OBGYN Rules Altered

University of South Florida health sciences officials explained to USF trustees this week 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, associate dean Peter Fabri said.

The doctor who complained about the program to the American Board of Obstetrics and Gynecology 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.

"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.

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.

Fabri explained to the trustees Thursday 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."