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Program Objectives for Neonatal-Perinatal Medicine Fellowship

The objectives of the program are to allow the trainee to achieve:

  • Professional competence in the clinical care of the critically ill newborn.
  • Skill in the design and conduct of clinical and basic science research
  • Excellence in teaching

The program emphasizes the fundamentals of clinical diagnosis and management of problems seen in the continuum of development from the prenatal through the intrapartum and neonatal periods, including assessment of outcomes. There are ample opportunities for clinical and basic science research. A special effort is made to help fellows acquire and practice formal teaching skills. Graduates of the program will be well prepared for an academic as well as clinical career.

The first year of training involves approximately 5 months of clinical time in the NICU working closely with the attending neonatologist. Fellows gain experience in the assessment of high-risk pregnancies, antenatal consults, delivery room care and resuscitation, transportation of the critically ill neonate by ambulance or helicopter, all aspects of care of extremely low birth weight infants, and high technology therapy such as High Frequency Ventilation (Jet and Oscillator), ECMO (extracorporeal membrane oxygenation), Nitric Oxide therapy and Whole Body Cooling for neonatal hypoxic ischemic encephalopathy. They supervise and perform a variety of procedures including umbilical venous and arterial catheterization, insertion of peripheral arterial catheters, percutaneous central venous catheters, and thoracostomy tubes. They supervise residents and work with nurse practitioners during their clinical rotations.

During a 2 week rotation in Maternal Fetal Medicine (MFM) Service, NPM fellows learn assessment of high risk pregnancies by, antenatal testing, genetic amniocentesis and fetal ultrasonography. Fellows provide consultations for high-risk obstetrical patients, discuss management of high-risk deliveries and fetal monitoring, and participate in Perinatal-Neonatal conferences throughout the 3 years of fellowship. They attend 16 High-Risk Follow up and 4 Developmental Outpatient clinic sessions, in order to learn the outpatient management of NICU graduates. The balance of their time in the first year is spent on Research and Scholarly activity, learning the essentials of study design and statistics. They are encouraged to develop their own projects under the guidance of the research mentor. They participate in all departmental and divisional teaching activities.

The second year of training includes approximately 4 months of clinical service in the NICU where the Fellow further refines his/her clinical and supervisory skills. Fellows continue to participate in outpatient High-Risk and Developmental follow-up clinic. Pediatric Cardiology/Cardiovascular surgery training is provided by a 4 week rotation in the second or third year. There is increased emphasis on research during the second year with time spent in laboratory or clinical research. Close involvement with research mentors during this time is essential in ensuring appropriate progress toward the goal of a completed research project leading to a peer reviewed publication by the end of the period of training.

The third year is primarily devoted to research with 3 months of NICU inpatient service, and 1 month of High Risk outpatient/developmental follow-up. The research time in the second and third year are tailored to the individual needs and goals of the Fellow depending on the type of research preference. There are opportunities for clinical and basic science research at the Georgetown University Medical Center and at the National Institutes of Health.