Complex Family Planning Fellowship

The clinical and research activities of the Division of Complex Family Planning offer a diverse training program, supported by physician scientists and academic clinicians. This provides exposure to different practice approaches, patient populations, and experiences throughout the course of fellow's training.

• Sheila Mody, M.D., M.P.H.
• Sarah Averbach, M.D., M.A.S.
• Pratima Gupta, M.D., M.P.H.
• Kelly Culwell, M.D., M.P.H.
• Danielle Vachon, M.D.

UC San Diego Fellows in Family Planning

• Kelsey Loeliger, M.D. – completed her residency in Ob/Gyn at UC San Francisco and attended medical school at Yale School of Medicine in New Haven, CT
• Karen Greiner, M.D., MPH – completed her residency at Kaiser Permanente San Francisco

First trimester services

In the Pregnancy Options Clinic we offer dilation and suction curettages. Currently, the anesthesia for first trimester clinic Dilation & Suction Curettages is oral versed, intramuscular Toradol and paracervical block with lidocaine.

Early pregnancy loss

We have embraced early pregnancy management because there is a local need for this service. We consistently receive referrals for early pregnancy loss management from family medicine, infertility clinics, and midwives clinics. In addition, we consistently have patients that come to the emergency department with early pregnancy losses and require outpatient management. Early pregnancy loss management is incorporated in the Pregnancy Options Clinic. Fellows will get a great deal of exposure to medical and surgical management of early pregnancy loss.

Second trimester services

Fellows will get experience with D&Es. Complex cases include maternal medical conditions from rare lung conditions to morbid obesity. Obstetrically complex cases include molar pregnancy, bicornuate uterus, and placenta accreta.

Call schedule

Fellows will take two in-house general OBGYN (12–14 hour) paid calls a month, two weeknights back up (home) a month & one weekend back up (home) general OBGYN call every other month.

Teaching opportunities

The family planning fellows give the family planning lectures to the third year medical students. The fellows also help run the Medical Students for Choice Papaya workshop. In addition, the fellows help give the family planning lectures to the residents. They are also involved in the family planning simulation training. In the clinic and in the operating room, they are expected to assume the role of the teacher with faculty supervision.

Contraceptive training

Complex Contraceptive Clinic 
In this clinic we counsel and provide contraception to patient with various medical conditions including a history of transplant surgery, epilepsy, cystic fibrosis, migraine with aura and lupus. The contraceptive methods and services are connected to other patient services within the hospital/medical center. The high-risk case manager works with the Family Planning Coordinator to refer postpartum patients to the complex contraception clinic. In order to encourage referrals to this clinic, UCSD health care providers can refer patients to the Complex Contraception Clinic via the Electronic Medical Record. We also have a dedicated patient access phone line to facilitate making appointments in the family planning clinics. We also have a strong relationship with Student Health therefore family planning fellows get exposure to contraception counseling and provision for adolescents.

Clinical training sites

Jacobs Medical Center
The Jacobs Medical Center in La Jolla has 245 beds, 14 operating rooms, 8 labor and delivery rooms, 3 labor delivery ORs, 3 midwife birthing rooms, 32 postpartum rooms and 52 neonatal intensive care rooms. The top 3 floors of this hospital are dedicated to women’s reproductive health services.

Planned Parenthood of the Pacific Southwest (PPPSW) 
PPPSW is one of the largest affiliates. The mission of PPPSW is: "to ensure broad public access to reproductive health care through direct service, education, and advocacy.” It is unique affiliate because it covers not only San Diego but also Riverside and Imperial County.

Masters degree options

The UC San Diego Family Planning Fellows have the option of completing Master level course work during their fellowship via the CREST program. If fellows would like, they can pursue a Masters of Advanced Studies in Clinical Research at University of California, San Diego but this would involve their own financial contribution.

Masters of Advanced Studies in Clinical Research
The Masters of Advanced Studies in Clinical Research is offered via the Clinical Research Enhancement through Supplemental Training (CREST) Program.

• Track II program facilitates obtaining a Masters of Advanced Studies in Clinical Research. The program involves 8 modules which is equal to 16 credit hours. One module is 10 weeks long and involves 2 hours of class in the early evening. In addition, the fellow would be matched with a faculty research mentor for an individual research project.

International Opportunities

Family Planning Fellows at UCSD have several international mentors and opportunities. Dr. Averbach has extensive experience in Nepal, Uganda and Zimbabwe. Dr. Culwell has a close relationship with World Health Organization, International Planned Parenthood Federation and Engender Health.

Didactics

The family planning fellows will follow the Fellowship in Family Planning Guide to Learning. They are expected to gain competency in the following areas:

• Anatomy and physiology of reproduction
• Mechanism of action of contraceptive methods
• Use of contraception by women with complex medical problems
• Surgical and medical termination of pregnancy
• First and second trimester ultrasound
• Laparoscopic sterilization procedures
• Placement and removal of long acting reversible contraception
• Psychological considerations including pregnancy options counseling
• Family Planning Public policy and advocacy
• International family planning

Collaborations

Center for Gender Equity and Health (GEH)
The mission of GEH is “to improve population health and development by improving the status, opportunities and safety of women and girls, globally. The Center focuses on conducting innovative global public health research, medical and academic training, and development and evaluation of evidence-based policies and practices related to gender inequities (girl child marriage, son preference and daughter aversion) gender-based violence (partner violence, sexual assault & exploitation, sex trafficking).”

State Collaborations
UC Family Planning Collaborative UCSD is the part of the UC Family Planning Collaborative. The mission of the collaborative is to inform policy, training and patient care by conducting multi-campus family planning research. Dr. Mody is the Principal Investigator for the Grant from the University of California, Office of the President Grant to establish the UC Family Planning Collaborative. There is a family planning fellowship trained participant at UCSF, UCLA, UC Davis, UC Irvine and UCSD. Fellows participate in the quarterly UC Family Planning Combined Journal Club. They will also be able to take advantage of potentially recruiting subjects for their research studies at other UC campuses.

National Collaborations
The family Planning fellows are encouraged to apply to become junior fellows in the Society of Family Planning.

Advocacy Mentorship
Dr. Pratima Gupta has joined our faculty and will serve as an advocacy mentor. She will teach the fellows how to participate in letter writing and lobbying.

Additional Program Highlights

Psychosocial Support
There are quarterly social events with family planning faculty to create a welcoming environment for fellows.

Dr. Mody and Dr. Averbach oversee the fellows’ research studies. They ensure the fellows pick feasible projects and have realistic timelines to facilitate completion of the projects during the fellowship. Depending on a fellow’s research interests, the fellows will be matched with an appropriate research mentor. We know that fellows may have diverse interests from basic science to international health.

Research Resources

Clinical Translational Research Institute (CTRI) 
This center has multiple resources for fellows including biostatical assistance. Specifically, CTRI has weekly open door office hours. Fellows can seek help to decide  sample size, request creation of randomization, and help with data analysis. Dr. Chambers, one the research mentors for the fellows, is the Associate Director for the Clinical Translational Research Institute.

Research and clinical interests of directors 
Dr. Mody has several existing family planning research projects taking place at UCSD. Most of the projects focus on Complex Contraception and involve collaborations with other departments such as Transplant Surgery, Neurology, Psychiatry and Oncology. She is also very passionate about improved pain control for family planning procedures such as IUD insertion. Recently, Dr. Mody has also started doing more Community Engagement with refugee communities in San Deigo. It would be very feasible for a family planning fellow to develop a research project from one of these existing partnerships. Dr. Mody’s ability to be a strong family planning fellowship mentor at UC San Diego is evident not only in her extensive research but also by her clinical service initiatives. For example, she introduced expanded pain management options for family planning procedures and introduced MVA in the Emergency Department.

Dr. Averbach has considerable experience in global reproductive health and research as well as clinical expertise in family planning gained during her fellowship training at UCSF. She is the Director for Program in Global Women's Health within the Department of Obstetrics, Gynecology & Reproductive Sciences at UC San Diego. This program seeks to address health disparities in family planning care and to transform patient care and research collaborations globally in a sustainable way. In order to build this program, she focused on strengthening relationships with colleagues in academic institutions and NGOs around the world including existing relationships in Mozambique, Nepal, Uganda and India.

Application Deadline is Monday, May 6, 2024 at 2:00 p.m. PT / 5:00 p.m. ET

The Electronic Residency Application Service (ERAS) coordinates the Complex Family Planning Fellowship application process, including letters of recommendation. The UCSD Complex Family Planning Fellowship program accepts one fellow each year.