Fellow Supervision
Day to day supervision of fellows is provided by daily teaching rounds in the nursery. During these rounds, management decisions made by the fellows are carefully reviewed to ensure that the fellow is developing an appropriate understanding of neonatal management technique. For the remainder of the day, the attending neonatologist is available for consultation and problem solving in the nursery to assist the fellow. When the trainee is on-call at night, an attending neonatologist is on-call by telephone from home and is required to come to the hospital upon request of the fellow, or when the neonatology staff member feels that the fellow needs further help to adequately deal with the problem at hand.
Attending staff neonatologists also aid the trainee in preparation of conferences, in development of research protocols and investigations, as previously outlined, and in the development of managerial skills which are required by any academic physician. An advisor for each fellow is provided, as well as the assistance of the Fellowship Committee to assist the trainee with consultation for research projects and in the preparation of protocols, abstracts and papers.
Regular meetings with the Fellowship Director are held with each fellow to privately review their progress in the fellowship program, with regard to clinical rotations, research development and personal growth. To assist in this regard, fellows are evaluated by each member of the attending neonatology staff with whom they clinically serve in either of the institutions involved in the fellowship training program. If problems are identified with any fellow, the members of the Fellowship Committee meet to discuss how the fellow might best be aided in overcoming any perceived problem. These evaluations are reviewed by the members of the Fellowship Committee and the Director of the Division of Neonatology. Trainees are promptly notified of any problems arising and appropriate counseling is provided for fellows with problems.
In addition to evaluation of the fellows, fellows are required to evaluate faculty performance. Faculty evaluations consist of at least one year-end review with the Divisional Director and the formal yearly evaluation by the Departmental Chairman. The Departmental Chairman utilizes the fellowship review of faculty members to determine how well members of the neonatology faculty have achieved previously mutually agreed upon goals. These goals include development of patient services, educational activities, research presentations and publications, assumption of administrative responsibilities, and development of external professional activities.
Evaluation of patient care provided by both fellows and staff members in neonatology is ensured by the following mechanisms: (1) Monthly neonatal quality assurance committee meetings conducted by the Division of Neonatology in association with the hospital administration; (2) Review of mortality rate by the Director of the Division of Neonatology in conjunction with a national evaluation service and; (3) Monthly meetings with the nursing management of the neonatal intensive care nursery and the transitional nursery. Thomas Jefferson University Hospital has extensive basic science colloquia in molecular biology, physiology, biochemistry, pathology, anatomy, and microbiology that fellows are encouraged to attend if topics relate to their areas of investigation. Fellows with appropriate research interests may also present their research topics at these basic science conferences held in the University.
Trainees in neonatology, as previously described, are expected to present formally on an annual basis. Fellows must develop the capacity to capably analyze and critique scientific papers that bear on the field of neonatal-perinatal medicine. In addition, fellows will present on several occasions throughout their training period with respect to the design and implementation of their research investigations and are required to defend their research findings to members of the Division of Neonatology and other scientific investigators in the University who may share common interests.
During the initial phases of training, neonatology fellows are closely supervised by members of the neonatology divisions at both Thomas Jefferson University Hospital and Christiana Hospital to ensure that the fellow has an appropriate understanding of neonatal management and the development of appropriate technical skills in newborn medicine. During the second and third year, the fellow also has an opportunity to act as an attending in one of the intensive care nurseries and conduct daily teaching and management rounds to ensure that the fellow has acquired appropriate skills to assume the role as an attending faculty member upon departure from the neonatology program. Fellows are also asked to provide prenatal consultation services to the perinatology staff and speak with mothers of high-risk infants to inform those patients as to the types and likelihood of problems that may occur following delivery.
