Neonatal-Perinatal Fellowship Program

  • About the fellowship program

    The mission of the three-year Neonatal-Perinatal Medicine Fellowship Program of The Children's Hospital of Philadelphia (CHOP) is:

    • To develop outstanding clinicians with solid backgrounds in physiology, pathophysiology and evidence-based practices in neonatology
    • To provide a high-quality scholarly experience that contributes to the scientific community
    • To promote the choice of an academic career in neonatology

    These goals are accomplished through comprehensive clinical training in the care of sick neonates in both the inborn and outborn setting, as well as access to accomplished research mentors within CHOP’s Division of Neonatology and the Perelman School of Medicine at the University of Pennsylvania.

    We offer fellows:

    • A structured curriculum for education in fetal and neonatal physiology and pathophysiology, biostatistics and epidemiology, quality improvement, evidence-based practices, team training, and academic career development
    • A mentored research experience for scholarly projects in a wide-range of subject areas

    The program includes:

    Upon completion, the fellow is eligible for certification by the sub-board of neonatal-perinatal medicine of the American Board of Pediatrics.

    Program leaders

    Scott A. Lorch, MD, MSCE
    Director, Neonatal-Perinatal Fellowship Training Program
    215-590-1714; email Dr. Lorch

    Heather M. French, MD, FAAP
    Associate Director, Neonatal-Perinatal Fellowship Training Program
    215-590-1653; email Dr. French

  • Clinical education

    Clinical education during the fellowship encompasses all areas of clinical neonatal and perinatal medicine.

    Clinical training occurs at two primary teaching sites:

    • The Children’s Hospital of Philadelphia (CHOP)
    • The Hospital of the University of Pennsylvania (HUP)

    Under the supervision of a diverse and dynamic faculty, fellows will gain exposure to the management of babies with a broad range of medical and surgical diagnoses. The academic year is divided into 13 four-week blocks in accordance with training requirements of the Accreditation Council for Graduate Medical Education (ACME).

    Over the three years of fellowship training, each fellow will complete one block of clinical orientation, one block of research orientation, 13 clinical blocks and 21 research blocks. Each fellow receives four weeks of vacation per year.

    The 13 clinical blocks include:

    • 8 blocks — CHOP’s Newborn/Infant Intensive Care Unit (N/IICU) and HUP’s Intensive Care Nursery (ICN)  
    • 2 blocks — CHOP’s Neonatal Surgery Service 
    • 1 block — Neonatal follow-up care
    • 1 block — CHOP’s Cardiac Intensive Care Unit
    • 1 block — Elective

    Clinical education orientation

    The new fellow will begin fellowship with a four-week clinical orientation program. The program includes:

    • Introduction to the clinical services at CHOP and HUP
    • Introduction to ECMO management
    • Introduction to air and ground transport
    • Neonatology Boot Camp, which includes procedural training and neonatal resuscitation program training
    • Short courses on ventilators and pulmonary functioning testing
    • Simulation training, including exercises in teamwork and communication, neonatal and infant resuscitation, perinatal counseling and giving difficult news

    New fellows will shadow senior fellows during daytime clinical service and at night on-call during this four-week block.

    Clinical curriculum

    The clinical curriculum consists of practical clinical experiences and didactic seminars that supplement bedside learning. The clinical rotations include:

    Intensive Care Nursery at HUP

    Fellows will practice in a 36-bed inborn Intensive Care Nursery (ICN) at The Hospital of the University of Pennsylvania, where approximately 4,000 infants are delivered annually. Teaching teams in the ICN consist of an attending neonatologist, a neonatology fellow, senior pediatric residents, pediatric interns and other frontline clinicians (i.e. neonatal nurse practitioner [NNP], physician assistant [PA] and hospitalist).

    Fellows are responsible for the day-to-day management of the unit’s patients as well as attending infant deliveries and completing neonatology consults for high-risk delivery patients. Fellows will work closely with obstetrics (OB) and maternal-fetal medicine (MFM) services to ensure the needs of laboring mothers are identified and met.

    Fellows on-service prepare conferences with the MFM fellows for a bi-weekly Perinatal Conference, including morbidity and mortality review, evidence-based reviews, and presentation of interesting cases.

    Newborn/Infant Intensive Care Unit (N/IICU) at CHOP

    Fellows will practice in an 86-bed, outborn, quaternary referral Newborn/Infant Intensive Care Unit (N/IICU) at The Children's Hospital of Philadelphia. The N/IICU has an average daily census of 87 infants, ranging in age from newborn to 1 year old.

    The N/IICU receives more than 1,050 transports annually and fellows participate in the most critically ill patient transports by air and ground. Teaching teams consist of an attending neonatologist, a neonatology fellow, second-year pediatric residents and other frontline clinicians (NNP, PA and hospitalist).

    Fellows are responsible for the day-to-day management of the unit’s patients, participation in critically ill infant transports, managing patients on ECMO, and attending deliveries of high-risk infants in the Garbose Family Special Delivery Unit (SDU), part of CHOP’s Center for Fetal Diagnosis and Treatment. Fellows on-service prepare conferences for a bi-weekly CHOP Clinical Conference, including morbidity and mortality review and presentation of interesting cases.

    Neonatal Surgery Service at CHOP

    Fellows will practice collaborative care of neonates with surgical diagnoses on the Neonatal Surgery Service at CHOP. Teaching teams in general, thoracic and fetal surgery consist of an attending neonatologist, an attending pediatric surgeon, neonatology and pediatric surgery fellows and surgical nurse practitioners.

    Neonatology fellows have opportunities to participate in the transport of neonates with surgical problems and to participate in maternal consults and deliveries in the SDU. The SDU is the nation’s first birth facility created specifically for mothers expecting babies with known birth defects.

    The high-risk fetuses with surgical and cardiac malformations are delivered in close proximity to the cardiac and surgical ORs and cardiac catheterization suites.

    Neonatal follow-up clinics at CHOP and HUP

    The follow-up experience is a cross-sectional experience during the first year of fellowship. Fellows attend both the CHOP Neonatal Follow-up Program and the HUP Special Babies Clinic. These multidisciplinary clinics are focused on providing guidance to pediatricians caring for N/IICU and ICN graduates with complex medical needs, and providing long-term neurodevelopmental assessment of babies to maximize physical and mental potential and access to services.

    Clinical practice in CHOP’s Cardiac Intensive Care Unit (CICU)

    Second-year fellows participate in the management of neonates and infants in the CICU as a member of the team, attend deliveries of infants with prenatally diagnosed congenital heart disease born in the SDU, and if time allows attend fetal echocardiography clinic and observe cardiac catheterizations and surgeries.

    Elective block based on personal interest

    Fellows have the unique opportunity to plan an elective block based on their personal interests. Elective opportunities include maternal-fetal medicine, rotating with the ECMO team, clinical time at an affiliated Level 3 community NICU, and an additional clinical block at CHOP or HUP.

  • Research education

    Research education is a major focus of the Neonatal-Perinatal Medicine Fellowship Program. Fellows have ample protected time throughout their fellowship to participate in rich and rewarding research experiences.

    The primary goal of the research component of the fellowship program is a high quality, in-depth scholarly activity that furthers a fellow's career development. The goal of the program is to provide the fellow with basic and/or clinical research tools, guided tutorials and a broad exposure to research experiences during the fellowship.

    Because individuals have different capabilities, motivations and career goals, the choice of research area (i.e. bench research, clinical epidemiological research, clinical trials, health services research, medical education, quality improvement) is selected by the individual fellow with guidance and approval of the research project through the Division of Neonatology's Scholarship Oversight Committee.

    Research orientation program

    Research orientation is focused into a common research block for all first-year fellows during the fall of the first year.

    In addition to overviews of research options within the Division of Neonatology, Division of Pediatrics, and Medical School, fellows receive introductory seminars in biostatistics, epidemiology, study design and developing a research hypothesis.

    Ample time is given to fellows to participate in short research rotations with research mentors, which can help fellows determine their scholarly pursuits.

    Research curriculum

    In addition to meeting the subspecialty training requirements for scholarly work, the research program curriculum provides an in-depth research experience for each fellow, in keeping with our mission to train the next generation of academic neonatologists.

    This high-quality research experience is designed to deliver a comprehensive experience, providing graduating fellows with the skills to compete for academic faculty positions, extramural funding and a career in laboratory or clinical investigation. It also serves to develop an evidence-based approach to patient care, and establishes approaches for the life-long assimilation of future research into clinical practices.

    The most meaningful research comes from each fellow identifying his/her research interests with the help of the fellowship and research leadership. Incoming fellows often find it challenging to identify their research interests, either by topic or methodology (clinical, translational or basic).

    Research orientation, as described above, provides a directed approach for fellows to identify a topic for research, develop a hypothesis to be tested, and design a research plan for years two and three of the training program.

    Scholarly activities available to fellows are vast and can be either basic science-focused or clinical in nature. Projects can be completed within or external to CHOP’s Division of Neonatology. Fellows have access to research projects and mentors across the Perelman School of Medicine at the University of Pennsylvania.

    Attendance at the Responsible Conduct of Research seminar during the second year of fellowship is a requirement of all fellows engaged in research activities. This seminar provides content on ethical aspects of research and clinical/laboratory protocol oversight.

    The research curriculum can be supplemented with additional classes in biostatistics, epidemiology, molecular biology, etc. as determined by the fellow and research mentor. Fellows are encouraged to apply for both internal and external funding for research projects and can also apply to have their fellowship activities funded by T32 training grants. Fellows are also encouraged and supported to present their research at regional and national meetings.

    Fellows’ research activities are reviewed annually by the Scholarship Oversight Committee (SOC). The committee consists of the director of neonatology research, an ad hoc member of the Division of Neonatology, and a member from the medical school external to the Division of Neonatology. At the end of fellowship, the SOC is responsible for determining whether the completed scholarly work has met the American Board of Pediatrics’ requirement for sub-specialty board eligibility.

    Research by past fellows

    Past research projects completed by our fellows have included:

    • The microbiota regulates neutrophil homeostasis and host resistance to Escheria coli K1 sepsis in neonatal mice
    • Hyperoxia-Induced NF-κB activation occurs via a maturationally sensitive atypical pathway
    • In utero gene therapy and stem cell transplantation for the rescue of alpha thalassemia in mice
    • The impact of bacterial PCR and cerebrospinal fluid cytokines on the diagnosis of bacterial meningitis in infants
    • The role of serial echocardiography to detect an asymptomatic patent ductus arteriosus in very low birthweight infants: a pilot randomized control trial
    • The pain response to mydriatic eye drops in preterm infants
    • Development and testing of a decision aid for parents facing imminent preterm delivery at the limits of viability
    • Cost-effectiveness of interventions to improve neonatal mortality rates in Ghana
    • Subjective and objective measures of social status in a low-income population and their relationship with maternal health outcomes
    • Proficiency and retention of neonatal resuscitation skills by pediatric residents over time
    • Direct provider feedback decreases narcotic prescribing errors in a neonatal intensive care unit

    Learn more about the wide variety of research projects conducted within the Neonatal-Perinatal Medicine Fellowship Program and meet research mentors within the Division of Neonatology.

  • Additional training and research opportunities

    Advanced degree programs

    Multiple advanced degree programs are available for fellows. Each program consists of coursework and a thesis or practicum, requiring two years to complete. Further information is provided for each program below.

    Certificate in clinical research

    For trainees interested in clinical research, but who are not planning on pursuing a career as an independent physician-scientist, the Center for Clinical Epidemiology and Biostatistics offers a certificate program. This program consists of 5 courses, many of which are offered in short summer courses, and provides comprehensive training in epidemiology and biostatistics. Learn more.

    Pediatric-Scientist Development Program

    The Pediatric-Scientist Development Program (PSDP) is an NIH-sponsored program designed to provide research training relevant to specialty areas of pediatrics and to prepare entry-level faculty for research careers in academic pediatrics.

    Physicians currently in a pediatric residency — who wish to train in basic, translational or clinical research with an established investigator/mentor — are encouraged to apply. Candidates seeking training in epidemiology/statistics, informatics, health services or health policy, are also encouraged to apply.

    A commitment to an investigative academic career is essential. The Neonatology Fellowship Training Program at CHOP has a strong history of fellows supported through this program. To learn more about this unique opportunity, contact us.

    Quality improvement training

    The Accreditation Council for Graduate Medical Education (ACGME) incorporated quality improvement training into its Practice-Based Learning and Improvement (PBLI) and Systems-Based Practice (SBP) competencies.

    As required by the ACGME, fellows are taught quality improvement (QI) methods and participate in a QI project during the fellowship. The QI project will be overseen by the Division of Neonatology’s QI Leadership Team.

  • Scheduled educational seminars

    Clinical and research rotations for the Neonatal-Perinatal Medicine Fellowship Program are supplemented by a rich series of educational experiences. Every Wednesday afternoon, fellows are relieved of their clinical and research responsibilities to attend educational seminars. These seminars rotate on a 4-week schedule.

    Week 1:

    1. Fellowship Meeting
    2. Fellows Physiology Conference
    3. Neonatology Board Review or Review of Current Neonatology Literature

    Week 2:

    1. Neonatology Radiology Rounds
    2. Journal Club

    Week 3:

    1. Cardiology Case Discussion
    2. Neosurgery Case Discussion
    3. Life After Fellowship

    Week 4:

    1. Simulation

    The components of this schedule include:

    Fellows Physiology Conference — This is a two-year curriculum of fetal and neonatal physiology and pathophysiology taught by neonatology and other subspecialty attendings from The Children’s Hospital of Philadelphia (CHOP) and the Perelman School of Medicine at the University of Pennsylvania (Penn). Topics include developmental anatomy, genetics, immunology and cardiorespiratory physiology. Each fellow is required to present one physiology conference in his/her third year of training.

    Cardiology Case Discussion — Cardiac intensivist attendings participate in a monthly discussion of relevant cases in the Newborn/Infant Intensive Care Unit (N/IICU) or the Cardiac Intensive Care Unit. Pathophysiology, cardiac anatomy, cardiac catheterization and echocardiogram results are reviewed.

    Neosurgery Case Discussion — Surgery and neonatology attendings participate in a monthly discussion of relevant cases in CHOP's N/IICU. Embryology, presentation, and surgical and medical management are reviewed.

    Neonatal Radiology Rounds — Pediatric radiologists at CHOP participate in a monthly discussion of radiology techniques and how they can be used to aid in the diagnosis and management of neonates and infants. Interesting cases are also reviewed.

    Simulation — Fellows participate in multidisciplinary simulation education consisting of procedural training, neonatal and infant resuscitation in both the delivery room and N/IICU, and non-technical skills training (communication, teamwork, leadership, crisis resource management). Additionally, fellows participate in standardized patient experiences several times a year to enhance communication skills in areas such as perinatal counseling, giving bad news and medical error disclosure.

    Neonatology Board Review — Every other month fellows participate in neonatology board review sessions that focus on high-yield reviews of topics covered by the American Board of Pediatrics subspecialty examination in Neonatal-Perinatal Medicine. An audience response system is often employed to engage the fellows in test-taking techniques.

    Review of current neonatology literature — Every other month fellows divide up the current neonatology literature and present a short summary of newly published reports and findings. In this way, the fellows collaborate with one another to keep the entire group up-to-date on the latest research in neonatology.

    Journal Club — The Journal Club is a monthly seminar that supports the acquisition of tools necessary to complete a research project, and promotes an evidence-based approach to clinical care. Led by faculty with advanced training in clinical research methodology, this seminar provides didactic and practical experience in biostatistics, clinical epidemiology and clinical study design. To reinforce concepts, the group reviews a neonatology-focused paper in clinical research each session.

    Life After Fellowship — Life After Fellowship is a seminar series that covers topics relating to non-clinical topics in the practice of medicine. The topics covered in this series have included:

    • Life as a N/IICU director
    • Medicolegal topics for neonatology attendings
    • N/IICU care, billing and collections: How are they connected?
    • So you want to be a neonatology program director?
    • Work-life balance with two academic careers
    • Teaching in a clinical setting

    Career development curriculum

    Because teaching and communication are integral parts of a career in academic neonatology, we require fellows to participate in seminars designed to foster these skills that are offered by the Offices of Faculty and Professional Development at CHOP and the Perelman School of Medicine at the University of Pennsylvania.

    Each fellow is encouraged to take at least one seminar focused on writing a grant, clinical manuscript or basic science manuscript.

    Other seminars are chosen based on each fellow's strengths and weaknesses, and have included:

    • Providing feedback in a clinical setting
    • Conducting an effective Q & A session
    • Developing effective presentations
    • Abstract preparation
    • Effective poster and platform presentations
    • Introduction to advanced PowerPoint

    Divisional and departmental conferences

    Clinical conferences at CHOP and HUP

    Weekly clinical conferences are held every Tuesday and alternate between The Hospital of the University of Pennsylvania (HUP) and CHOP. Each site holds a Morbidity and Mortality Conference monthly.

    Topics at HUP are chosen in conjunction with maternal-fetal medicine. Topics at CHOP relate to the management of patients in a quaternary care N/IICU and often include surgical care, ECMO therapy and transport issues. Fellows are responsible for presenting these conferences.

    Neonatology Research Seminar Series

    Neonatology Research Seminar is a weekly seminar serving as an official forum for fellows, neonatal faculty and visiting lecturers to present their research. Each fellow will present the final results of his/her research project to the Division of Neonatology during his/her third year of training.

    Pediatric Grand Rounds

    Departmental Ground Rounds occur every Wednesday morning.

    Clinical Consensus

    Four to five times a year, a two-hour conference is held in which a group of fellows and faculty members present a controversial topic in patient management. Participation of nursing, house physicians, nurse practitioners and ancillary staff is encouraged. The group then works on a consensus statement that is adopted as a practice guideline for the division. All fellows are required to participate in at least one clinical consensus during his/her fellowship.

  • Fellowship faculty
  • How to apply

    Instructions for application

    Our three-year Neonatal-Perinatal Medicine Fellowship Program seeks physicians who will have completed two to three years of training in an ACGME-approved pediatric residency program and who are eligible to sit for the American Board of Pediatrics certifying examination.

    American medical graduates must have:

    • An unrestricted license in order to practice in the Commonwealth of Pennsylvania
    • Graduate medical training licenses to practice medicine in the Commonwealth of Pennsylvania

    Acceptance into the program may be delayed until all parts of the National Board Examination have been passed.

    Foreign medical graduates must have:

    • A valid certificate from the Educational Commission for Foreign Medical Graduates (ECFMC)
    • U.S. pediatric training
    • Pediatric training
    • A graduate medical training license
    • An unrestricted license in order to practice in the Commonwealth of Pennsylvania

    As a result, acceptance into the program may be delayed until all parts of the National Board Examination and the Test of English as a Foreign Language (TOEFL) exam have been passed.

    Application procedure

    Our fellowship program participates in the Electronic Residency Application Service (ERAS) universal application process and the National Residency Matching Program (NRMP). Please visit the ERAS website for an application, information about our program and important deadlines. For more information, see the National Resident Matching Program.

    The following information should be uploaded to ERAS:

    1. Completed online application
    2. Current photograph
    3. Personal statement
    4. At least three letters of recommendation, including at least one from a neonatologist who has worked with the applicant and one from the Program Director. 
    5. Dean's letter or Medical School Performance Evaluation (MSPE)
    6. Medical school transcript
    7. Parts 1, 2 and 3 of the United States Medical Licensing Examination (USMLE), taken within the 7-year time frame as required by the Commonwealth of Pennsylvania, or equivalent scores
    8. If a graduate of a medical school outside the United States, Canada or Puerto Rico, a valid ECFMG certificate or one that does not expire prior to the start of the fellowship
    9. If a not a citizen of the United States or a permanent resident, a copy of current, appropriate visa

    Tentative deadlines

    On July 15, 2015, applicants may begin loading documents into ERAS.

    We will schedule interviews in September, October, and possibly early November 2015. Since the recruiting cycle is so compressed and we will have a limited number of interview spots, we urge candidates to have their applications in ERAS complete by Aug. 25, 2015.

    Match results will be released in November 2015 for fellowships to begin on July 1, 2016.

    Applicants are advised to access their file frequently to ensure timely submission of all components of their application. A personal interview is required for applicants who will be ranked for matching, and the Division of Neonatology can offer up to $200 (plus hotel for out-of-town candidates) to offset travel expenses.

    Tobacco-free hiring policy

    To help preserve and improve the health of its patients, their families and its employees, The Children’s Hospital of Philadelphia implemented a tobacco-free hiring policy. This policy applies to all candidates for employment (other than those with regularly scheduled hours in New Jersey) for all positions, including those covered by the Collective Bargaining Agreement.

    Job applicants who apply after July 1, 2014 will be expected to sign an attestation stating they’ve been free of nicotine or tobacco products in any form for the prior thirty (30) days. They will also undergo a cotinine test as a part of the Occupational Health pre-placement drug screen administered after the offer of employment has been accepted but before the first day of hire.

    Exemptions: Attending physicians (excluding CHOP physicians in the Care Network), psychologists, principal investigators and/or Penn-based faculty are exempt from this process to better align with our colleagues at the University of Pennsylvania Perelman School of Medicine.

  • Contact

    Anne Goldblatt, MA
    Division of Neonatology
    The Children's Hospital of Philadelphia
    Main 2NW
    34th Street and Civic Center Boulevard
    Philadelphia, PA 19104-4399
    Email Anne Goldblatt

Reviewed on June 18, 2015