Residency Experience

Sioux Falls Family Medicine Residency Women’s Health Fellowship (PGY4)

For those interested in providing women’s health to rural or underserved communities, we offer a FP-OB fellowship with training in advanced obstetrics and gynecology, including high-risk obstetrics, surgical obstetrics, and gynecological procedures. This is offered in conjunction with a large tertiary care center providing women’s healthcare to our region. Fellows will be expected to primary on more than 150 cesarean deliveries in their 11-month fellowship, in addition to learning to perform operative vaginal deliveries, gynecologic office procedures, high-risk pregnancy care, and neonatal resuscitation. Fellows will learn in an unopposed setting from OB-Gyn providers, see their own family medicine clinic panel, and help provide education for family medicine residents.

Applicants must have completed a 3-year ACGME accredited Family Medicine Residency and be board certified in Family Medicine or be in their 3rd year of residency and on-track to be certified by August 1. The fellowship year starts August 1st.

Please submit the following to apply:

A copy of your CV

2-page maximum personal statement detailing the following:

  • Reasons for pursuing additional training in obstetrics, specifically surgical obstetrics
  • Previous experience with obstetrical care (both in residency and outside residency)
  • Future career goals

Letter of support from your Program Director (if in residency) or Medical Director (if practicing)

Two additional letters of reference, preferably from one family physician and one OB/GYN who have current experience with your skills and knowledge

Current list of OB & GYN procedural numbers from the past 2 years

ABFM Examination score of 2nd year In-Training Examination score, if still in training.

Curriculum and Milestones


  1. Gain competence in operative obstetrics including cesarean sections, operative vaginal
    deliveries, and preoperative and postoperative care for patients.
  2. Improve competence in the management of high risk pregnancies.
  3. Increase outpatient gynecologic procedure skills.
  4. Increase OB ultrasound skills.
  5. Participate in neonatal resuscitation of the newborn.
  6. Teach obstetric knowledge and skills to family medicine residents in both the inpatient and
    outpatient settings.
  7. Increase family medicine outpatient skills.

Competency-Based Milestones:

At the completion of the fellowship year, family medicine PGY4s will demonstrate competency in the

  1. Understand indications and complications of cesarean section (Medical Knowledge,
    Practice-Based Learning and Improvement)
  2. Explain the risks and benefits of cesarean section to patients to obtain culturally-sensitive
    consent for the procedure (Interpersonal and Communication Skills)
  3. Be able to safely perform scheduled, urgent, and emergent cesarean section (Medical
    Knowledge, Patient Care and Procedural Skills)
  4. Understand indications, risks, and benefits of operative vaginal delivery (Medical
    Knowledge, Practice-Based Learning and Improvement)
  5. Explain the risks and benefits of operative vaginal delivery to patients to obtain culturallysensitive consent for the procedure (Interpersonal and Communication Skills)
  6. Be able to safely perform operative vaginal delivery (Medical Knowledge, Patient Care and
    Procedural Skills)
  7. Triage L&D patients appropriately and in a culturally-sensitive manner (Medical Knowledge,
    Interpersonal and Communication Skills)
  8. Understand indications, forms, and limitations of labor induction (Medical knowledge,
    Patient Care and Procedural Skills, Practice-Based Learning and Improvement)
  9. Demonstrate knowledge of epidemiology, pathophysiology, appropriate testing, and
    treatment for common pregnancy complications such as hypertension, preeclampsia,
    diabetes, preterm labor, premature rupture of membranes, and vaginal bleeding in
    pregnancy (Medical Knowledge, Patient Care and Procedural Skills)
  10. Assist in transfer of high-risk antepartum patients from rural sites to Avera McKennan
    (Systems-Based Practice)
  11. Management of high-risk antepartum patients in conjunction with MFM specialists (Medical
    Knowledge, Patient Care and Procedural Skills, Systems-Based Practice)
  12. Demonstrate skill with obstetrical ultrasound in determination of AFI, placental location,
    fetal presentation, and obstetrical dating (Patient Care and Procedural Skills)
  13. Management of routine, urgent, and emergent laboring patients (Medical Knowledge,
    Patient Care and Procedural Skills)
  14. Management of intrapartum complications such as intraamniotic infection, non-reassuring
    fetal heart tones, malpresentation, shoulder dystocia, and postpartum hemorrhage (Medical
    Knowledge, Patient Care and Procedural Skills)
  15. Perform advanced perineal repairs including third and fourth degree laceration repair as
    well as cervical laceration repair (Patient Care and Procedural Skills)
  16. Identify and treat common postpartum complications such as delayed postpartum
    hemorrhage, preeclampsia, and endometritis (Medical Knowledge, Patient Care and
    Procedural Skills)
  17. Identify and treat common postoperative complications such as endometritis, wound
    infection, and ileus (Medical Knowledge, Patient Care and Procedural Skills)
  18. Assessment of the neonate at time of delivery with Apgar scores and determination of the
    need for neonatal resuscitation (Medical Knowledge, Patient Care and Procedural Skills)
  19. Perform neonatal resuscitation and stabilization for distressed newborns (Medical
    Knowledge, Patient Care and Procedural Skills)
  20. Perform outpatient gynecologic procedures including colposcopies, endometrial biopsies,
    and management and placement of LARC (Patient Care and Procedural Skills)
  21. Supervise and educate family medicine residents in prenatal care, L&D triage, labor
    induction and management (Systems-Based Practice, Medical Knowledge)
  22. Communicate effectively with patients, demonstrating active listening skills, a respectful
    approach to issues that may be sensitive for women, and collaborative care planning with
    the patient (Interpersonal and Communication Skills, Professionalism)
  23. Consult and communicate appropriately with obstetrician-gynecologists (OB-GYNs),
    maternal-fetal medicine specialists, and allied health care professionals to provide optimum
    health services for women (Medical Knowledge, Systems-Based Practice)

These milestones will be evaluated through the following learning activities and responsibilities:

  1. Manage low- and high-risk laboring patients
    • Supervise resident admissions and management of antepartum and postpartum
    • Interpret fetal heart tracings and implement appropriate treatment when needed.
    • Teach family medicine residents basic obstetric skills including triage evaluation,
      cervical examinations, IUPC/FECG/cervical ripening balloon placement, vaginal
      deliveries, laceration repairs, shoulder dystocia, and postpartum hemorrhage.
    • Participate in daily MFM rounds on L&D.
    • Participate in a minimum of 80 vaginal deliveries (may be in an educational role with
      family medicine residents).
    • Maintain presence on L&D to be available for complex labors, operative deliveries,
      and emergency cesarean sections if not scheduled to be in outpatient clinic.
    • Take OB call on L&D one day per week, one weekend per 4-week block.
    • If no laboring patients, work on teaching activities or lectures, or assist in
      GYN/CFM/MFM clinic.
  2. Assess for indications, risks, and benefits of cesarean section and perform a minimum of 100 cesarean sections as the primary surgeon.
    • Be present for all 0730 scheduled cesarean sections.
    • Complete H&P, consents, and orders pertaining to operative patients, and meet
      patient prior to surgery start time.
    • Be present to scrub in on all cesarean sections while scheduled on labor and
    • Round on all postoperative patients.
  3. Staff family medicine OB clinic 1 half-day per 2 weeks.
  4. Family medicine continuity clinic 2 half-days per week.
  5. Participate in NRP with the NICU team (especially encouraged if not actively delivering or supervising a delivery).
  6. Participate in outpatient obstetric and gynecologic clinic 1-2 half-days per 4-week block (may include MFM clinic).
  7. Observe and participate in diagnosis and counseling of patients with perinatal complications seen in the outpatient MFM setting.
  8. Work with OB sonographers on both L&D and the outpatient setting to gain ultrasound skills in AFI, placental location, fetal presentation, and obstetrical dating (perform a minimum of 5 ultrasounds of each type).
  9. Provide a minimum of 3 OB lectures for family medicine residency noon conferences.
  10. Provide one M&M lecture for the OB campus at Avera McKennan.
  11. Optional rural elective to obtain knowledge in rural obstetrical care.

How to Apply

Application deadline is September 15th. Interviews will be offered at the end of September through the beginning of October. The fellows will be selected by November 15th.

Send applications to:

Attn: OB Fellowship Director

Center for Family Medicine

1115 East 20th Street

Sioux Falls, SD 57105

or email [email protected]