The Neonatal-Perinatal Medicine Fellowship at Dell Medical School has taken input from the neonatal faculty and associated specialties to design a curriculum with all the best components of training that the program’s leaders have experienced nationally and internationally.
Clinical training in the Neonatal-Perinatal Medicine Fellowship is grounded in applied physiology. Fellows will receive an in-depth understanding of the physiology and pathophysiology of the fetus and newborn, including the use of a national neonatology flipped classroom curriculum. Weekly fellow-oriented teaching is supplemented by a wide range of bedside and didactic teaching, simulations, multidisciplinary conferences, audio-podcast curricula and case reviews.
- Fellows didactic/flipped classroom teaching
- Fraser rounds — cardiovascular physiology
- Cardiac surgical planning
- Neonatal grand rounds
- Pediatric grand rounds
- Quality assurance (M&M)
- Fetal care conference
- Fellow research progress update
- Neonatal journal club
- Radiology review
- Cardiology journal Club
- Joint NICU-maternal-fetal medicine journal club
- Joint NICU-cardiology journal club
- Fellow half-day academic meeting (joint with pediatric subspecialties)
- Neonatal neuroradiology conference
On-service clinical rotations take place at both Ascension Seton Medical Center Austin and Dell Children’s Medical Center, and are taken in four-week blocks to give an opportunity to follow the natural history of neonatal conditions.
In each clinical rotation, fellows will be paired with two neonatology attending physicians for consistency of supervision. Specific learning goals will be discussed at the beginning, middle and end of each rotation, with written feedback also provided at the end of each rotation. Feedback will not only focus on clinical knowledge but also the essential skills needed for a successful independent neonatal practice. These include communication with families and care-team providers, systems-based care with cost-conscious decision-making, procedural skills, teaching skills and leadership (as appropriate based on year of training).
Clinical rotations are concentrated in the first two years of the program to allow maximal time for research and scholarly activity later in the program. In the third year, fellows will have two four-week “pre-attending” blocks where they are expected to run the clinical service with an attending present throughout rounds for immediate support. Blocks in the cardiac intensive care unit and maternal-fetal medicine are also included.
As this is a relatively new program, there will not be an initial requirement for full night coverage of both neonatal intensive care unit sites by fellows. The program aims to have full night-call coverage at both sites by year 3 of the fellowship when the full complement of nine fellows are available. Fellows will have the autonomy to design their own call schedule coverage model. Annual vacation (three weeks per year) can be taken during any of the research blocks.
Protected time for board preparation is available for the four weeks leading up to the pediatric board exams. For fellows who have already completed pediatric boards, this time can be used for additional research, electives, family leave, with approval by program leadership.
Four four-week blocks of elective time are allotted. These can be used by fellows in any combination and can be used for research, additional clinical time or a range of educational experiences.
Ethics: Training in bioethics includes a primer in basic ethical concepts and principles, which all fellows receive. Additional focus allows for an in-depth review of important historical cases and their respective precedents, bedside instruction in the practical application of clinical bioethics and attendance at ethics meetings and leading case discussions.
Global health: Collaborating with the UT Global Health Program, this training promotes education, research and service to promote health equity for vulnerable populations. UT Austin currently has training partnerships with Kenya and Mexico. With appropriate advance notice and administrative approvals, other sites can be considered for clinical rotation and research.
Point-of-care ultrasound: This training includes assessment opportunities related to vascular access, circulatory function, procedural skills and more. All fellows will have the opportunity to acquire basic POCUS skills, with elective and research time allowing more in-depth skills acquisition.
Advocacy: Mentorship in advocacy projects is available through the Dell Medical School Department of Pediatrics Advocacy Committee, which focuses on legislative policy, education, community outreach, social determinants of health, innovation solutions and research.
Health economics and administration: This training offers practical exposure to the leadership, management and strategic-development skills required to guide an expanding multisite neonatology service. Through existing state-wide clinical and quality-improvement mechanisms, fellows will gain insight into regionalization of care and collaborative efforts among health care systems.
Palliative care: This training provides experience in the active and total care of infants with life-limiting conditions, with a focus on enhancing quality of life, managing symptoms and supporting families across multiple specialties and embracing physical, emotional, social and spiritual elements.
Biomedical engineering/technology development: This training collaborates across multiple divisions with a focus on understanding pathophysiology of diseases and developing and applying biosensors to track and predict health. It also includes the potential development and licensing of a number of novel with support from UT Austin’s Office of Technology Commercialization.
Every fellow will be mentored by a scholarly oversight committee of three members, one of which will be from outside the Division of Neonatology. Fellows will meet regularly with their mentors and discuss progress on scholarly projects at biweekly research meetings. With scholarly oversight committee and program leadership approval, fellows can design unique elective experiences that align with their overall career path and goals.