Neonatology Fellowship Clinical Experience

Nationwide Children’s Hospital NICU

The Nationwide Children's Hospital NICU has 130 beds and is a level IV unit capable of providing continuous life support including high-frequency ventilation, inhaled nitric oxide, and ECMO. The NCH NICU includes 4 units of varying degrees of acuity and specialized care models. The C04A unit is a developmental care unit for patients with BPD. Twenty-three beds in the C04B unit are dedicated to the Small Baby Program.

Fellows work alongside four neonatology attendings as well as neonatal nurse practitioners, and residents. 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, 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. 

Senior fellows will spend one month on the C04A BPD unit developing skills in managing this challenging condition. The BPD unit at Nationwide Children’s Hospital has a unique approach to care and receives transfers from across the country to access specialized treatment and family support.

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 three neonatology attending physicians each month and are given increasing responsibility to manage patients, lead rounds, and teach as their training progresses. Fellows work along side neonatal nurse practitioners and supervise a team of eight pediatrics interns and residents. The Ohio State and Nationwide Children’s main campus NICUs are in close physical proximity (10 minute drive).

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 second 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 six weeks per year in the Developmental and BPD clinics.

Neurodevelopmental Follow-Up Clinics
These clinics follow high-risk patients discharged from the NIUC including premature infants and other populations at risk for neurodevelopmental delay. Special populations followed in this program include patients with BPD, cerebral palsy, neonatal abstinence syndrome, and infants with a history of neonatal neurological injuries. Fellows work alongside an interdisciplinary team including physicians, nurse practitioners, nurses, nutritionists, physical/occupational therapists, and social workers. They learn how to conduct thorough neurological exams and how to evaluate for developmental delay using tools such as Bayley Scales of infant and toddler development.

Transport Team

Nationwide Children's Transport program provides 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 three weeks on the Transport service over 3 years.

Call Schedule

Fellows take in-house call at a frequency of approximately q5 on average, with call divided equally between NCH and OSU. Call is taken with an in-house faculty member, neonatal nurse practitioners, and residents.

Additional Clinical Experiences

The Ohio State University and Nationwide Children's have active simulation labs with opportunities for residents and fellows. Fellows also participate in the fetal consultation program and collaborative management conferences with MFM and cardiology. First year fellows participate in a regional bootcamp for procedure and communication skills during their orientation month. Fellows will also have special educational opportunities pertaining to infant feeding disorders.