Clinical Education

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

Clinical training occurs at two primary teaching sites:

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:

Clinical education orientation

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

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.

Date: June 2014

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