational Institute. Additionally, residents have the ability to collaborate on ongoing projects with UC San Diego Division of Maternal-Fetal Medicine faculty conducting clinical and epidemiological research.

Lifestyle Medicine for Maternal Health

For residents interested in Lifestyle Medicine, all UC San Diego Preventive Medicine Residents go through the Supervised Lifestyle and Integrative Medicine (SLIM) which is a shared medical appointment program for patients with obesity. On a case-by-case basis, residents have the ability to work with UC San Diego Maternal Health obesity care program and the Diabetes in Pregnancy program.