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Curriculum

Boot Camp Picture

The objectives of the Neonatal-Perinatal Medicine Fellowship curriculum vary by year, commensurate with the experience fellows have gained. Fellows increase their knowledge-base in the first year and participate in management of the team by the third year. Neonatologists who train at Indiana University School of Medicine are prepared to manage any neonatal problem.

Clinical Overview

Fellows rotate through various clinical settings, including a comprehensive Level IV NICU in a referral center, Level III NICUs that care for neonates with more common neonatal problems, a county hospital Level III NICU serving the vulnerable population, and community NICUs—all associated with IU School of Medicine.

Integral to the fellowship training program is fellows’ on-call responsibilities. While on call, fellows supervise pediatric residents, medical students and neonatal nurse practitioners in the NICU, manage patients on Extracorporeal Membrane Oxygenation, and attend high-risk deliveries. Fellows are on call an average of every sixth night throughout the three years of training. An attending physician is on call with the fellow and is readily available for consultation as needed.

Program Progression

First-year fellows rotate through a significant portion of their clinical service time to build a strong clinical base. First-year fellows are mentored through exploring research opportunities and, by midyear, choose a research project, mentor and scholarship oversight committee. Mentorship from neonatal faculty and divisional leadership helps guide fellows toward choosing a scholarly project.

Second-year fellows have decreased inpatient clinical service, opening time to devote to the scholarly project. Although the amount of time devoted to clinical activities decreases during the second year, the clinical experience broadens to include a rotation in the cardiovascular intensive care unit and high-risk consult rotation in which fellows participate in multidisciplinary prenatal consults.

The clinical experience during the third year of fellowship is individually designed based on the fellow’s personal and professional goals. Given the breadth of clinical, educational and basic science research opportunities at IU School of Medicine, neonatology fellows choose a career track at the end of their second year of fellowship. Fellows are asked to reflect on their personal and professional goals and choose from the following tracks: Physician Scientist, Clinician Educator, Clinical Scholar. Physician Scientists focus on obtaining funding and developing a career research plan. Clinician educators and Clinical scholars may choose to do electives during their third year including community NICU rotation, Cardiovascular ICU or other subspecialty areas.

First Year Second Year Third Year
Weeks of Clinical Service 18 weeks
(Riley SFT, RMT, Eskenazi)

10 weeks
((Riley SFT, RMT, CVICU, Consult)

Physician Scientists:
9 weeks

Clinician Educators:
18 weeks

Clinical Scholars:
24 weeks

(Riley SFT, RMT, Consult, Electives)

Clinical Emphasis Increase knowledge-base and clinical skills Improve teaching and management skills Improve teaching and management skills
Research Identify research project, mentor and scholarship oversight committee Clinical service time decreased, time devoted to research project; Choose personalized academic track at the end of the year Complete scholarly activity with manuscript submission
Quality Improvement Project Personal QI project curriculum Optional scholarly QI project Complete optional QI project
Specialized Education Ethics curriculum, Board Review, 1st year simulation curriculum, ECMO series, specialty clinics, IU Talk  Ethics curriculum, Board Review, Upper Level simulation, ECMO series, specialty clinics, IU Talk  Ethics curriculum, Board Review, Upper Level simulation, ECMO series, specialty clinics 

Specialized Longitudinal Education Programs

The board review curriculum is a three year, rotating curriculum in which all topics of neonatal-perinatal medicine are covered by the completion of fellowship. Fellows review material in preparation to review board style questions with faculty members. The schedule follows our board review conference series in order to provide reinforcement of previously learned topics.

Fellow start by participating in an ECMO boot camp during their first month with pediatric critical care fellows, pediatric cardiology fellows, and pediatric surgery fellows. They continue to join these fellows to participate in a three year didactic lecture series focused on ECMO management. The program consists of in person lectures, assigned reading, simulated cases, and ECMO M&Ms.

Neonatal fellows go through a three year Ethics curriculum, led by one of our neonatologists who has a focus in neonatal ethics. In addition to reviewing ethical principles and procedures, fellows have the opportunity to meet with guest speakers, participate in book clubs, and have a forum to discuss ethical dilemmas with their colleagues.

First and second year fellows go through a simulation based communication course to better prepare themselves to navigate difficult conversations and clinical care scenarios with patients’ families. The first year course serves as an introduction to the topics and the second year expands on skills previously learned.

First Year: Our first year fellows complete a simulation curriculum geared toward difficult situations that are likely to arise multiple times through their fellowship and career. In a safe environment, fellows have the opportunity to perform high risk/low volume procedures, work on communication skills, and learn about team management and leadership. The curriculum begins with a one day “boot camp” during fellow orientation and continues throughout the academic year.

Upper Level: Second and third year fellows build upon the skills and knowledge they learned in their first year and continue working through a simulation curriculum. Led by faculty with a focus in simulation, fellows have the opportunity to practice procedures and scenarios in a low risk environment.

The ACGME requires neonatal fellows to participate in follow up clinics for neonates. Due to multiple subspecialty clinics in our hospital system, fellows can participate in follow up clinics for chronic ventilator patients, developmental pediatrics, genetics/metabolism, intestinal rehab, neonatal neurology, and newborn follow up patients. Fellows also have the opportunity to participate in maternal-fetal medicine clinics to gain a perspective on prenatal management of the patients they will be caring for in the NICU.