DEPARTMENT OF PEDIATRICS

General Neonatology Training

The Neonatal training program is a three year program based on an apprenticeship model of education with additional responsibility given with progression in the program.

The NYU NPM fellowship program consists of the following components as outlined by the Program Requirements for Education developed by the American Board of Pediatrics (ABP) and ACGME Resident Review Committee (RRC) for Neonatal-Perinatal Medicine.

Fellows are assigned to these components in an educationally appropriate sequence over the usual 36 months of training.

The clinical curriculum is based on providing 1st year fellows with a high degree of direct patient contact and responsibility in the NICU with direct Attending oversight.

In addition, the curriculum provides first, second, and third year fellows graded supervisory responsibility for the PL-1/2/3 residents, medical students, neonatal nurse practioners, physician assistants and their patients.

The first year consists of predominately clinical activities and the second and third years integrate intensive scholarly activity into the curriculum.

The clinical fellow is viewed as a leadership physician and functions as a junior staff doctor in the supervision of the hour-to-hour care of critically ill newborn infants.

Formal training in NRP and transport of the critically ill newborn infant are provided during the first year.

First Year

During the first year, the Neonatal-Perinatal Medicine Fellow spends a total of six months assigned to clinical duties in the Neonatal Intensive Care Unit.

During this period, the Fellow is directly supervised by the Attending Neonatologist. The first month of clinical service is an orientation month where the fellow shadows a senior fellow and attends weekly didactic and practical sessions by the Attending.

After orientation the fellow is assigned to the NICU clinical service at NYU Tisch Hospital or Bellevue Hospital.

NYU Tisch

While at NYU Tisch, the fellow supervises a team consisting of two senior pediatric residents (PL2 and PL3), one or two pediatric interns (PL1), one Emergency medicine intern as well as third and fourth year Medical Students, Physician Assistants and Neonatal Nurse Practitioners, Pediatric Nutritionist, Respiratory therapists and Social Worker.

During clinical months in the Neonatal Intensive Care Unit, the Fellow learns all clinical techniques in the management of the critically ill infant and is responsible for neonatal transports for critically ill infants.

The Fellow makes daily work rounds and teaching rounds with the Neonatology Attending.

The team attends daily radiology conference rounds.

The fellow also meets daily with the Neonatal Attending to discuss all new admissions and management plans for all cases.

The Attending suggests readings and references regarding specific cases.

The Fellow is responsible for direct communication to parents and community physicians, and organizes both transfers to the Neonatal Intensive Care Unit and transfers to the Pediatric Ward, Newborn Nursery, or community hospital.

The Fellow attends and contributes to formal weekly Social Service Multidisciplinary Planning Rounds and participates in all family care meetings.

The Neonatal-Perinatal Medicine Fellow also performs perinatal consults prior to delivery and attends all high risk deliveries.

The Attending attends all high risk deliveries with the fellows until the fellow gains expertise in delivery room management. At that point, the Attending attends all deliveries of infants< 28 weeks with the fellow.

Bellevue Hospital

While at Bellevue Hospital, the Public Hospital, the fellow supervises a team consisting of one Physician Assistant and one Neonatal Nurse Practitioner as well as a third and fourth year medical student.

During clinical months in the Neonatal Intensive Care Unit, the Fellow learns all clinical techniques in the management of the critically ill infant and is responsible for neonatal transports for critically ill infants.

The Fellow makes daily work rounds and teaching rounds with the Neonatology Attending.

The team attends daily radiology conference rounds.

The fellow also meets daily with the Neonatal Attending to discuss all new admissions and management plans for all cases.

The Attending suggests readings and references regarding specific cases.

The Fellow is responsible for direct communication to parents and community physicians, and organizes both transfers to the Neonatal Intensive Care Unit and transfers to the Pediatric Ward, Newborn Nursery, or community hospital.

The Fellow attends and contributes to formal weekly Social Service Multidisciplinary Planning Rounds and participates in all family care meetings.

The Neonatal-Perinatal Medicine Fellow also performs perinatal consults prior to delivery and attends all high risk deliveries.

The Attending attends all high risk deliveries with the fellows until the fellow gains expertise in delivery room management. At that point, the Attending attends all deliveries of infants< 28 weeks with the fellow.

Second Year

The Neonatal-Perinatal Medicine Fellow has a similar clinical experience during the second year of the fellowship.

The Fellow continues to gain experience in the medical management of the critically ill infant in the NICU and spends a total of four months assigned to clinical duties in the Neonatal Intensive Care Unit.

During this period, the fellow is given increased responsibility and autonomy for decision making and is encouraged to lead rounds and team discussions in the presence of the Neonatology Attending.

Third Year

During the third year, the Fellow functions as a senior fellow for two months and as Junior Attending in the Neonatal Intensive Care Unit for two months.

During the month, they provide all the leadership and teaching to the 1st and 2nd year fellow, house officer, Nurse Practioner, Physician Assistant and Medical Students in the NICU, with guidance from the Neonatal Attending.

The Neonatal attending meets with the fellow as a background supervisor, observing all aspects of patient care behavior, medical knowledge and all of the competencies expected of a Junior Faculty. During this time, the senior fellow assumes all the attending responsibilities.

During this last year, they are expected to engage in Quality Assurance Projects with the Clinical Directors to more closely understand practice based medicine during administrative meetings.

The fellow gains an understanding of the administration of the NICU as well as the role of billing both for the physician and hospital.

The fellow continues to attend weekly follow-up Program as well as participate in transports from affiliate hospitals to the NICU.

Neonatal Comprehensive Continuing Care Program

During the months that the Fellow is not on NICU rotations the Fellow attends weekly Developmental Follow-up Program to begin their exposure to the evaluation and care of high risk infants with developmental problems as well as continue to gain experience in the psychosocial demands of the field of neonatology.

Apnea SIDS Program

Fellows attend monthly Friday training sessions in apnea downloads and monitor assessments.

These conferences provided by Dr. Anthony Orsini assist the fellows in becoming proficient with apnea monitor download assessments.

By the end of the training program each fellow is able to participate in an apnea program as a faculty member if they choose to do so.

Fellows also gain knowledge in the communication of the disorders associated with apnea and the training of parents when a child requires apnea monitoring after discharge.