Medical Disorders of Pregnancy Fellowship

Updated: September 25, 2025

Program Director:
Dr. Kristin Harris
Maternal Fetal Medicine Specialist | Mount Sinai Hospital
Medical Lead, Medical Disorders of Pregnancy | Division of Maternal Fetal Medicine
Medical Co-Lead, Obesity in Pregnancy | Division of Maternal Fetal Medicine
Medical Lead, Wound Care | Division of Maternal Fetal Medicine
Assistant Professor | University of Toronto

Contact:
Thamilini Pirathapan
Tel: (416) 586-4800 x8669
Fax: (416) 586-8601
Email : thamilini.pirathapan@sinaihealth.ca

Setting:
Mount Sinai Hospital

Application Deadline:
Submit the Fellowship Application Form (PDF) and all required documents by November 30 of each year.

Start date:
Annually, July 1–June 30

Program Information:
The Medical Disorders of Pregnancy (MDP) Fellowship is a one-year clinical program designed for specialists in Maternal-Fetal Medicine seeking advanced, hands-on training in the care of pregnancies complicated by complex medical conditions. Based at Mount Sinai Hospital, a high-volume tertiary referral center, this fellowship offers immersive exposure to the full spectrum of maternal medical diagnoses — from common comorbidities to critically rare diseases — in both ambulatory and inpatient settings, including obstetric critical care.

Fellows will work within a robust multidisciplinary team, collaborating closely with internal medicine subspecialists in cardiology, nephrology, neurology, endocrinology, hematology, and more — all with expertise in pregnancy. This integrated, collaborative model ensures comprehensive, cutting-edge care for high-risk pregnancies.

Fellows will receive advanced obstetrical and surgical training in high-risk pregnancies, participating in procedures and on-call rotations within the high-risk obstetric fellow schedule. This immersive clinical training is supported by a highly collegial and supportive learning environment, committed to academic excellence and professional development.

Key features of the program include:

Extensive exposure to complex maternal medical conditions, including autoimmune diseases, cardiac disorders, hematologic abnormalities, endocrine disease, renal pathology, and more.
Training in physiologic adaptations of pregnancy and how they intersect with underlying and emerging disease.
Integrated multidisciplinary teaching from both Maternal-Fetal Medicine specialists and Internal Medicine subspecialists.
Participation in high-risk obstetric surgeries and deliveries, with opportunities to assist and lead in relevant procedures.
Protected time for academic scholarship, with the expectation of completing an original research project from conception to submission for publication.

Upon completion of the fellowship, the graduate is expected to function at the consultant level, with advanced expertise in the assessment and management of pregnancies complicated by complex maternal medical conditions. The graduate will be recognized as an expert in maternal medicine and obstetric critical care, capable of leading multidisciplinary teams and providing specialist consultation to general obstetricians, internists, and other healthcare providers. Graduates will be well-equipped to establish and lead multidisciplinary maternal medicine units within their own institutions, fostering collaboration between obstetric, medical, and surgical specialties to optimize outcomes for medically complex pregnancies. Fellows will also develop academic and research competencies, enabling them to contribute meaningfully to clinical scholarship, guideline development, and education in the field of medical disorders of pregnancy.

Fellows are expected to demonstrate the highest standards of patient-centered care and professionalism, including sensitivity to gender, culture, ethnicity, and other aspects of diversity. Graduates of this program will be well-positioned to serve as consultants and leaders in maternal medicine, both within academic and clinical settings.

Eligibility Criteria:

Board certification: applicants must be fully certified specialists in Obstetrics and Gynaecology from national board.
Maternal Fetal Medicine fellowship training: applicants must have completed an accredited fellowship program in Maternal Fetal Medicine with certification available for review (or letter of good standing available from Fellowship Program Director).
For International Medical Graduates (IMG):

English Language Evaluation:
- TOEFLiBT or IELTS as department standard
  - TOEFLiBT: overall score of 93/120 and score of 24/30 in Speaking section.
  - IELTS Academic: overall score of 7 and Speaking sub-score of ³ 24
- English language evaluation waivers granted if:
  - Applicant is from a country using English as official language.
  - Medical degree and examinations undertaken in English.
  - Residency training and board-certifying examinations undertaken in English.

Canadian medical graduates with an independent CPSO license in Obstetrics and Gynaecology and subspecialty training in Maternal Fetal Medicine are encouraged to apply. Subspecialists may find this fellowship to be a valuable opportunity to deepen their expertise in maternal medical disorders and high-risk obstetric care. International medical graduates with appropriate funding support may also be considered, provided no suitable local candidate is identified. All applicants must demonstrate a strong clinical interest and aptitude in the care of medically complex pregnancies, supported by relevant case experience and letters of reference.

Duration of training:
The duration of fellowship training is for one year.

Funding considerations:

Salary will be equivalent to PGY7 salary per PARO
Allowance for conference: $2000
Funded SMFM critical care course

Call responsibilities:
Fellows will participate equally in the Maternal-Fetal Medicine (MFM) Fellow call schedule at Mount Sinai Hospital, typically covering 3–4 calls per month, which includes 2–3 weekday nights and one 24-hour weekend call. All call shifts are supervised by staff MFM physicians, with progressive responsibility as the Fellow gains experience. During call, the Fellow will be expected to assume a leadership role in the delivery of high-risk obstetrical care, providing supervision and support to medical students, interns, and OBGYN residents.

Fellowship Objectives:

To develop advanced clinical skills and professional experience in the management of medical disorders in pregnancy, aligned with each of the CanMEDS roles: Medical Expert, Communicator, Collaborator, Leader, Health Advocate, Scholar, and Professional.
To acquire in-depth knowledge of the physiologic adaptations of pregnancy and how these affect the presentation, progression, and management of acute and chronic medical conditions.
To become proficient in the inpatient and outpatient management of pregnant patients with complex medical conditions, including but not limited to:
1. Cardiac disease (e.g., congenital, acquired, and peripartum cardiomyopathy)
2. Hematologic conditions (e.g., thrombophilias, SCD, anticoagulation)
3. Endocrine disorders (e.g., Type 1 and 2 diabetes, thyroid disease)
4. Renal disease and transplant
5. Neurologic conditions (e.g., epilepsy, stroke, neuromuscular disorders)
6. Autoimmune and rheumatologic conditions (e.g., lupus, inflammatory bowel disease)
7. Oncologic and infectious diseases in pregnancy
8. Substance use and Psychiatric disorders
9. Obesity medicine
10. Gastrointestinal and Hepatic disease (e.g. MASLD, live transplant, advanced cholestatic conditions, inflammatory bowel disease)
To develop competency in obstetric critical care, including the identification, triage, and management of severely ill pregnant patients in collaboration with internal medicine and intensive care teams. Completion of an advanced critical care course to support this learning.
To gain experience in the interdisciplinary management of complex pregnancies through close collaboration with subspecialists in internal medicine, anesthesiology, neonatology, and surgery.
To participate actively in the high-risk obstetric call schedule, developing leadership skills by supervising junior learners, managing acute obstetric scenarios, and coordinating care for complex patients with progressive autonomy.
To assist in and lead obstetrical procedures and deliveries involving patients with medical complexity, including cesarean sections in patients with cardiac disease, coagulopathy, or other high-risk medical profiles.
To develop skills in obstetric imaging as it relates to medical disorders (e.g., fetal growth restriction due to maternal illness, surveillance in preeclampsia, cardiac and renal anomalies).
To become a medical expert in maternal medicine, able to provide consultation and leadership in the management of complex medical conditions during pregnancy, delivery, and the postpartum period.
To collaborate and communicate effectively as an independent, respectful, and trusted member of multidisciplinary care teams.
To advocate for patient-centered, equitable care, particularly for pregnant individuals with chronic illness, disability, complex psychosocial needs, or barriers to care.
To function as a professional and educator, demonstrating commitment to teaching, mentoring, and lifelong learning within the field of maternal medicine.
To pursue scholarly activity, including completion of an original research project that contributes to improving the care and outcomes of patients with medical disorders in pregnancy.
To participate in educational rounds, journal clubs, seminars, and conferences within the Department of Obstetrics & Gynaecology and associated medical specialties.
To serve as an ally and advocate in promoting equity, diversity, and inclusion, both within healthcare teams and in the care of diverse patient populations.