Goals & Objectives

By the end of the first year of training fellows will be competent to:
- Recognize the significance of the changes that normally occur in the transition to extrauterine life
- Explain the pathophysiology of disorders commonly affecting the neonate such as:
  - respiratory distress syndrome
  - patent ductus arteriosus
  - necrotizing enterocolitis
  - intraventricular hemorrhage
  - retinopathy of prematurity
  - others
- Comprehend the significance of the post-natal maturational changes that affect the neonate such as:
  - circulation-changes in the pulmonary vascular resistance
  - changes in glomerular filtration rate
  - changes in bilirubin production and metabolism
- Recognize congenital malformations and understand their significance
- Perform competently the technical skills needed to care for the sick newborn such as:
  - endotracheal intubation
  - umbilical vessel catheterization
  - thoracocentesis
  - thoracostomy
  - lumbar puncture
- Provide prenatal counseling to parents of at risk pregnancies
- Provide pre-operative and post-operative management of neonates with disorders requiring surgical intervention
- Develop and carry out the management plans for common neonatal problems (with supervision), such as:
  - ventilation strategies in respiratory distress syndrome
  - fluid and electrolyte therapy in the high risk neonate
  - phototherapy for the treatment of hyperbilirubinemia
  - treatment of pulmonary hypertension including high frequency ventilation, nitric oxide and ECMO
- Understand the long term needs of the high risk neonate
- Counsel and educate families with information regarding the current status and prognosis of their babies
- Demonstrate an analytical approach to clinical situations, apply knowledge of study design and statistical methods to reading the medical literature critically, particularly that which is relevant to neonatal issues
- Gather information regarding the research interests of the neonatal faculty and select a research mentor
- Understand the essentials of proper study design
- Develop research questions
- Design an original research protocol
- Apply for grant support for research
- Understand the different business models in neonatal medicine
- Utilize information technology to help make patient care decisions and educate parents
- Present case presentations
- Prepare and deliver full length lecture
- Give a research presentation
By the completion of the second year of training the fellows will be competent to:
- Broaden one’s knowledge of normal neonatal physiology and the pathophysiology of common neonatal problems as previously listed and effectively teach these concepts to others in training
- Participate in the management of common neonatal problems with a greater degree of independence. Although the faculty will continue to be involved, it is expected that second year fellows will be capable of formulating their own plan of management and to function more autonomously. In addition, second year fellows should be competent to manage more complex diagnoses in the neonate such as pulmonary hypertension, congenital cyanotic heart disease, profound hypoglycemia, severe electrolyte imbalance
- Perform all the technical skills previously described with indirect supervision. In particular, by the end of the second year fellows should be competent in abdominal paracentesis, peripheral arterial catheterization, peripheral long line catheterization, pericardiocentesis, perform exchange transfusion
- Comprehend the evaluation and management of the high risk pregnancy including an understanding of the indications for fetal ultrasound, chorionic villous sampling, amniocentesis and genetic testing and counseling (Perinatology rotation)
- Independently counsel parents either prenatally or post-natally through a greater understanding of long term outcome
- Anticipate the long term needs of neonatal patients
- Utilize consultants when appropriate
- Enhance one’s knowledge by reading the neonatal literature critically
- Perform research project to the extent that one is generating data during this second year of training
- Understand medical statistics and be able to apply it to one’s own data
- Ask new research questions and develop new studies
- Apply for grant support
- Facilitate the learning of others by giving an internal research presentation
- Prepare abstracts for presentation
- Present one’s research at external meetings either at the local or national level
- Prepare and deliver a minimum of one full length lecture
- Understand the fundamentals of billing properly for neonatal services
- Explain the ethical dilemmas in the field of neonatal medicine.
- Obtain and utilize information about our own patient population to make informed clinical decisions
By the completion of the third year of training the fellows will be competent to:
- Function autonomously in the Intensive Care Nursery. Faculty will continue to provide support as needed
- Understand the preoperative and postoperative management of babies with complex congenital heart disease. To understand the indication for fetal echocardiography, cardiac MRI, electrophysiologic studies. To learn active participation in the care of neonatal cardiac patients and to be able to counsel families of babies with congenital heart problems (Cardiothoracic rotation, see separate Goals for this rotation)
- Counsel parents of sick neonates independently and to comprehend the psychosocial implications of disorders of the unborn or newborn baby
- Call in consultants appropriately
- Show a commitment to the ethical principles pertaining to withholding care, protecting patient confidentiality and information consent
  - Collate data and perform statistically analysis
  - Present results of research internally as well as at national meetings including preparation of abstracts
  - Prepare a minimum of one manuscript on one’s research and submit it to a peer-reviewed journal for consideration
  - Give an internal research presentation
  - Give seminars and full length lectures
  - Bill appropriately for neonatal services