Neonatology
Clinical

Clinical Training

The clinical curriculum in the Neonatal-Perinatal Medicine Fellowship Program at Cincinnati Children’s includes clinical experiences at three intensive care units, as well as experience in transport and in High Risk Follow-Up Clinic. This broad experience ensures that neonatal fellows are fully exposed to the complete range of neonatal issues and graduate with exceptional skills in the management of sick neonates.

The fellowship program provides diverse clinical experiences, as well as instruction in the psychosocial dynamics surrounding the birth and care of a sick neonate. Fellows participate in clinical rotations in three intensive care nurseries in Cincinnati – Cincinnati Children’s Hospital Medical Center, Good Samaritan Hospital and University Hospital. Our fellows consider this opportunity to be one of the greatest strengths of the program.

Cincinnati also has one of the few fetal care programs in the country, and fellows are given training and the opportunity to participate in subspecialized care programs, including fetal care, the congenital diaphragmatic hernia team and ECMO at the NICU at Cincinnati Children’s.

Curriculum and Call

The curriculum for the neonatology fellowship in neonatal-perinatal medicine is structured to foster camaraderie, educational excellence and outstanding patient care. To fulfill the requirements of the ABP, fellows complete 11 months of clinical service throughout their three-year education. Clinical time is concentrated in the first and second years, with the majority of the third year devoted to research. Flexibility in the clinical and call schedules allows fellows to block time and tailor their educational programs to meet their long-term career goals.

During the first year of training, fellows develop the skills required to diagnose and manage problems of the newborn and gain experience in delivery room management and transport medicine. New fellows orient with a senior fellow for their first service block and first month of call. During this year, fellows also identify a suitable research mentor and begin a research project.

Schedule for first-year fellows:

  • Five to seven in-house calls per month
  • Four to five transport calls per month (from home)
  • 15-18 weeks’ NICU service
  • Research for the remainder of the time

During the second year of training, fellows refine skills acquired in the first year, teach in a variety of settings and enhance their leadership skills through a number of avenues.

Teaching opportunities are present in all three NICU settings, as core pediatric residents rotate through the NICUs. Teaching opportunities in each unit vary, giving fellows a chance to cover a wide range of subjects.

Second-year trainees learn to identify high-risk pregnancies and evaluate fetal well-being and maturation. They also have the opportunity to become skilled in the preoperative and postoperative management of infants requiring surgery.

In the second year, fellows have the opportunity to enhance their clinical skills and their salary by “moonlighting” – taking more than four calls per month in the NICU.

In addition to clinical time, second-year fellows spend half of their year on research, advancing their research skills and making progress on their chosen projects.

Schedule for second-year fellows:

  • Five to six in-house calls per month
  • Two to four transport calls per month (from home)
  • 15-18 weeks’ NICU service; one week Cardiac Care Unit (CCU) service
  • Research for the remainder of the time

During the third year, fellows complete a research experience relevant to pregnancy, the fetus and / or the newborn. Fellows also select an available clinical elective during the third year. To ensure that they have mastered the clinical and leadership skills needed to lead a neonatal team, fellows function as attendings by completing a junior attending rotation during their third year. Senior fellows also have the opportunity to enhance their financial stipends, as all in-house calls are considered moonlighting in the third year.

Schedule for third-year fellows:

  • Four in-house calls per month
  • Three weeks’ junior attending NICU coverage; two weeks’ CCU service
  • Three to four weeks’ elective time
  • Research for the remainder of the time

Fellows in the Neonatal-Perinatal Medicine Fellowship Program at Cincinnati Children’s complete a CCU elective, and can choose between a perinatology or international elective during their elective time.

  • The CCU elective, based at Cincinnati Children’s, gives fellows the chance to care for infants with cardiac diseases common to the neonatal period. Fellows round daily in the CCU and participate in the pre- and postoperative management of newborns with congenital heart disease and cardiac issues.
  • The perinatology elective at either University Hospital or Good Samaritan gives fellows the opportunity to assist board-certified perinatologists in the care and management of high-risk pregnancies, with the goal of understanding the pathophysiology of problem pregnancies.
  • For the international elective, fellows interested in global health can arrange a one-month elective in the country of their choice, giving them exposure to neonatal diseases that are uncommon in the United States and neonatal practice in regions with limited resources.
Throughout fellowship training, neonatal fellows in the neonatal-perinatal medicine fellowship take part in the care of critically ill neonates transported to and from Cincinnati Children’s. There are approximately 500 neonatal transports per year, and neonatal fellows accompany the transport team for 20-25 percent of those transports, gaining critical experience in transport medicine and beneficial exposure to smaller referral hospitals. Experience outside of the NICU helps fellows gain critical skills that are useful in the variety of practice environments they encounter after fellowship.
The fellowship program provides diverse clinical experiences, as well as instruction in the psychosocial dynamics surrounding the birth and care of a sick neonate.
  

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