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Curriculum

The NPM fellowship program consists of the following components as outlined by the Program Requirements for Education developed by the American Board of Pediatrics (ABP) and ACGME Resident Review Committee (RRC) for Neonatal-Perinatal Medicine. Fellows are assigned to these components in an educationally appropriate sequence over 36 months of training.

The curriculum is structured to foster educational and academic excellence as well as outstanding, high-quality patient care. Twelve to fourteen months of the three-year fellowship are devoted to clinical service. Clinical time is concentrated in the first and second years, with the majority of the third year devoted to scholarly activities. The clinical experience at UMASS Medical Center offers the opportunity to master advanced techniques while acquiring a sound foundation in the fundamentals of neonatal physiology, evidence-based care, neonatal transport, and convalescent care. The overall training focuses on the six core competencies and accompanying milestones for each competency, while involving multiple aspects of quality improvement (QI).

During the first year clinical rotations, fellows concentrate on developing a broad fund of knowledge while improving their clinical, technical, supervisory, teaching and team leadership skills. They work closely with the attending neonatologists in overseeing care for all infants in the NICU, including co-management of all surgical and cardiothoracic patients and infants admitted to clinical units outside the NICU. NICU rotations provide a supportive environment for fellows to progressively develop competence in academic leadership, and teaching skills while collaborating with medical students, pediatric residents and neonatal nurse practitioners. With attending support, fellows acquire proficiency in effective, sensitive communication by assisting and guiding families in times of ethical dilemma and bereavement.

Rotations on the antenatal consultation and labor and delivery service offer interactions with the Maternal-Fetal Medicine and Genetics services and provide exposure to perinatal genetics, physiology, diagnosis and intervention. While on the antenatal consultation service, fellows supervise delivery room resuscitation and stabilization for all high-risk infants. Fellows are trained in the transport of critically ill newborns and in post- operative. They also participate in the Newborn Follow-Up Program.    

During the second year, the fellow becomes proficient, and in the third year the fellow develops real expertise in the 6 core competencies. Each fellow also becomes a leader of an ongoing QI project. The clinical responsibilities are reduced as research endeavors become established. Fellows continue to develop their knowledge of advanced topics in Neonatal-Perinatal Medicine, and enhance their academic leadership and teaching skills. Senior fellows spend their final clinical rotation demonstrating their competence as they function as junior attending physicians in our NICU while being supervised by a senior attending.

Administratively, the goal of the program is to provide the fellow with organizational skills and the knowledge of how to set up and operate a NICU on a daily basis in regard to education, problem-solving, quality, regionalization and perinatal statistics, outreach programs, insurance, and billing. The fellow is a member of the multidisciplinary neonatal education committee for scheduling neonatal conferences and helping in selection of cases, topics and speakers. The fellow attends all multidisciplinary neonatal conferences (high-risk obstetrics, patient management, perinatal mortality/morbidity, pediatric grand rounds, neonatal neurology, neuropathology, ethics, respiratory therapy, cardiology, and developmental conferences). The fellow schedules patient management conferences with all the neonatologists which deal with basic science, pathophysiology, research and journal review. The fellow attends monthly nursery organizational meetings (when off service). The fellow participates in equipment/technique evaluation, researches neonatal care protocols (e.g. drug dosage guidelines) and helps to revise neonatal handouts for residents.

The fellow is the liaison between the UMass Memorial Health Care - UMass Campus and the Memorial perinatal center regarding readmission of NICU graduates. The fellow participates in the regional perinatal outreach program during the third year (neonatologist, perinatologist, neonatal nurse clinician and perinatal nurse specialist) by presenting data, discussing cases and presenting a perinatal topic to community hospital physicians and nursing. The fellow also has a session on financing/billing in Neonatology.

The Division of Newborn Medicine maintains an atmosphere of inquiry and evidence-based practice with a major focus on quality of care through regular seminars, journal clubs and presentations on a variety of clinical, investigational, and research topics. Fellows attend core lectures on neonatal intensive care and research related topics, which are offered regularly throughout the year. Procedural and simulation training is offered regularly while a core curriculum lecture series on advanced topics in neonatal medicine is offered specifically to enhance the fund of knowledge in preparation for subspecialty certification examination. The Division of Newborn Medicine, the Department of Pediatrics and University of Massachusetts Medical Center also hold a number of other educational weekly conferences. Our clinical curriculum is in tight alignment with the ACGME and ABP requirements for subspecialty training.