Curriculum
Orientation
The goal of the orientation is to assure that each fellow has the opportunity to make a smooth transition from the role of Pediatric resident or primary care pediatrician to the role of Neonatology fellow. This orientation typically occurs during the first 2 months of training. Fellows will function at a senior resident level during this period and are assigned patients. They are expected to follow the patients throughout the orientation period, with the responsibility for decision making on management, diagnostic tests and procedures, discharge planning as well as communication with parents, attending physicians, consultants and nursing under the direct supervision of faculty.
The fellows are preferentially given opportunities to perform as many procedures as possible, under attending or senior fellow's supervision, in order to improve their procedural skills and confidence. Additionally, fellows can hone their skills in doing less common procedures by practicing in our fully equipped Simulation lab under faculty guidance. After the initial orientation period and satisfactory demonstration of basic clinical competencies in neonatal care, the fellows take progressively increasing responsibilities throughout the 3 years of fellowship. By third year of fellowship the fellows work as junior faculty with a neonatology attending readily available for consultation.
During this rotation, in the 1st year the fellows are introduced to patient management skills and are responsible for clinical assessment of all the infants in the NICU and development of appropriate care plan, participation in the daily multidisciplinary rounds, communication with attending physicians, referring physicians, obstetricians, sub specialists, pediatricians, ancillary staff, parents and other care givers, discharge planning coordination, supervision of resident procedures, evaluation and triaging of outside consultations and transport calls, participation in all fellowship related educational and administrative activities.
During the 2nd and 3rd years, the fellows play a progressively increasing supervisory role, with increasing autonomy in clinical decisions. The fellow is responsible for supervising and teaching the residents and medical students who rotate through the NICU in this rotation.
The main responsibility during this rotation is to provide support to the NICU primary fellow and attending. They are also responsible for prenatal, newborn nursery and pediatric floor consultations, attending all high-risk deliveries, clinical assessment of all “feeders and growers” and development of appropriate care plan, discharge planning coordination of these infants, participation in the daily multidisciplinary rounds, coordination of all admissions and transfers, evaluation and triaging of outside consultations and transport calls and participation in all fellowship related educational and administrative activities.
The goal of this 1-month rotation is to achieve an understanding of essential principles of medical and surgical management of complex congenital and acquired cardiac conditions in neonatal patients. During this rotation, fellows participate in all NICU cardiology consults and diagnostic evaluations, attend cardiac conferences where all neonatal pre and post-operative cardiac cases are discussed, interpret diagnostic tests like ECG, Holter reports, ECHO Doppler, and cardiac catheterization and also have an opportunity to follow some of these infants in the cardiology outpatient clinic. During this rotation fellows also have an opportunity to work with cardiovascular surgery team in the pediatric cardiac ICU at ACH-OL and participate in the pre-op and post-op care of these neonates.
During this 1-month rotation in Perinatology, fellows work closely with maternal fetal medicine team to learn the process for identifying high risk pregnancies via evaluation of maternal medical history, previous obstetric history and genetic screening. They also gain understanding about prenatal evaluations including ultrasounds and fetal echo cardiograms. They participate in the multidisciplinary prenatal consultations of high-risk pregnancies through our Center for Fetal Care program.
During this rotation the fellow develops a progressive understanding of developmental as well as medical consequences of high-risk birth. They actively participate in the NICU Follow-up Program which provides neurodevelopmental evaluation for high-risk infants until 3 years of age. They function as a member of clinic multidisciplinary team which includes a coordinator, physical therapist, occupational therapist, speech and language pathologist, audiologist, nutritionist, and social worker. Fellows learn to administer screening examinations and are expected to demonstrate progressively increasing responsibilities for the medical component of the child's evaluation and interpretation of findings with families. Additionally, fellows participate in other interdisciplinary clinics which includes Down Syndrome Clinic, Spina Bifida Clinic, Cleft Palate and Craniofacial Clinic, and Center for Cerebral Palsy and Neuromuscular Clinic.
This rotation is designed to provide the fellow with protected time to work on their mentored research project. The time committed to research rotations allows for the development of a research project, data acquisition and analysis, completion, writing and submission of research projects. A range of experiences from bench research to patient-centered prospective or retrospective studies are offered based on the fellow clinical interest. Supervision and guidance are provided by faculty and fellow mentors through all stages of project from conception to submission of the manuscript to a peer reviewed journal. Each year of training has specific goals and expectations, evaluated at 6-month intervals by scholarship oversight committee, which must be met in order to complete the research project within 3 years. Departmental and institutional support for fellowship research is available which includes educational support.
