Current Practices and Gaps in Antenatal Counseling Training in United States Neonatal–Perinatal Medicine Fellowships

Antenatal counseling (AC) is vital in neonatal-perinatal medicine (NPM) to support families and align care plans. NPM fellows report gaps in communication and AC training, and current literature offers little on effective teaching methods. Standardized recommendations to assess AC skills are lacking. To create effective training programs, we must first understand how AC is currently being taught and evaluated in clinical education. Our aim was to assess the national landscape through an environmental scan of AC curriculum in NPM fellowship to establish a baseline of current educational practices and identify areas for improvement.Survey was developed based on a literature review and expert collaboration, with pilot testing performed on a subset of program leadership and fellows. It was distributed via email listserv nationally to NPM fellows and fellowship program leadership in 2024 to 2025. Survey included select-all, multiple-choice, and Likert-scale questions.Thirty-three percent of programs (33/102) and 18% of fellows (146/815) completed the survey. Most institutions use various methods to teach AC, though some report no formal training. Over 80% of fellows want more AC training. Only 39% of fellows reported being observed more than three times during their fellowship regardless of year in fellowship, whereas 79% noted they typically perform four or more consults per month while on service. Most programs (85%) lack formal assessment methods.While diverse educational modalities are employed in AC training, fellows desire more training. Limited observation and assessment highlight a need for improved curricula and formal feedback to better support skill development. · Fellows want more antenatal counseling training.. · Antenatal counseling observation and feedback are rare despite volume.. · Most programs lack formal assessment of fellows performing antenatal consults..