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 run in our unit by our neonatologists and fellows. The Nationwide Children's Hospital 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. The Fetal Center provides comprehensive diagnostic, consultation, fetal surgical, delivery and postpartum care to our families.
Fellows work alongside 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. Seniors will also rotate on our fetal consultation and delivery service and lead delivery room resuscitations at our Fetal Center.
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. ECMO is run in the unit by the neonatology team with pediatric surgery consultation.
Fellows are first call for ECMO patients on service and call. All fellows are invited to participate in cannulation, ECMO procedures, trials off and daily hybrid ECMO rounds. Each of these events includes dedicated just-in-time education by the ECMO attendings not primarily managing the patient.
Perinatal Medicine
Fellows work closely throughout training with faculty and fellows from the Division of Maternal Fetal Medicine at The Ohio State University. Fellows will spend 2 weeks in first year on a perinatal medicine rotation. 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.
Neurodevelopmental Follow-Up Clinics
Fellows spend a total of six weeks per year in the Developmental and BPD clinics. These clinics follow high-risk patients discharged from the NICU including premature infants and other populations at risk for neurodevelopmental delay. Special populations followed in this program include patients with BPD, cerebral palsy, neonatal opioid withdrawal 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.
Fetal Center
Fellows will have an opportunity to participate in the care of families who require fetal consultation, diagnostic evaluation, fetal intervention, and/or delivery in our main campus Fetal Center. Fellows will rotate in the Fetal Center during their Neonatal Cardiology rotation (focusing on the fetal cardiology population) and during their third year on a dedicated Fetal Center rotation.
Call Schedule
Fellows take in-house call at a frequency of approximately q6 on average, with call divided equally between Nationwide Children's and OSU. Call is taken with an in-house faculty member, neonatal nurse practitioners, and residents. Fellows do not round postcall.
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.