Program Structure

The three-year ACGME-accredited Neonatal-Perinatal Fellowship Program at Rush University Medical Center (RUMC) fully meets the requirements of the Neonatal-Perinatal Medicine subspecialty board of the American Board of Pediatrics. The program provides trainees with a broad range of experiential clinical, research, teaching and leadership opportunities, with the goal of training physicians who achieve excellence in all four domains. The 72-bed, state-of-the-art level 3 (highest designation in Illinois) single family room Neonatal Intensive Care Unit (NICU) provides specialized interdisciplinary, neonatal care that is family-centered and evidence-based. Training occurs as a continuum, with progressively more clinical responsibility and dedicated research time over the three-year fellowship experience. Most clinical activities are conducted at RUMC, a large tertiary-care academic hospital and referral center in Chicago. Fellows rotate at the Ann & Robert H Lurie Children’s Hospital, an affiliate of RUMC, for their Cardiac ICU rotations and one Maternal-Fetal Medicine rotation.

Clinical Curriculum

Clinical training is evidence-based, with direct patient care, didactic and hands-on simulation-based components. Fellow responsibilities include patient care, consultation with specialists/sub-specialists, antenatal counseling, parent/family conferences, transports, in-house night call, and collaboration with the interprofessional healthcare team to provide optimal care for patients in the NICU. Clinical NICU training comprises 12 months of the three-year Program; five months in year one, four months in year two and three months in year three. In addition to overseeing the management of patients in the NICU, in collaboration with advanced practice providers, fellows serve as supervisors for house staff, junior fellows and medical students.

Year 1

During the first two weeks, fellows are oriented to the NICU environment, and program expectations are outlined. Fellows participate in neonatal resuscitation training (NRP) simulation-based difficulty conversations training, and the Midwest Neonatal Simulation Boot Camp, as well as other onboarding activities. During the first year, each fellow spends a total of five months in the NICU. Under the direction of an Attending neonatologist, fellows are expected develop skills required to diagnose and provide clinical care, gain experience in neonatal resuscitation and delivery room management, and coordinate transports. Fellows are expected to gradually gain skill in common neonatal procedures and begin to develop teaching and leadership skills, progressing throughout the first year. Fellows achieve an increasing level of responsibility and independence, based on demonstrated ability and confidence as they progress throughout the year.

Weeks	Rotation
2	Orientation/Simulation-based training
20	NICU
4	Maternal-fetal medicine
2	Radiology
4	Infectious diseases
16	Research
4	Vacation

Maternal-Fetal Medicine: Fellows rotate with the Maternal-fetal medicine service to understand and participate in the care of families with high-risk pregnancies and those with morbidities that can impact the fetus. During the rotations fellows participate in interdisciplinary consultations for parents/families with high-risk, complex pregnancies in the Rush Fetal-Neonatal Medicine Center clinics and the Chicago Institute for Fetal Health at Ann & Robert H. Lurie Children’s Hospital.
Radiology: The two-week rotation is designed to provide one-on-one training with a pediatric radiologist for fellows to learn the interpretation of neonatal radiologic studies, including x-rays, CTs, ultrasounds, MRIs, etc.
Infectious Diseases: During this rotation fellows learn about neonatal infectious diseases and their appropriate treatments, laboratory methods used in pediatrics relating to the diagnosis and management of infections in neonates, and the appropriate use of antimicrobials. In addition, fellows participate in HIV clinics, when pertinant to the neonatal population, as well as didactics and journal club.

Year 2

In the second year, each fellow spends a total of five months in the NICU, and the second year builds upon the first. With progressively less direct supervision, fellows are expected to demonstrate increasing knowledge of fetal/neonatal physiology and pathophysiology, develop diagnostic and treatment plans, direct and supervise clinical care, and demonstrate developing skill in neonatal resuscitation and delivery room management. Fellows are expected to conduct transports and demonstrate more advanced procedural and teaching ability. As the second year progresses, fellows are expected to demonstrate emerging leadership skills and attain growing knowledge of the administrative aspects of the field of neonatology.

Weeks	Rotation
16	NICU
4	Genetics
4	Pediatric Cardiac ICU
24	Research
4	Vacation

Genetics: Fellows rotate with the genetics team to gain an understanding of common metabolic diseases in the neonate, current genetic testing methods, and the impact of teratogens.
Pediatric Cardiac ICU: To gain an understanding of congenital heart defects and experience in the pre- and post-operative management of neonates with congenital heart defects, fellows rotate (in year 2 and 3) with the cardiothoracic teams in the Pediatric Cardiac ICU. Fellows also participate in a four-day, interdisciplinary hands-on ECMO training course.

Year 3

During the third year, each fellow spends a total of three months in the NICU. Third-year fellows are expected to function with increased independence, and for the final two clinical rotations function as the “Acting Attending Physician” (under the supervision of the Attending Physician on service). Fellows are expected to apply advanced knowledge of neonatology to develop diagnostic and treatment plans and direct and supervise the interprofessional care team, demonstrate procedural proficiency and advanced clinical and leadership skills in neonatal resuscitation and delivery room management. Third year fellows are responsible for teaching and supervising house staff, junior fellows and students. The third year provides fellows the opportunity to develop advanced leadership skills and additional knowledge and experience in the administrative aspects of neonatology.

Weeks	Rotation
12	NICU
4	Cardiac ICU
32	Research
4	Vacation

High-Risk Follow-Up Clinic

Fellows rotate in the Rush Neonatal High-Risk Follow-Up clinic during their research rotations. Fellows work closely with the Attending Neonatologist and the multidisciplinary team that includes neurodevelopmental child psychologists, dietitians and physical therapists. Fellows participate in the longitudinal evaluation and management of high-risk neonates, including very low birth weight infants, those who received therapeutic hypothermia and those with congenital heart disease.

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