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USF Officials Explain Changes To Fellowship Program

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By LINDSAY PETERSON | The Tampa Tribune

Published: February 26, 2009

TAMPA - University of South Florida health sciences officials explained to USF trustees today the changes planned for an obstetrics and gynecology fellowship program that lost its accreditation earlier this month.

The program provides specialty training to visiting doctors who want to learn more about handling high risk pregnancies.

"We have everything in place to address every single one of the board's concerns" by bringing the fellowship under the graduate medical education program, said associate dean Peter Fabri.

The doctor who had complained to the board about the program said he was pleased by the proposed changes.

"These are all recommendations we had been making," said Adam Urato, now an assistant professor at Tufts University in Boston.

He disputed earlier claims by David Keefe, chairman of USF's obstetrics and gynecology department, that the problems stemmed from a dispute with another doctor over how the fellowship was being run. "That's false," Urato said.

"It's not about a power struggle. It's not about taking over the fellowship. It's about protecting the integrity of training and protecting the public," Urato said.

"I did not want to take over the fellowship. The statement that it was about that is false and absurd. A person of my junior rank would be unable to run the fellowship."

The accrediting board requires fellowship supervisors to have at least five years' post fellowship experience.

The obstetrics board's concerns focused on the management and supervision of the doctors in the program, who worked in clinics for low-income women with high-risk pregnancies.

Previously the fellowship doctors saw patients at a clinic in Manatee County, where they were not always supervised. A supervisor was available by telephone, but after Urato complained, the accrediting board told USF it had to stop the "telemedicine arrangement."

Fellowship doctors continued to work at a Tampa clinic, and Urato complained that the supervision problems existed there, too.

After a site visit in October, the accrediting board's executive director, Norman Gant, informed the university that it planned to pull its accreditation for the maternal-fetal medicine fellowship.

In particular, Gant said, the fellowship doctors were seeing too many patients with too little supervision. He also said problems found on an earlier visit remained. The fellows weren't evaluated often enough, for instance.

Fabri explained to the trustees today that from the start, the maternal-fetal health fellowship was different from all the other graduate programs, largely because it was considered to be professional development for practicing doctors, not graduate medical education.

"No [patients] were ever hurt," Fabri said. "These individuals were very, very well trained."

Reporter Lindsay Peterson can be reached at (813) 259-7834.

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