The educational program is structured to provide progressive clinical experience and instruction so that the neonatal-perinatal fellow develops competence in the care of critically ill newborns and specialty-specific skills (e.g. neonatal resuscitation, endotracheal intubation, umbilical line placement). Emphasis is placed on the fundamentals of clinical diagnosis and management of problems seen in the continuum of development from the prenatal through the intrapartum and neonatal periods, including longitudinal follow-up.
Clinical training and acquisition of specialty-specific skills are the main objectives of the first year of training. The first year neonatal-perinatal fellow completes 5 rotations (months) in the NICU assigned to a team of pediatric residents or NNPs. They learn pulmonary pathophysiology of common newborn lung diseases and how to manage modes of respiratory support including synchronized intermittent mandatory ventilation and high frequency ventilation. They participate in a procedure lab to learn proper techniques for umbilical line placement and chest tube insertion. To learn advanced resuscitation skills, they are certificated as an instructor for the American Academy of Pediatrics Neonatal Resuscitation Program. Each fellow selects a mentor and submits a formal proposal for a scholarly activity for approval by the departmental scholarship oversight committee and begins the approved project.
During the second year, fellows are expected to develop an advanced understanding of complex clinical problems and to be able to independently formulate an appropriate differential diagnosis, diagnostic evaluations, and initial treatment of ill newborns. They are scheduled to complete 4 months in the NICU and rotations in perinatology/genetics and cardiology. They are expected to assume a more managerial role in the care of the patients, supervision of team members, and interactions with other consultants. They have 6 months to conduct their approved scholarly activity and present their work in progress twice in the second year to their scholarship oversight committee.
During the third year, the fellow is expected to develop skills to practice neonatology competently and independently. They complete 3 months in the NICU, with one month as a “junior attending” supervising a NICU team. 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.
To develop an understanding of fetal disorders and the high-risk pregnancy, the second year fellows participate in a month rotation in maternal-fetal medicine and genetics. This includes observation of fetal ultrasounds, and participation in consultation in the high-risk obstetric clinic (UMMC Center for Advanced Fetal Care). They attend genetics clinic and participate in genetic counseling and consultations.
Each fellow spends a month in cardiology during the second year to observe fetal and neonatal echocardiograms and cardiac catheterizations, and participate in cardiology clinics, consultations, and post-op cardiac care.
Each fellow participates in a core curriculum that includes topics in biostatistics, clinical and laboratory research methodology, study design, scientific writing, grant application preparation, critical literature review, principles of evidence-based medicine, ethical principles in clinical research, curriculum development, principles of adult learning, lecture skills, providing feedback, and teaching skills in oral and written forms. Curriculum formats include in-depth 1-2 week courses, one-day topic-specific conferences, and individual lectures.
Research opportunities under the direction of a mentor are available. With more than 15,000 square feet of research space, the department of pediatrics manages active funded programs including those of the neonatology division with interests in brain and lung development, and the role of inflammation in neonatal brain, lung, and intestinal injury.
The Department of Pediatrics is in the top 10 of state-funded schools for research grants. Each fellow is required to complete a scholarly activity during their fellowship training (e.g. clinical, basic, translational research, educational curriculum development, or health services, to name some of the possibilities). Fellows are expected to present their work at regional and national meetings of professional societies.