Steven Louis Bloom, M.D., became the sixth Chair of Obstetrics and Gynecology on July 25, 2006. He was very familiar with the role, having served as Interim Chair since January 1, 2005, while a nationwide search was conducted. Like four of his predecessors, Dr. Bloom was a specialist in maternal–fetal medicine. But he made it clear from the start that he was here to lead all of OB/Gyn.

“We want to continue to work to make our subspecialties bigger and better. We also want to create an infrastructure that will foster translational research in our department. The bar for this department has always been high. And, I think it’s going to be a lot of fun for us to challenge ourselves to raise the bar even higher. We hope to recruit additional outstanding clinical scholars in our subspecialties, skilled clinicians to augment our clinical services at Parkland, plus a new director and new faculty to rekindle our basic research program.”

Little did anyone imagine the challenges the next 16 years would bring. Back in 2005–06, medicine was on the cusp of change. Health-care reform spawned economic uncertainty. Health systems were merging into large organizations as universal health insurance loomed as a reality. Paper records gave way to electronic medical records with the attendant chaos when digital information systems malfunctioned. Radiographic images, now 100 percent digital, were stored in giant repositories, available to health-care providers on demand. University and hospital administrations changed and with them the way business was conducted. Then in 2020, the coronavirus pandemic, COVID-19, struck. Masks were mandated, people worked from home, and everything became “virtual.” It was a very different world by 2021.

Still, much remained unchanged. Yes, robotics had entered the operating room, but surgeries still required surgeons. Babies kept coming after nine months gestation and were delivered in the same way they had been forever — one at a time by trained medical personnel. Training programs and both basic and clinical research were just as essential as they had been 16 years earlier.

Having attended medical school at UT Southwestern (1987-1990), completed an OB/Gyn residency at Parkland (1990-1994), and finished a maternal–fetal medicine fellowship in the Department of Obstetrics and Gynecology (1994-1996), Dr. Bloom joined the Department’s faculty as an assistant professor in 1996. By 2002, he was an associate professor. Like his predecessors, he was a Parkland-based physician, who practiced evidence-based medicine. His congenial demeanor and skill as a clinician and researcher served him well at Parkland, where he honed his leadership skills and eventually served as President of the Medical Staff from 2008-2011.

As interim chair, Dr. Bloom set out to learn everything there was to know about the Department, its business operations, its finances, its research activities, its clinical practices, and its educational programs. He opened channels of communication between his office and the rest of the Department. By the time he was named chair, he had his finger on the pulse of the Department and met at least annually with each faculty member. There were few things that escaped his attention. Yet, he didn’t micromanage. Instead, he created an atmosphere where people were eager to get involved and find solutions.

Working together they opened two new hospitals, both with level IV (the highest level) maternity services. Replacing University Hospital St. Paul, the 1.3-million-square-foot UT Southwestern Clements University Hospital opened in December 2014. The hospital had 460 single-patient rooms and was equipped with the latest in digital technology. A third hospital tower with an additional 300 beds, operating rooms, and expanded emergency facilities opened in 2020. Nearby, the Dallas County Hospital District opened its new 2.5-million-square-foot Parkland Memorial Hospital across the street from its namesake in August 2015. The semi-private rooms of the old Parkland were replaced with 862 single-patient rooms equipped with the latest technologies. The two health systems also expanded their outpatient practices to reach further into the community and surrounding area.

Caring for Thousands, One Woman at a Time

The Department’s outpatient practice moved beyond the main Dallas campus at UT Southwestern — until, the Department had a Children’s Health–UT Southwestern pediatric-adolescent gynecology service at Plano–Legacy, a gynecology service at UT Southwestern–Frisco, general obstetrics and gynecology practices at UT Southwestern–Las Colinas and Park Cities, and maternal–fetal medicine services in Irving and Plano. At Parkland, new outpatient facilities opened in under-served areas of Dallas County. These neighborhood clinics offered medically indigent women access to medical care close to home. With expansion came increased training opportunities and supervisory responsibilities.

The faculty numbered 72 when Dr. Bloom became Chair. By the time he resigned, there were 100 faculty members. Young faculty, many of whom had trained in the OB/Gyn residency and fellowship programs, began to assume leadership positions in both the Parkland Health and Hospital System and in the UT Southwestern Health System. Where there was opportunity, there were faculty eager to take on the responsibilities. The results of this effort were impressive.

Between January 2005 and the end of August 2021, Department faculty and trainees delivered 233,642 babies to 160,453 women, among them a set of quintuplets delivered at University Hospital–St. Paul in 2012. They performed 560,702 surgical procedures and 759,230 diagnostic ultrasounds. Incredibly, they cared for 440,334 unique patients and managed 3,241,897 patient visits. The UT Southwestern practice grew to have the third largest patient volume of any program on campus. And, 97% of all women delivering at Parkland Memorial Hospital received prenatal care in the Parkland Health and Hospital System prior to delivering — an accomplishment that would have pleased clinic-founder and former Chair, Jack A. Pritchard, M.D.

“It is tempting to be mesmerized by the numbers. But behind each one of those numbers is a woman who entrusted her health to our care—a woman whose quality of life we affected. That is a humbling responsibility that keeps us focused on caring for the individual.”

This patient-care environment created educational opportunities found in few other departments of obstetrics and gynecology. With 80 approved positions and 72 residents in training, the Department has the largest OB/Gyn residency program in the United States.

Educating Hundreds - Training Tomorrow's Physicians Today

Doximity and US News and World Report consistently ranked the Department’s Residency Program in the top 10 (out of approximately 285 programs) for both reputation and research output. Over the 16 years of Dr. Bloom’s tenure, the program attracted top candidates from across the country as well as graduates from UT Southwestern who were drawn to the specialty following clinical rotations while medical students. In fact, approximately one out of every 80 OB/Gyn residents in the country trained in the UT Southwestern–Parkland Residency Program.

Graduating residents from Parkland and across the country vied for positions in the Department’s five subspecialty fellowship programs. In 2018, a Minimally Invasive Gynecologic Surgery Fellowship was introduced to complement the programs in Female Pelvic Medicine and Reconstructive Surgery, Gynecologic Oncology, Maternal–Fetal Medicine, and Reproductive Endocrinology and Infertility. The number of clinical fellows grew to 18 per year.

The educational mission of the Department was shared by all faculty members. Led by medical-class coordinators, department faculty participated in medical student education in all four years with major emphasis in the third and fourth years. The residency program was under the leadership of a residency director with input from the faculty Clinical Competency Committee; and fellowship programs were under division fellowship directors. Although the faculty shared a common educational philosophy, there was no central entity connecting these educational components together.

With the mission to provide the strategic vision for the educational aspects of the Department and to identify and implement opportunities to align across educational training and development, the Division of Education and Faculty Development was formed in 2019. This organizational structure tied the Department’s undergraduate and graduate education missions into a cohesive entity by linking the divisional fellowship programs (which remained under their respective divisions) to the other graduate and undergraduate programs which reported to the Chief of the Division of Education and Faculty Development, Vanessa L. Rogers, M.D.

As its title suggests, the Division of Education and Faculty Development’s mission extended beyond trainees to include the faculty as well. Although senior faculty had long mentored their junior colleagues, there had never been a formal mentoring and education program just for faculty. This new division filled that void — mentoring faculty, and coordinating the promotions and tenure process for the Chair’s Office. What is more — realizing that only through a commitment to personal health can physicians be effective teachers and healers, the Division also led the effort to develop a faculty wellness program that emphasized physical, mental, and emotional health.

“Operating the largest physician-training program in the country is a big responsibility. It requires faculty members who are dedicated to teaching—faculty members who are as committed to learning as they are to educating others. We are humbled by the responsibility and proud to be today’s mentors of tomorrow’s doctors.”

Since 1969, the education mission has included the publication of the textbook, Williams Obstetrics. While F. Gary Cunningham, M.D., was Chair (1983 through 2004), he assumed the editorship from Jack A. Pritchard, M.D.; and he continued as editor-in-chief after retiring as chair. Between 2005 and 2022, five more editions were produced, including the silver anniversary 25th edition in 2018.

Dr. Cunningham — like the original author of Williams Obstetrics, J. Whitridge Williams — believed that the disciplines of gynecology and obstetrics belonged together. And for years, he’d been thinking about a companion gynecology textbook to Williams Obstetrics. Following his retirement as department chair, Dr. Cunningham enlisted gynecologists — John O. Schorge, M.D., Joseph I. Schaffer, M.D., Lisa M. Halvorson, M.D., Barbara L. Hoffman, M.D., and Karen D. Bradshaw, M.D. Together they published Williams Gynecology in 2008.

In gratitude for his guidance, the dedication read, "Appropriately, our inaugural edition of Williams Gynecology, is dedicated to Dr. F. Gary Cunningham, whose academic vision led to the creation of this text. … During this text’s production, we, his co-authors, have benefited greatly from Dr. Cunningham’s writing genius, his meticulous organization, and his tenacity to task. We feel privileged to have learned the craft of clear, concise academic summary from a consummate master."

Three more editions of Williams Gynecology appeared in 2012, 2016, and 2020.

Advancing Our Knowledge Through Basic and Clinical Research

When Dr. Bloom was named Chair in 2006, the Department was at a crossroads. The loss of the Cecil H. and Ida Green Center for Reproductive Biology Sciences in 1999 left the basic science faculty without their signature venue and had a negative impact on researchers’ ability to attract funding. This loss was followed in October 2006 by the dissolution of the Division of Maternal Health and Family Planning after the last of their clinical programs was moved to the Parkland Health and Hospital System. The legacies of two former chairs, Paul C. MacDonald, M.D. (1970-1976) and Jack A. Pritchard, M.D. (1955-1970), were gone and with them much of the Department’s identity.

Early on in his administration, Dr. Bloom led the search for a director of basic research. With the support of Dean Alfred G. Gilman, M.D., Ph.D., the plan was to move the Cecil H. and Ida Green Center for Reproductive Biology Sciences back to its birthplace in the Department of Obstetrics and Gynecology and house it in newly renovated space adjacent to the Department’s academic offices — space that coincidently served as the first home of Green Center back in 1974.

After a nation-wide search, in 2010, W. Lee Kraus, Ph.D., from Cornell University became the new Director of the Green Center and the Vice Chair for Basic Research in the Department of Obstetrics and Gynecology as well as the Chief of the Department’s Division of Basic Reproductive Biology Research.

With Dr. Kraus as its Chief, the Division of Basic Reproductive Biology Research was re-energized. Its mission encouraged synergism between the Department’s basic, translational, and clinical researchers and offered training opportunities in reproductive biology for graduate students, postdoctoral fellows, interns, residents, and clinical fellows. Both the Division and the Green Center promoted cutting-edge, integrative, and collaborative basic research in female reproductive biology. In the Green Center, this mission also focused on signaling, gene regulation, and genome function.

Dr. Kraus provided the leadership that had been lost with the death of Dr. Paul MacDonald in 1997. He recruited new faculty and fellows to join the Green Center. By agreement, these recruits had appointments in the Department of Obstetrics and Gynecology and were members of Basic Reproductive Biology Research Division. The Green Center and the Department were united once again.

Reinvigorated, the basic science faculty successfully competed for renewal of the National Institutes of Health (NIH) program project grant, “Initiation of Human Labor: Prevention of Prematurity.” First funded by NIH in 1974 under Dr. Paul C. MacDonald’s leadership, this research was concerned, as its title suggests, with enhancing our understanding of the biological mechanisms that trigger childbirth. Recent investigations focused on identifying the molecular events during pregnancy that cause remodeling of the cervix from a closed, rigid structure to one that expands to enable passage of a term fetus. Between September 2005 and August 31, 2021, this multi-principal-investigator grant was responsible for more than $18.6 million in research support from the National Institutes of Health.

With Dr. Kraus at the helm, Green Center faculty brought in more than $23 million in additional research funding between 2010 and 2021. The advances made by the faculty of the Green Center did not go unnoticed. And, in 2019, the Cecil H. and Ida Green Center for Reproductive Biology Sciences became an independent, department-level, endowed academic research center at UT Southwestern — a dream come true. This meant that faculty recruited to the Green Center would have primary appointments in the Center and secondary appointments in affiliated departments — Obstetrics and Gynecology among them. While now an independent entity, the Center maintained its alliance with the Department of Obstetrics and Gynecology, and most of its faculty had primary or secondary appointments in the Department.

Basic research had its counterpart on the clinical side. Since 1956, the Department had been recognized nationally for its clinical outcomes research. From about 1980 until his death in 2020, Kenneth J. Leveno, M.D., former Chief of the Division of Maternal–Fetal Medicine and Vice Chair for Clinical Research, led this clinical research effort. The philosophy was simple — “to measure what we practice.” Dr. Leveno believed that physicians had “a responsibility to measure the efficacy and safety of what we do for our patients.”

Clinical studies ran the gamut of the health problems faculty and trainees treated. For example, during Dr. Bloom’s tenure, Department faculty led the $30 million effort of the NIH Maternal-Fetal Medicine Units Network to screen 10,000 women for subclinical hypothyroidism and evaluate its impact. Another study conducted by gynecology faculty as part of the NIH Pelvic Floor Disorders Network found that an estimated 20 percent of childbearing women suffered from pelvic floor disorders as they age.

The Department consistently ranked among the top 20 OB/Gyn departments for funding from the National Institutes of Health. In addition to the program-project grant ($18.6 million), individual research grants generated more than $17.2 million in funding between September 2005 and August 31, 2021. The Department was also fortunate to participate in the NIH Contraceptive Clinical Trials Network, the NIH Maternal–Fetal Medicine Units Network, the NRG Oncology/Gynecologic Oncology Group, and the NIH Pelvic Floor Disorders Network. All totaled, these NIH clinical trials networks were responsible for more than $25.6 million in research funding during Dr. Bloom’s tenure. That brought the total departmental federal funding between September 1, 2005 and August 31, 2021 to $61,461,268.

Underlying the money is the research that was responsible for the funding. It had always been Dr. Leveno’s hope to have a perinatal research center dedicated to clinical research. Due largely to his reputation as a clinical investigator and his passion for delivering quality patient care regardless of socioeconomic status, he found support for that concept from the Simmons Sisters of Dallas, a foundation that was dedicated to both helping children and to early childhood education. In 2017, the Simmons Sisters of Dallas awarded a five-year, $2,500,000 grant to the Parkland Foundation to “help sustain and expand the operation of the Parkland–UT Southwestern Medical Center Obstetrical Quality Research Center.” A dream come true for Dr. Leveno and the Department, the staff moved into newly renovated space adjacent to the Department’s academic offices and the Green Center.

Over the course of Dr. Bloom’s chairmanship, the Department made significant contributions to the body of scientific knowledge in obstetrics, gynecology, and female reproductive biology through clinical and basic investigation. Faculty had been invited to lead multi-center clinical studies and even to testify before Congress. And, the Department’s reputation for quality, evidence-based clinical care, and basic research was reinforced by its publications.

In 2010, the Department began compiling an annual list of publications by faculty and fellows. Understandably, most of the 964 articles published over the next 10 years were in journals devoted to the OB/Gyn specialty and its subspecialties. But, the faculty and fellows also left their mark in the “highest impact” journals with eight articles published in the Journal of the American Medical Association, 14 in the New England Journal of Medicine, three each in Cell and Science, and one each in Lancet and Nature. Research was embedded in the departmental DNA.

“Underlying our clinical practice and training programs is a continual quest for knowledge to help us define best practices. It drives us to measure outcomes and conduct clinical trials. It leads us to foster cutting-edge, integrative, and collaborative basic research. Whatever its form, research—as much as anything else—defines who we are as a department.”

Federal funding alone is not enough to support the Department’s research efforts. Aside from scholars’ awards and training grants, federal support does not contribute to the other missions of the Department. State funds only cover a portion of the cost the Department incurs to educate medical students, residents, and fellows. The balance comes from patient-care revenue, contracts for services, and philanthropy.

Among the non-federal funding sources, endowments serve as a barometer of the Department’s impact outside the university’s enclaves — its recognition by the community and influence nationally. Of the six endowments that were added during Dr. Bloom’s tenure, three were named for esteemed faculty members whose reputations and contributions to their specialty reached beyond the United States.

The Norman F. Gant, Jr., M.D. Chair in Obstetrics and Gynecology was endowed in 2010 by various donors to honor the physician–scientist who pioneered studies in the vascular responsiveness of angiotensin II in human pregnancy and was recognized internationally as a leader in obstetrics and gynecology. Dr. Gant was chair of OB/Gyn at UT Southwestern from 1977 until mid-1983 and served as the Director of the American Board of Obstetrics and Gynecology (ABOG) from 1993 until his retirement at the end of 2009. He was named Professor Emeritus in 2010. The first recipient of the Gant Chair was George D. Wendel, Jr., M.D., who was Director of the OB/Gyn Residency Program from 1994 to 2012.

First endowed in 2016 as a professorship, in 2019, the Distinguished Professorship in Obstetrics and Gynecology in Honor of F. Gary Cunningham, M.D. was established. Dr. Cunningham, former chair of OB/Gyn (1983 through 2004) and an authority on the hematological and hypertensive disorders of pregnancy, was known worldwide as the editor-in-chief of nine editions of Williams Obstetrics. He also spearheaded the creation of the companion textbook, Williams Gynecology; and was co-editor and contributing author of Chesley’s Hypertensive Disorders in Pregnancy. Barbara L. Hoffman, M.D., was the inaugural holder of the professorship.

Also in 2019, former fellows endowed the Bruce R. Carr, M.D. Professorship in Reproductive Endocrinology and Infertility in honor of their mentor. Dr. Carr succeeded Paul C. MacDonald, M.D., as fellowship director in 1985 and continued in that role through December 2020. In January 2021, he retired. An internationally recognized authority on steroidogenesis in the human fetal adrenal gland and a frequent lecturer on the disorders that affect fertility, he was editor-in-chief of the journal Seminars in Reproductive Medicine and co-editor of the foundational texts Essential Reproductive Medicine and the Textbook of Reproductive Medicine. Orhan Bukulmez, M.D., Chief of the Division of Reproductive Endocrinology and Infertility, was named the first holder.

During Dr. Bloom’s tenure, the Department added two more emeritus professors. In addition to Dr. Gant, whom we mentioned above, David L. Hemsell, M.D., was honored with emeritus status in 2016. The first Chief of Gynecology at Parkland Memorial Hospital (1977–1997), Dr. Hemsell was a world recognized authority on pelvic infections. His studies on the etiology and pathogenesis of pelvic infections following gynecological surgery led to guidelines for enumeration of risk factors in surgical patients and reduced in-patient post-operative days.

Remembering the Legacies of Those We Lost

Sadly, the Department lost several distinguished faculty. A pioneer in the field that came to be known as neuroendocrinology, John C. Porter, Ph.D., passed away in 2018. He was among the first to study how the hypothalamus interacted with the pituitary gland and to measure peptide hormones in the brain using an “embulating” device he invented to inject air bubbles at prescribed intervals during the collection process. This enabled him to collect discrete aliquots of hypophysial portal rat blood over long periods of times and prevented the blood from mixing during collection.

In 2019, we lost Gary E. Ackerman, M.D. In the late 1970s as the world awakened to the birth of the first test tube baby, Dr. Ackerman created the Department’s first sperm bank. He went on to become medical director of Parkland’s Women’s Intermediate Care Center (ICC) — a position he held for almost 20 years (1988–2006).

Two icons of maternal-fetal medicine passed away within a year of each other. Kenneth J. Leveno, M.D., whose unwavering belief that physicians are responsible for measuring and improving the quality of care they provide, died in 2020. The architect of a prenatal care system that is now accessed by 97 percent of women delivering at Parkland, his innovations and clinical research changed the outcomes for countless pregnant women.

Dr. Leveno’s death was followed in 2021 by another pioneer in women’s health care, Peggy J. Whalley, M.D. Dr. Whalley had many “firsts” to her credit. But, her most innovative first was the creation of the first neonatal high-risk pregnancy ward in Dallas at Parkland in 1971. Believing that bedrest would change the outcome for pregnant women with complications, she changed the paradigm for their care.

Reflecting on the legacies of his mentors, Dr. Bloom acknowledged the value of the culture he had inherited from his predecessors; and he sought to preserve the story of the Department. What began as a request to document the history of the Department chairs, evolved into a larger project that included documentation of the birth of basic research in the Department, the founding of the Green Center, and the contributions of emeritus professors. The results can be found on the OB/Gyn History webpages.

Dr. Steven L. Bloom pictured in front of three chair emeritus predecessors in 2006.

A side benefit of this quest was the publication of two books in 2014. The first was Every Life Has A Story, And This is Mine, the autobiography of the Department’s second chair, Jack A. Pritchard, M.D. And, the second was The Life and Times of William F. Mengert, M.D., the Department’s first chair. Both are available in the UT Southwestern Library Archives.

When the Parkland Foundation approached UT Southwestern clinical departments to raise funds for the new Parkland Memorial Hospital, as an incentive, they offered the opportunity for each department to place a display of their choosing in their area of the new hospital. After considering several options, the OB/Gyn Committee chose to commemorate the Department with a timeline entitled, "Mentors and Milestones in Obstetrics and Gynecology."

The timeline traces the history from the Department’s founding in 1943 through August 2015 when the new Parkland Memorial Hospital opened. Its story reveals the contributions of the team who built the Department as well as those who continued to build on that foundation. This impressive exhibit, also known as the “Parkland Wall,” hangs near Labor and Delivery on the third floor of the Serena Simmons Connelly Tower.

Timeline: Mentors and Milestones in Obstetrics and Gynecology

In August 2020, Dr. Bloom announced his intention to resign as chair when a successor could be found. It would be another year before he could step down and become the full time Associate Dean for Clinical Sciences. By then, he had led the Department of Obstetrics and Gynecology for a total of 16 years and 8 months.

His tenure had seen everything from the launching of the textbook, Williams Gynecology, to resurgence in basic research with the return of the Cecil H. and Ida Green Center for Reproductive Biology Sciences, to the expansion of community health services and the opening of two new hospitals with level IV maternity services, to the creation of a new division dedicated to education.

To cap it all off, there was a global pandemic which turned everything upside down and gave birth to a virtual life. In 16 years, the Department had gone from the dawn of the electronic medical record, to treating patients virtually, delivering student lectures virtually — even interviewing applicants for the residency and fellowships virtually. This virtual life came into existence in the space of one year. Talk about a challenge! This was “the granddaddy of them all.”

Through it all, Steven Bloom’s leadership kept the Department true to its mission — focused on providing quality evidence-based care to all patients served regardless of their socio-economic status, to teaching the next generation of physicians, and to advancing the knowledge of reproductive health through basic and clinical research.