DIVISION OF NEONATOLOGY

Neonatal-Perinatal Medicine Fellowship

Fellowship Third Year

During the third year, the fellow is expected to develop skills to practice neonatology competently and independently. They complete 3 blocks in the NICU, with one block as a “junior attending” supervising a NICU team. They also complete one block in the cardiac care unit to learn the management of post-operative cardiac care. They also assume responsibility for organizing conferences and call schedules. They are expected to complete the core curriculum and produce a “work product” to summarize their completed scholarly activity.

Each of the 3 years of fellowship is divided into 13 4-week blocks. On average during the three years of fellowship there are 17.5 blocks of clinical training, (including clinical electives, call, and follow-up clinic) 19.25 blocks for research and 2.25 blocks of vacation.

Third Year NICU Blocks

UH NICU (PGY6)
This rotation, several months into the last academic year, will allow the fellow maximum autonomy as the acting attending. They will demonstrate not only clinical skills but will be responsible for training and evaluating the residents as well. Staff backup and oversight will always be present and available; however, interference with fellow management plans will be kept to a minimum. The primary goal is to ensure that the fellow is a competent independent practitioner at the completion of their PGY6 year. Senior fellows continue to organize and run AM report with more autonomy than per PGY 4 and 5 years.

CSICU (PGY6)
Fellows will do one 4-week block in the cardiac intensive care unit during their PGY6 year. The main purpose of this rotation is for senior fellows to further their understanding of both the diagnosis and management of congenital heart disease (CHD) in neonates. Fellows will be directly supervised by the pediatric critical care staff, and have multidisciplinary interaction with pediatric cardiology, cardiothoracic surgery, and anesthesia staff. Fellows will primarily follow and make decisions on all neonatal and infant patients with CHD admitted to the unit for surgical repair of their disease. Didactic teaching will be given during daily rounds with the pediatric critical care and cardiology staff as well as weekly grand rounds with pediatric cardiothoracic surgery. Fellows will participate in any procedures required for their patients both pre- and post- operatively while in the CSICU, and will directly observe operative management by CT surgery and anesthesia in the operating room. Fellows will also participate in diagnostic management of patients with cardiology to include involvement with pre-operative echocardiograms and cardiac catheterizations, as well as through attendance of a weekly cardiac care conference.

PREMIEre Clinic (PGY6)
Fellows attend approximately 28-32 high-risk follow up clinics each year. The goal of this twice-weekly clinic is to provide health care management and maintenance to parents and their infants who were cared for at UH NICU and were born with a birth weight of <1500 grams and/or have a high risk for long term neurodevelopmental disability. The clinic provides patients with neurodevelopmental assessments using Bayley Scales of Infant Development as well as evaluation by a neonatologist and fellows for growth and neurodevelopment. The clinic follows patients from the time of discharge until they are 3 years old. Infants found to be at high risk for developmental delays are also referred to Early Childhood Intervention programs. Patients will be seen by the NICU fellow assigned to the clinic and supervised by a staff neonatologist. All management decisions and follow-up plans will be communicated with the patient’s primary care physician.

Other electives available during the fellowship include:

  • NICU rotations at an outside Level III or IV hospital
  • Maternal-fetal Medicine
  • Pediatric Cardiology
  • Clinical Statistics
  • Newborn Nursery/Neonatal Nurse Practitioner Service