Our goal for neonatal clinical training is to ensure our fellows acquire critical experience to prepare them for clinical practice at the most intense level of neonatal care. To achieve this goal, our fellows become proficient in antenatal consultation, delivery room resuscitation and stabilization, acute intensive care management, convalescent care, coordination of community consultation and neonatal transport, and high-risk infant follow-up as well as procedural skills and competency in use of ECLS (ECMO), inhaled nitric oxide (iNO), high-frequency ventilation (HFV), and therapeutic hypothermia. These skills are progressively earned through the annual support of nearly 3000 deliveries, 850 NICU admissions (range 22-42 weeks) and provision of supportive care for all surgical diagnoses including complex congenital heart disease and congenital diaphragmatic hernia at UF Health Shands Children’s Hospital.
Each year, our fellows complete four 4-week rotations in the NICU, 40 in-house night calls and 8 high-risk infant follow-up clinics, with the remainder of time spent in scholarly activity and electives. Clinical responsibilities progressively increase as the trainee advances through the three-year program culminating in two 4-week “ pre-attending” experiences (one each with resident’s team and NNP’s team). During these rotations, the 3rd year fellow performs the duties of a faculty attending physician in the Level IV NICU under the supervision of a faculty member to help prepare them for independent practice. Trainees also undertake an intensive rotation in our Pediatric Cardiac Intensive Care Unit as part of the busy UF Health Congenital Heart Center team. The CHC team performs nearly 300 cases annually with an average operative survival of 98% across all procedures including Norwood and Heart-lung Transplant. Pediatric surgical support for the >150 neonatal cases per year is provided by our comprehensive pediatric surgical training program and its faculty. Electives are made available in other clinical areas of excellence including cardiology, pediatric surgery, as well as other tertiary NICUs (development of Winnie Palmer in Orlando and Sacred Heart in Pensacola rotations in progress), based on the individual interests.
Transition from Resident physician to First year Neonatal Fellow
The transition from resident physician to subspecialty fellow can be challenging. The goals of the first year of fellowship are three-fold: 1) Rapidly gain competence in the varied procedures and practices in the NICU, 2) Begin the scholarly activity path, and 3) Prepare for and pass the General Pediatrics boards. The transition from resident to fellow role is fostered through a neonatology fellow “boot-camp” held in July where new fellows receive focused didactic and simulation teaching for intubation, thoracotomy tube placement, umbilical catheter placement and neonatal resuscitation. During boot-camp, the fellow will also learn to set up and operate all of the equipment in the delivery room and NICU, including conventional and high frequency ventilators, infusion pumps, amplitude-integrated EEG and cerebral oxygenation monitors. Throughout the year, the ongoing development of core clinical skills and critical thinking are fostered and is supported by faculty throughout the Department of Pediatrics. Additional procedural experiences will be available during the clinical service months including but not limited to lumbar puncture, peripheral arterial line, peripheral IV, and PICC line placement. In addition, the fellow will assist on transports with the neonatal transport team.