The family practice residency program at Cox Medical Center South once relied on a single community OB/GYN for on-call C-section coverage and OB support. Cox South, located in Springfield, MO, has a high-risk patient population, with a large portion of patients on Medicaid. The residency program accepts high-risk patient transfers from its partner maternal fetal medicine practice, which are even higher risk. Residents were tasked with caring for these high-risk OB patients with minimal support.