Neonatal-Perinatal Fellowship Program

Clinical Training Environments

Neonatal fellows train in a number of clinical environments across three institutions, giving them the opportunity to learn not only from a large faculty of neonatologists but also from the subspecialists involved in the care of neonatal patients. See below for brief descriptions of the sites where fellows rotate.

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

The Harriet and Ronald Lassin Newborn/Infant Intensive Care Unit (N/IICU) at CHOP is a 100-bed level 4 neonatal ICU with an average daily census of 99. We have over 1300 admissions a year which includes neonates with known congenital anomalies born in the Special Delivery Unit at CHOP, referrals from regional NICUs, and admissions from the emergency department. Patient complexity and acuity is extremely high with an average of 35-40 patients on invasive ventilation daily and over 30 ECMO patients a year. Our neonatal ECMO program has one of the highest volumes in the nation.

The medical teams provide care to a wide variety of patients with complex medical needs, each team caring for 12-16 patients. Our Chronic Lung Disease Program provides multidisciplinary care to patients with the most severe form of this neonatal morbidity. Additionally, we have a large population of patients with primary surgical disease cared for by the Neosurgery Team – a longstanding collaboration between neonatologists and surgeons that has an average census of 30.

The N/IICU is organized into 6 medical teams. Each team has a dedicated social worker, discharge planner, and dietician. The teams have access to an outstanding group of clinical pharmacists, psychologists, physical therapists, and speech therapists. We also benefit from the existence of a number of collaborative programs for subspecialty care featuring unique expertise and a remarkable array of technical and diagnostic capabilities. These include the Neonatal Craniofacial Program, the Neonatal Airway Program, and the Neonatal Neurocritical Care Program. Our unit provides training to pediatric residents, neonatology fellows, pediatric surgical fellows, nurse practitioner students, and hosts one of the only neonatal physician assistant residencies in the country.

Neonatal Follow-up Clinic

Neonatal fellows will spend a minimum of one month of their fellowship training in the Neonatal Follow-up Clinic on the main campus at CHOP. During this time, they will see graduates of the CHOP N/IICU and HUP ICN as well as other patients at high risk for neurodevelopmental delay. The clinic sees patients from early childhood through to school age (0-5 years). Fellows rotating in this transdisciplinary clinic work closely with neonatologists focused on follow-up care, developmental pediatricians, physical/ occupational therapists, and psychologists. They will observe psychological testing and gain an understanding of the ways in which neonatal outcomes are evaluated both clinically and in the conduct of randomized trials, which inform evolving clinical care. This experience will also give fellows insight into what life is like for families after discharge from the NICU, improving their ability to understand the life-course of NICU graduates and counsel families before and during NICU admissions. For fellows intending a career focused on follow-up, clinical time can be modified to include more time in the follow-up clinic, and many prior fellows have pursued quality improvement and research projects focused on neonatal follow-up.

Special Delivery Unit / Center For Fetal Diagnosis And Therapy (SDU/ CFDT)

The Garbose Family Special Delivery Unit (SDU) is the world’s first birth facility in a pediatric hospital specifically designed for healthy mothers carrying babies with known birth defects. Located within the Children’s Hospital's Center for Fetal Diagnosis and Treatment (CFDT), neonates are immediately resuscitated and transferred to either the Harriet and Ronald Lassin Newborn/Infant Intensive Care Unit (N/IICU) or the Evelyn and Daniel M. Tabas Cardiac Intensive Care Unit (CICU) for ongoing care.

Over 500 deliveries occur in the SDU each year, where fellows have the opportunity to work with and learn from maternal fetal medicine specialists, fetal and pediatric surgeons, fetal cardiologists, and neonatologists. Fellows are involved in the resuscitation of neonates born with congenital defects including congenital diaphragmatic hernia (CDH), congenital heart disease, omphalocele, gastroschisis, myelomeningocele, sacrococcygeal teratoma, lower urinary tract obstruction, and congenital pulmonary airway malformation, among various other diagnoses. The CFDT also has a busy perinatal palliative care program. Fellows are involved in the prenatal consultations and delivery room plans with a perinatal psychologist.

The CFDT is a world leader in ex utero intrapartum treatment (EXIT) procedures and fetal surgery including fetal myelomeningocele repair, lung lesion resection, FETO (fetal tracheal occlusion for CDH), sacrococcygeal teratoma resection, and fetoscopic selective laser ablation for twin to twin transfusion syndrome. Following delivery, fellows have the opportunity to care for neonates with primarily surgical diagnoses on the Neonatal Surgical Team, jointly managed by neonatologists and pediatric and fetal surgeons. The CDH Frontier program has allowed for exciting advances in both the clinical care of babies with CDH and research. Our CDH census is roughly 40-50 per year. Fellows actively participate in the surgical plans and procedures for a census of approximately 30-40 patients and gain exposure to a high volume of extracorporeal membrane oxygenation (ECMO). This unique population also provides ample opportunities for research and mentorship. 

Cardiac Intensive Care Unit (CICU)

The Daniel M Tabas Cardiac Intensive Care Unit (CICU) has 32 beds with an average census of 28 patients/day, and approximately 900 cardiothoracic surgeries are performed each year. The patients are divided into 3 teams supervised by cardiac care intensivists and cardiothoracic surgeons. Front line care is provided by PICU, cardiology, and NICU fellows, nurse practitioners, physician assistants, and hospitalists. Patient care is coordinated with a multidisciplinary team consisting of nurses, dieticians, pharmacists, social workers, case managers and other subspecialists. NPM fellows will have exposure to preoperative and postoperative management of congenital heart disease, acute and chronic heart failure, arrhythmias, myocarditis/cardiomyopathy, mechanical circulatory support, and heart/lung transplantation.

Hospital Of The University Of Pennsylvania Intensive Care Nursery (ICN)

The Hospital of the University of Pennsylvania (HUP) is located adjacent to CHOP in University City. HUP has an average of 4200 deliveries a year, with an active Maternal Fetal Medicine program. The Intensive Care Nursery (ICN) is a level IIIB NICU and admits, on average, 700 infants per year, including 120 very low birth weight infants, with an ICN average daily census of 36. Fellows rotate here during all three years of their fellowship and gain an invaluable experience in bread and butter neonatology, delivery room management, and the teaching and supervision of trainees.

Teams consist of neonatologists, pediatric residents, neonatal nurse practitioners, physician assistants, medical students, nurses, respiratory therapists, pharmacists, dieticians, occupational and speech therapists, and social workers. The ICN provides comprehensive care for a wide variety of complex infants including those requiring therapeutic hypothermia and video EEG, echocardiography, all modes of radiographic assessment, and ophthalmologic intervention. The ICN supports infants who need ventilation with high frequency oscillatory and jet ventilation, as well as inhaled nitric oxide. On-site subspecialty consultation is provided by CHOP subspecialists.

NICU fellows at HUP have the opportunity to provide prenatal consultation, to lead a multidisciplinary team on rounds and in the delivery room, all with close support of the attending physician. In the HUP ICN the NICU fellow gets a graduated level of autonomy in patient care as he/she progresses through fellowship, and leadership skills are cultivated here. There is a robust Quality Improvement program at HUP that encourages fellow involvement, as well as many opportunities to be involved in resident education, simulation, and perinatal research.

Pennsylvania Hospital Intensive Care Nursery (ICN)

Pennsylvania Hospital, the oldest hospital in the United States, is located in Center City Philadelphia, 2.5 miles east of CHOP. It features a 50-bed level 3B NICU staffed by physicians, nurse practitioners and physician assistants. Pennsylvania Hospital has an average of ~5000 deliveries a year, ~1000 admissions a year to the ICN, and an ICN average daily census of 35. Senior fellows rotate here during their second and third years, when they are able to solidify their skills in the care of preterm infants and gain valuable experience leading an interprofessional team at a high-volume delivery center.

Teams consist of neonatologists, front-line care providers, nurses, respiratory therapists, pharmacists, dieticians, occupational and physical therapists, psychologists, and social workers. The ICN provides comprehensive care for a wide variety of complex infants including those requiring therapeutic hypothermia, echocardiography, all modes of radiographic assessment, interventional radiology, and ophthalmologic intervention. On-site subspecialty consultation is provided by CHOP/Penn Endocrinology, Genetics, Neurology, Cardiology, Orthopedics, ENT, Plastic Surgery and Ophthalmology.

In addition to NICU fellows, medical students, NNP students, physician assistant residents, pediatric residents, and CHOP Hospitalist Medicine fellows can all opt to rotate through the Pennsylvania Hospital ICN. The rotation offers NICU fellows the opportunity to train in a third clinical environment to increase the exposure fellows have to various neonatology models and patient populations. Fellows participate in prenatal consultations, delivery room resuscitations, and patient care in the ICN while gaining valuable leadership skills, working side-by-side with the ICN staff.

Scholarship Pathways and 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 academic experiences.

There are many ways to shape a productive, academic career. A career as an independently funded physician scientist (bench or clinical) is the most traditional path for an academic neonatologist. However, we recognize that there are many additional academic paths. To assist fellows to get the most out of their time in fellowship and start building the tools necessary to embark on a career within their chosen academic focus, our fellows participate in Scholarship Pathways to promote individualized professional development. Tailored to meet every fellow’s unique scholarly interests, these pathways can accommodate fellows interested in Basic Science, Clinical Research, Translational Research, Bioethics, Medical Education, NICU Follow-Up, NICU Administration, QI/Patient Safety/Implementation Science, Bioinformatics, and Clinical Programmatic Development. Each pathway will provide individual fellows with unique opportunities to develop skills and expertise within a given academic niche. Specific mentors within the Division of Neonatology will oversee a fellow’s professional development and progress along his/her chosen scholarship pathway. Regardless of what pathway is chosen, all fellows complete a high quality, in-depth scholarly activity that furthers a fellow's career development and aligns with their scholarly interests.

While fellows pursue individualized research projects, all participate in a comprehensive research education program that consists of guided tutorials, journal clubs, and exposure to world-class researchers both on campus and from outside our institution. This ensures all fellows who graduate from this program have an ability to critically evaluate and engage emerging research findings and apply them to their clinical practice throughout their careers.

Research Orientation Program

Orientation to research methodology and options are 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, Department of Pediatrics and Perelman School of Medicine at the University of Pennsylvania, 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 during the first year, which can help fellows determine their scholarly pursuits based on early experiences and evolving interests.

Scholarly Project

All fellows propose and design (with the assistance of mentors) a comprehensive scholarly project. Beginning with project proposal and navigating oversight processes, data collection, and analysis, fellow projects culminate in a peer-reviewed publication. Almost all fellows present their work at regional and national conferences. As a result, our graduates are well positioned to compete for academic faculty positions, extramural funding, and pursue impactful academic careers.

Fellows enjoy the opportunity to pursue projects with the benefit of mentoring not only within the division of neonatology but also across the Perelman School of Medicine and the University of Pennsylvania. All fellows are guided in assembling a Scholarship Oversight Committee (SOC) comprised of intramural and extramural experts to mentor them through their scholarly projects.

The research curriculum can be supplemented with additional classes in biostatistics, epidemiology, molecular biology, etc. as determined by the fellow and research mentor(s)/ SOC. 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.

Research by past fellows

Past research projects completed by our fellows have included:

  • Long Non-coding RNAs are Preferentially Located Near Transcription Factors and Regulate Lung Development
  • Reducing Th2 Inflammation Through Neutralizing IL-4 Antibody Rescues Myelination in IUGR Rat Brain
  • Altered Lipid Metabolism in the Placenta in Spontaneous Preterm Birth
  • Development of Roles of Novel Uterine Macrophages During Pregnancy
  • Comparative Protemic Analysis of Human Placenta in Spontaneous Pre-Term Birth
  • Anemia, Apnea of Prematurity, and Blood Transfusions and the Effect of Blood Transfusions on Intermittent Hypoxia in VLBW Infants
  • Reliability of a Noninvasive Measure of V/Q Mismatch for Bronchopulmonary Dysplasia
  • Relationship Between Pulmonary Artery Acceleration Time and Artery Pressures in Infants
  • Prematurity is Associated with Cognitive Defects and Structural Brain Abnormalities in Adolescence
  • Temporal Trends and Center Variation in Early Antibiotic Use Among Premature Infants
  • Surviving Sepsis in the NICU: Time to Antibiotic Management in Neonatal Sepsis and Association within Hospital Outcomes
  • Continuity of Care in Infancy Impacts Utilization and Preventative Care in Early Childhood
  • Incidence Trends and Risk Factor Variation in Severe Intraventricular Hemorrhage Across a Population Based Cohort
  • Maternal Adverse Childhood Experiences, Race, and Risk for Adverse Birth Outcomes
  • Preferred Parental Decision-Making Role in Neonatal Intensive Care
  • Parental Perspectives on Diagnosis and Prognosis of Neonatal Intensive Care Unit Graduates with Cerebral Palsy
  • Reducing Variation in the Management of Apnea of Prematurity in the ICN
  • Impact of Flow Disruptions in Delivery Rooms
  • Performance and Outcome of Ventilation Correction Steps in the Delivery Room
  • Group B. Streptococcus Colonization Rates in Pregnant Women Near Term in Botswana
  • PRIMM Trial (Phone Reminder for Immunization) Optimizing Immunization in Ondo State, Nigeria

Additional training and research opportunities

Advanced degree programs

Multiple advanced degree programs are available for fellows who successfully apply for funding. 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 program leadership.

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.

Fellows are taught quality improvement (QI) and implementation science methods and participate in a QI project during fellowship. The QI project will be mentored 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 with Program Leadership
  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 or Maternal Fetal Medicine Case Discussion
  3. Professionalism, Ethics and Communication seminar

Week 4:

  1. Point of Care Ultrasound training
  2. Simulation

The components of this schedule include:

Fellows Physiology Conference — This is a three-year curriculum of fetal and neonatal physiology and pathophysiology taught by neonatology and other subspecialty attendings from CHOP and the Perelman School of Medicine at the University of Pennsylvania (Penn). Topics include developmental anatomy, genetics, immunology and cardiorespiratory physiology. 

Cardiology Case Discussion — Cardiac intensivists 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 discussions of relevant cases in CHOP's N/IICU. Embryology, clinical presentation, and surgical and medical management are reviewed.

Maternal Fetal Medicine Case Discussion – Maternal Fetal Medicine, obstetric, and neonatology attendings participate in discussions of maternal fetal medicine physiology and pathophysiology and its impact on the fetus and neonate. Embryology, clinical presentation, and maternal and fetal management are reviewed.

Neonatal Radiology Rounds — Pediatric radiologists at CHOP participate in a monthly discussion of radiologic 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 NICU, and non-technical skills training (communication, teamwork, leadership, crisis resource management). Fellows will learn how to facilitate and debrief simulations, running mock codes for the pediatric residents.

Point of Care Ultrasound Training – First year fellows participate in both didactic and hands-on ultrasound training from the division’s ultrasound-trained faculty, learning to use POCUS for procedural guidance and diagnostics. Senior fellows have the option to continue POCUS training through one on one sessions with augmented reality ultrasound simulators, hands-on practice with patients, and through individual feedback from faculty.

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 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 biostatistical and epidemiologic 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.

Professionalism, Ethics, Communication, Etc (PECx)  — Fellows receive instruction in topics relating to professionalism and bioethics. Fellows also participate in communication training using evidence-based approaches and standardized patients to enhance communication skills in areas such as perinatal counseling, giving difficult news and medical error disclosure. This training is partnered with a variety of non-clinical topics in the practice of medicine. The topics covered in this “Etc” series have included:

  • Life as a N/IICU director
  • Medicolegal topics for neonatology attendings
  • NICU 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 written and oral 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 individual fellow's strengths, weaknesses and professional development needs, and can include:

  • 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

Fellow-led clinical conferences are held weekly 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 have an emphasis on maternal-fetal medicine and routine neonatology patients. Topics at CHOP relate to the management of patients in a quaternary care NICU and often include surgical care, ECMO therapy, and transport issues.

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 group of fellows and faculty members present a controversial topic in patient management. Participation of nursing, front-line care providers, and ancillary staff is encouraged. The group works to build a consensus statement through iterative review for adoption as a practice guideline for the division. All fellows are required to participate in at least one clinical consensus during fellowship.

Program leadership

Neonatal-Perinatal Fellowship Program Director
Heather French, MD, MSEd
Associate Professor of Clinical Pediatrics

Neonatal-Perinatal Fellowship Program Associate Director
John Filbotte, MD
Associate Professor of Clinical Pediatrics

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

Application deadlines

Please consult NRMP for important recruitment calendar dates which vary slightly from year to year. In general, applicants may begin loading application documents into ERAS by mid-July. We urge candidates to have their applications completed in ERAS by mid-August. For selected applicants, we hold interviews during September, October, and early November. Match results will be released each year in December for fellowships beginning the following July.

Applicants are advised to access their file frequently to ensure timely submission of all components of their application. An 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 for in-person interviews.

Tobacco-free hiring policy

To help preserve and improve the health of its patients, their families and its employees, CHOP 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 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.

Contact

Meredith Feldman, BS
Division of Neonatology
Children's Hospital of Philadelphia
Main 2NW
3401 Civic Center Boulevard
Philadelphia, PA 19104-4399
215-590-4393
Email Meredith Feldman