First, your midwifery practice must be affiliated with an academic medical system.  

This means that the medical center has ACGME (Accreditation Council for Graduate Medical Education) residency programs for physicians in training. These medical residents graduate from your medical center, they do not simply rotate there for clinical experience. This also means that the medical center has a contractual arrangement with a medical school and that faculty physicians have faculty appointments with this medical school. There needs to be a written agreement between the medical school and the medical center that provides faculty appointments for physician teachers and provides access to:

• Faculty advancement
• Faculty development
• Medical school committee appointments/involvement
• Library and simulation lab facilities

How do you find this out?  

• Identify a “Residency Program Director,”  preferably in OB   
• Find out what faculty appointments physician colleagues have  
• See if your institution has a Chief Academic Officer and an office of Academic Affairs  

Who needs to be on board with the idea of incorporating a MEP?  

First and foremost, other midwives within your practice group. There has to be a group mission and vision to accomplish program design, development, and participation. Do all midwives have to do the work? No, but all midwives have to be supportive of the endeavor. Additional support from other area midwifery groups would be helpful, as well.  

You will need to identify allies and supporters within your department.  

Who are the biggest supporters of existing midwifery programs within your department? Generalists? Faculty physicians? Residency chair? Talk with them first, feel them out about the idea, ask their thoughts. You will eventually need the support of the chair of the department.

Key hospital administrators will need to be brought on board, as well.

This will be the task for the department chair, with your input. Who are these people?  

• Chief Operating Officer
• Chief Executive Officer
• Chief Education Officer
• Liaison between the affiliated medical school and the medical center (title may vary)

The MEP within the academic medical center will be a Post Graduate Certificate Program and a graduate degree will not be conferred. So how will the students receive the master’s degree required to sit for the AMCB exam? An academic affiliation will need to be developed with a school that can grant the master’s degree. This could be a school of nursing, public health, midwifery or another. A Memorandum of Understanding will need to be developed in which that institution agrees to accept the credits earned during the MEP as transfer credit, adds an agreed-upon number of courses and grants the degree. The students pay tuition for these courses separately directly to the university.

How will this work financially?   

The program will be partially self-supported by tuition payments once the first class is admitted. The program will be completely self-supporting once the first class has graduated. At that time, the academic medical center can complete the application for Graduate Medical Education funding available through Medicare Part B to Allied Health Programs within an academic medical center. This application must be made annually but is already being done for the residency programs within the academic medical center so it will not be difficult to add this program on.

There will be start-up costs and funding will need to be obtained for this. This investment will need the support of the institution. There may be alternative funding streams that you or your institution administrators may be aware of.  

Where do I begin?  

Put together a brainstorming session with the interested parties you have identified. Ascertain if there is enough information to move forward with an assessment of feasibility. No one can do this alone. You will need a work group of committed individuals and you will need consultants. We have the needed expertise, we used a consultant to start our program, and we have successfully been educating students within a medical center since 1990.