Training & Curriculum
Clinical Training
Fellows in the Newborn Critical Care Center will fulfill the clinical role of consultant or “junior attending,” with a level of responsibility between the attending physician and the senior resident. It is expected that the fellow will be intimately familiar with all infants admitted to the Newborn Critical Care Center and their care plans while on service. The fellow will become involved as a teacher and supervisor and will contribute to the care of high-risk infants without usurping the responsibilities of the pediatric house staff. UNC’s pediatric residents are the primary front-line caregivers for patients n the NCCC, responsible for direct patient care (i.e., writing orders, performing routine procedures, updating the families of patients, etc.). It is assumed that fellows in neonatal-perinatal medicine will have already had this kind of experience, and the fellowship program will not attempt to duplicate it.
In addition to clinical training in the Newborn Critical Care Center, fellows have the opportunity to enhance their clinical skills through a number of required rotations and electives, including:
- Maternal Fetal Medicine (including prenatal ultrasound, genetic counseling)
- Rex Special Care Nursery
- Complex Care Elective
- Cardiovascular Surgery
- ECMO (in conjunction with the UNC PICU)
- Pediatric Surgery
- Transport
Clinical Schedule
Schedules will be individualized with particular attention to the needs of each fellow and the availability of institutional resources, but will in all cases meet the requirement of the American Board of Pediatrics. In general, fellows are on clinical service for a total of 50 weeks over three years and are assigned in-house call an average of 50 days per year.
Year 1: The first year of fellowship emphasizes acquiring skills in clinical neonatology with five to six months assigned to the NCCC plus assigned in-house call shifts.
Year 2: The second year will be individualized with less emphasis on clinical neonatology and more emphasis on scholarly activities. The fellow will be expected to make significant progress on his/her chosen scholarly project and may take advantage of increased teaching opportunities. Fellows interested in clinical/epidemiology research may have the opportunity to take this year to complete an MPH at the UNC Gillings School of Global Public Health.
Year 3: The fellow’s third year will be completely customized to his/her specific goals and will additionally include one month as acting attending in the NICU.
A sample daily schedule in the NICU
7:00 Sign Out / Pre-round
7:50 Board Rounds / Unit “Safety Huddle”
8:00 Lecture for NCCC Housestaff / Grand Rounds (Thursday)
8:30 NICU Radiology Rounds
8:45 Work Rounds
11:00 Patient Care Activities
12:00 (WEDNESDAYS) Fellow’s Conference (journal club, pathophysiology, board review)
2:30 (WEDNESDAYS) Division Meeting (research, administrative issues, M&M)
4:00 Sign out to night fellow
Weekly:
Perinatal Care Conference (with MFM, genetics, surgery, cardiology, etc.)
BPD Huddle (with OT/PT, nutrition, pharmacy, Pulmonary, nursing, etc.)
Multidisciplinary DC planning rounds (with social work, pastoral care, nursing and others)
Complex Infant Planning Session (with Supportive Care, nursing, etc.)
Educational Opportunities
Teaching Rounds
Teaching rounds are conducted daily in the Newborn Critical Care Center. Attending responsibility is shared among members of the Neonatal-Perinatal Medicine faculty.
Neonatal-Perinatal Medicine Division Meetings
The Division holds weekly meetings that include:
- Journal Club
- Research seminars by division members
- Clinical management seminars
- Business meetings to discuss administrative issues of the division and the Newborn Critical Care Center
- Quality assurance, and
- Mortality/morbidity review
Fellows’ Conference
The fellows’ conference is a weekly meeting planned by the Neonatal-Perinatal Medicine fellows, which includes members of the division and guest lecturers. Meetings cover subspecialty topics, selected topics of clinical interest, ethics, administration, statistics, and clinical study design.
X-ray Conferences
Fellows engage in daily neonatal X-ray reviews with faculty from pediatric radiology.
Perinatal Care Conference
The weekly perinatal care conference features discussions about patient care issues by specialists from maternal-fetal medicine, pediatrics and surgery focused on patients referred to the UNC Center for Maternal and Infant Health.
Pathology Conference
Approximately 20 percent of the cases reviewed at the weekly pediatric pathology conference are neonatal.
Departmental Conferences
Other departmental conferences include grand rounds, airway conference, congenital heart disease conference, ECMO conference, subspecialty conferences, and departmental teaching conferences.
Basic Science Seminars and Conferences
Opportunities in various areas are available to fellows participating in basic science research.
Core Curriculum for Pediatric Fellows
The yearly seminar series for all pediatric fellows is intended to facilitate interaction among pediatric fellows and cover content areas that are common to all subspecialty residents. Seminars include a variety of pertinent topics including: Starting Out in Research, Presenting Research, How to be an Effective Teacher, How to Find a Job, Communicating with Families, and others.