Trainees spend the majority of their NICU rotations at the MCH NICU during the 2-year period. NPM residents will participate and eventually direct rounds as they gain seniority. They will go to resuscitations as part of a resuscitation team where they will gain invaluable experience in neonatal resuscitation. Due to the high acuity and active turnover of patients, attendings and NPM residents work together in order to be effective both in patient care and guiding NPM residents to become confident in their development of differential diagnosis and management of patients and of the unit. In addition, the presence of all the Pediatric Sub-Specialists allows the NPM residents to care for patients with all types of pathology. Furthermore, NPM residents will give presentations to the Neonatology group and teach residents and students.
Trainees spend several rotations at the JGH NICU during a 2 year period. Initially, they will co-direct rounds and go to resuscitations with the attending. Once a certain comfort level is reached and the attending assesses appropriate skill level, trainees can enjoy autonomy and independence of practice. They must continue to report several times a day to the attending that will guide them so they become confident in their development of differential diagnosis and management of patients and of the unit. The code “lavender” which means that our experienced obstetrics colleagues are delivering a sick neonate is activated 2-7 times in a 24 hour period. The experience gained from a very active delivery room, allows for graduating NPM residents to become NRP instructors and feel very confident in resuscitating our most fragile 23 week neonates. As a result, trainees receive excellent experience with all related procedural skills in neonatology. Finally, trainees enjoy teaching residents and students.
Transport, Procedures and Consultation (TCP) Rotation
The TCP Rotation was established in 2016 by the NPM residents and has now been incorporated into the NPM program. It has the unique aspect of being created by NPM residents for NPM residents to meet the requirements they wanted.
During the TCP Rotation the NPM residents participates in morning rounds as the Bed Manager. The Bed Manager manages movement in and out of the unit throughout the day and is in constant contact with each Neonatalogist on service and the Nurse in Charge. The NPM resident answers all transport calls and if the patient requires an MD, they are dispatched with the team to go stabilize and transport the infant. Furthermore, NPM residents review and do complex antenatal consults and consults for extreme prematurity. The neonatologist is present for assistance and feedback. Also, an NPM resident on this rotation has priority for procedures. This is an opportunity to help establish independent thought for the NPM resident and to give them a clear understanding of what the transport team does and what the limitations in the community are. Currently, the TCP Rotation is a two-week rotation in the second year of training but will soon be established as a junior Rotation as well. NPM residents enjoy and learn a lot about how to manage patients more independently.
NPM residents will have several blocks of research during the 2 year period in order to complete a scholarly activity. Initially they must decide on a topic that interests them and locate a research mentor with whom they wish to work. Upon completion of training, an NPM resident is expected to create, disseminate, apply and translate medical knowledge through scholarly activities. Scholarly activities can be and are not limited to Basic Science Research, Clinical Research, Epidemiology, Education, Quality Improvement, Public Health or Leadership projects.
Maternal Fetal Medicine
The MFM rotation is an elective 1 block rotation that NPM residents enjoy in their second year of training. The rotation is tailored to the resident’s interests so that they may participate in fetal surgery, MFM clinic, ultrasound clinic, the management of MFM patients on the wards, observe procedures (examples: amniocentesis, percutaneous umbilical blood sampling) and/or fertility clinic.
Follow-up Clinic is an elective 1 block rotation that NPM residents enjoy during their 2 year residency training. The clinic is very active with graduate patients from the Children’s who are seen on a specific routine. NPM residents do assessments of development and general pediatrics and write the clinic note, which is a global assessment of the patient’s visit and plans for treatments and follow up. This rotation also offers a 1 year fellowship in Follow-Up for graduating NPM residents and Pediatric Residents who are interested.