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Neonatal-Perinatal Medicine Fellowship: Program Curriculum |
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Residency & Fellowship Programs > Pediatrics > Neonatal-Perinatal Medicine Fellowship: Program Curriculum |
The Neonatal-Perinatal Medicine Fellow participates in the inpatient service and a variety of outpatient clinics. The Fellow works closely with the staff of the Neonatal Division, both in their capacity as clinical supervisors and research mentors. Faculty members meet with the Fellow daily to discuss clinical issues and weekly to discuss research projects. Formal didactic sessions are conducted to expose the Fellow to a broad range of issues including basic science, statistics, epidemiology, current research and ethics. The Fellow has the opportunity to interact with families of sick newborns and to develop an appreciation of the impact that illness of a newborn has on family function. Back to Top Inpatient Experiences - Neonatal Intensive Care Unit The Fellow has direct supervisory responsibility for the care of all acute and chronic patients in the Neonatal Intensive Care Unit (NICU). In addition, the Fellow attends high risk deliveries with senior pediatric residents, and neonatal nurse practitioners. All referrals for transport are discussed with the Fellow, who will consult with community physicians regarding problems in the Newborn Nursery. The Fellow may consult on infants transferred from the Neonatal Intensive Care Unit to either the Pediatric Floor or community hospitals. An Attending Neonatologist directly supervises the Fellow. The Fellow rounds daily with the Attending Neonatologist to discuss new admissions, management issues, and patient discharges. The Attending Neonatologist is also available to consult about all high risk deliveries, referrals for transport, and consults on the Pediatric Floor or in community hospitals. The Fellow makes daily rounds with a Pediatric Radiologist to review all radiologic studies, and meets weekly with the Maternal-Fetal Medicine Service to discuss all admissions to the Neonatal Intensive Care Unit and all prospective admissions. The Fellow has access to all consultants in the Neonatal Intensive Care Unit on a case-by-case basis. Altogether, the Fellow makes 13-15 hours of rounds with faculty each week. Back to Top Inpatient Experiences - Cardiac Intensive Care Unit The Neonatal-Perinatal Medicine Fellow participates in a one month external rotation at the Cardiac Intensive Care Unit (CICU) at Children's Hospital in Boston. The Fellow will rotate through the CICU during one month of either the second or third year of fellowship. The CICU is dedicated to the post-operative care of infants and children who have undergone surgery for repair of congenital heart disease at Children's Hospital. Back to Top The Neonatal-Perinatal Medicine Fellow participates in a variety of outpatient clinics. The outpatient clinical experience includes the medical and developmental follow-up of high risk NICU graduates. Developmental and Medical Follow-Up Clinics The Neonatal-Perinatal Medicine Fellow attends the NICU Follow-Up Clinic and directly participates in the medical and neurological evaluation and assessment of each infant presenting to the clinic. The Fellow becomes acquainted with a variety of tools and instruments for investigating delays or abnormalities in cognitive, gross motor, fine motor and speech and language skills. The Fellow masters a working knowledge of administering, scoring and interpreting these developmental assessment tools, and helps formulate plans for early intervention services. In the NICU Follow-Up Clinic, the Fellow is supervised by a Developmental Pediatrician. The Neonatal-Perinatal Medicine Fellow attends the Neonatal Medical Follow-Up Clinic. Infants discharged from the Neonatal Intensive Care Unit who have complex medical needs are referred to attend the Neonatal Medical Follow-Up Clinic for consultation and follow-up of medical problems related to their NICU course. The Fellow learns about the natural history of many of the processes dealt with in the NICU, and helps families deal with integrating their fragile newborn into their lives and their community. Additional Inpatient Experience In order to broaden the scope of cases seen during the Neonatal-Perinatal Medicine Fellows clinical service, an additional one month rotation is currently being established at the Children's Hospital to expose the Neonatal-Perinatal Medicine Fellow to a greater variety of Pediatric Surgical cases. Back to Top During the first year, the Neonatal-Perinatal Medicine Fellow spends a total of six months assigned to clinical duties in the Neonatal Intensive Care Unit. During this period, the Fellow is directly supervised by the Attending Neonatologist, Pediatric Surgeon, or Neonatal Nurse Practitioner regarding any technical procedures with which the Fellow is unfamiliar. During clinical months in the Neonatal Intensive Care Unit, the Fellow supervises a team consisting of a senior pediatric resident (PL2 or PL3), 1 or 2 pediatric interns (PL1), family practice residents, Acting Interns (senior medical students) and Neonatal Nurse Practitioners. The Fellow makes daily work rounds and teaching rounds (Daily schedule attached), and meets daily with the Neonatal Attending to discuss all new admissions and management plans for all cases. The Attending suggests readings and references regarding specific cases. The Fellow is responsible for direct communication to parents and community physicians, and organizes both transfers to the Neonatal Intensive Care Unit and transfers to the Pediatric Ward, Newborn Nursery, or community hospital. The Fellow attends and contributes to formal weekly Disposition Planning Rounds. The Neonatal-Perinatal Medicine Fellow or Attending attends all high risk deliveries. During the first year, the Fellow begins to evolve focused research interests. At bi-monthly divisional meetings, Fellows present potential areas of research and are critiqued by the entire staff. During this time, Fellows conduct library research and begin to design, write, and initiate their research projects. A research mentor is chosen and begins work with the Fellow. Fellows attend monthly Developmental Clinic and begin their exposure to the evaluation and care of high risk infants with developmental problems. When not on clinical service, they attend weekly Neonatal Medical Follow-Up Clinic for the medical follow-up and developmental screening of graduates of the NICU. The Neonatal-Perinatal Medicine Fellow has a similar clinical schedule during the second year of the fellowship. The Fellow spends a total of six months assigned to clinical duties in the Neonatal Intensive Care Unit, and is given increased responsibility and autonomy for decision making. During the second year, the Fellow's research project is clearly delineated and is conducted under the supervision of the research mentor. During either the second or third year, the Fellow participates in a one month external rotation at Children's Hospital in Boston in Cardiac Intensive Care focusing on the immediate post-operative management of infants after cardiothoracic surgery. Back to Top During the third year, the Fellow functions as a co-attending in the Neonatal Intensive Care Unit for six months. During the other six months, the Fellow completes the research project, presents the results to the Department of Pediatrics, and submits the results for presentation at major national scientific meetings and for subsequent publication. The third year Fellow continues to attend medical and developmental follow-up clinics. Back to Top The on call schedule for the Neonatal-Perinatal Medicine Fellow varies depending on whether the Fellow is on a clinical month or a research month. On a clinical month, the Fellow will take night call twice a week during the week, and two weekends during the month. On a research month, the Fellow will take night call once a week and one weekend during the month. All call is taken from home. Neonatal-Perinatal Medicine Fellows will receive calls from senior pediatric residents in the NICU regarding high risk deliveries, NICU admissions, clinical care of inpatients, and consults from referring physicians. If needed, it is expected that the Neonatal-Perinatal Resident will be in the NICU within 20 minutes of a call. On every assigned night, an Attending Neonatologist is also on night call. The Neonatal-Perinatal Medicine Program has positions for two Neonatal-Perinatal Medicine Fellows. Prospective candidates are encouraged to apply during their second year of pediatric residency. The Fellowship Director, with the aid of the Neonatal-Perinatal Medicine Faculty, selects from the completed applications those candidates who will be offered an interview. It is not possible for the Neonatal-Perinatal Medicine Program to reimburse candidates for their interview expenses. Criteria for acceptance into the NPM Fellowship program are:
For successful candidates, we make every effort to help in finding suitable housing and spousal employment. |
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