Neonatology Fellowship Clinical Experience

Nationwide Children’s NICU

The Memorial Tournament NICU has 99 beds and is a level IV unit capable of providing continuous life support including high-frequency ventilation, inhaled nitric oxide, and ECMO. The unit is divided into the main J4 NICU (57 beds), a level III developmental BPD unit (28 beds) and a 16-bed level II unit.  Fellows are supervised by two neonatology attending physicians each month and will work with 2nd year pediatric residents and NNPs.

Fellows spend their NICU month in J4 caring for high acuity patients.  The neonatal fellow will play a central role in providing care as a member of a multidisciplinary staff comprised of dedicated professionals, including specially trained nurses and nurse practitioners, respiratory therapists, clinical pharmacists, nutritionists, educators and social workers.   Fellows will also have the ability to interact with pediatric surgery, neurosurgery, cardiothoracic surgery, pediatric anesthesiology and a full range of pediatric medical subspecialists.

The experience for the first and second year fellows will focus on increasing skills in medical decision making, gaining proficiency in procedures frequently performed on neonates, establishing leadership skills by supervising residents, and improving communication techniques by interacting with parents, consultant physicians, and other members of the health care team.  As fellows gain confidence and knowledge, they are given more responsibility and autonomy with the major focus of the third year rotations being developing skills as an independent neonatologist. 

OSU NICU

The Ohio State University NICU has 49 beds and is a Level III unit capable of providing continuous life support, including high-frequency ventilation, and inhaled nitric oxide. An active, high-risk delivery service managed by Maternal-Fetal Medicine provides fellows with ample opportunity to become proficient at the resuscitation and initial management of critically-ill newborns. Fellows are supervised by two neonatology attending physicians each month and are given increasing responsibility to manage patients, lead rounds, and teach as their training progresses.

ECMO

A thorough 1 week ECMO course is offered annually and fellows have the opportunity to manage patients on ECMO with appropriate faculty supervision.

Perinatal Medicine

Fellows spend one month in their first year of training working with faculty and fellows from the Division of Maternal Fetal Medicine at The Ohio State University. Fellows attend daily board checkout rounds to discuss high risk patients and can attend clinics for high risk pregnancies including preterm labor and diabetes in pregnancy. The fetal therapy program at Ohio State offers treatment for a variety of conditions including isoimmunization, twin-twin transfusion syndrome and fetal pleural effusions/ascites, as well as the EXIT procedure for fetal neck masses.

Neonatal Cardiology

Fellows spend one month in their first year of training with the pediatric cardiac intensivists in the Cardiac ICU at The Heart Center at Nationwide Children’s Hospital. Fellows are responsible for consults in the NICU with supervision from Cardiology staff and get experience in the post-operative management of infants with congenital heart disease. Several didactic conferences are held each week and fellows can attend prenatal consultations including fetal echocardiography and MRI.

Outpatient Clinics

Fellows spend a total of two weeks per year in the Developmental and BPD clinics.

Developmental
The Neonatal Developmental Clinic follows high-risk patients discharged from the NICU including premature infants or other infants at risk for neurodevelopmental delay.  Fellows gain experience in downloading and interpreting apnea monitors as well as application of tools to evaluate for developmental delay such as the Bayley Scales of infant and toddler development.

Bronchopulmonary Dysplasia (BPD)
As one of the key programs of the Neonatology Division, the Comprehensive Center for BPD allows fellows to gain experience in the inpatient 28-bed BPD unit as well as in the outpatient management of infants with BPD. An interdisciplinary team including physicians, dedicated nurses, nutritionists, physical/occupational therapists, and social workers care for these infants.

Transport Team

Nationwide Children's Transport program provides 24 hour pediatric and neonatal critical care transport services via mobile ICU, helicopter, and jet aircraft to over 1,800 patients each year, with more than half of those being newborns. The team is one of the few in the country capable of transporting neonates on nitric oxide therapy and high-frequency oscillation at the same time.  The neonatal fellow will spend two weeks on the Transport service over 3 years.

Call Schedule

Fellows take in-house call with faculty backup at Nationwide Children’s Hospital or at Ohio State University NICU 6 times per month while on service in the NICU and during Cardiology/Perinatal Medicine rotations. While on research months, fellows take 4 in-house calls per month at either hospital. For all months, one of the in-house calls will be on a weekend (Saturday or Sunday). Call at Nationwide Children’s is taken with 2 neonatal nurse practitioners and one 2nd year pediatric resident. Call at Ohio State is taken with 2 pediatric residents and/or neonatal nurse practitioners and one pediatric intern. Fellows are required to follow the mandated ACGME work hours during all rotations.

Additional Clinical Experiences

The Ohio State University has an active simulation lab with opportunities for residents and fellows.