DEPARTMENT OF PEDIATRICS AND HUMAN DEVELOPMENT DEPARTMENT OF PEDIATRICS AND HUMAN DEVELOPMENT

Department of Pediatrics and Human Development
College of Human Medicine

Department of Pediatrics and Human Development
College of Human Medicine



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Neonatal-Perinatal Fellowship Program

The Michigan State University Neonatal-Perinatal Medicine Fellowship is a three-year ACGME-accredited program designed to develop excellent, well-trained neonatologists with experience in clinical neonatology, research, teaching, and administration. Clinical experience is provided at Sparrow Hospital in downtown Lansing, with an elective cardiothoracic rotation available with the University of Michigan. As they progress through their clinical rotations, fellows devote more and more of their time to researching a topic of interest. A broad range of mentors and research facilities are available at Michigan State University's East Lansing campus, only a few miles down the road from Sparrow Hospital.

Inpatient rotations are completed in the Michigan State University-Sparrow Hospital Regional Neonatal Intensive Care Unit (RNICU). Established in 1972 as a 6-bed local unit accepting perhaps one fellow every two years, the facility has since expanded to serve the entire Mid-Michigan region with 47 beds, several faculty, and up to five fellows at a time.

Since its inception in 1984, the MSU Neonatal-Perinatal Medicine Fellowship has graduated some 35 fellows. In recent years, the program has distinguished itself, with many fellows winning prestigious national, regional, and local awards, and accepting academic positions in Neonatology at high-ranking institutions.

PROGRAM OVERVIEW

Each Subspecialty Resident must design, conduct, analyze, and report the results of a clinical or laboratory research project. To this end, the Fellow is requires (with the assistance of the Program Director) to identify an area of research and a research preceptor no later than the end of the Fellow's sixth month with the program. We have enlisted basic scientists whose labs are open to providing Fellows with high-level training and mentoring. The mentors become part of the Fellow's Scholarly Activity and Oversight Committee, and will supervise the Fellow for the next two to three years.

In addition to their menor, the Fellow will have a faculty member acting as their preceptor. The preceptor will neet with the Fellow on a regular basis to provide ongoing evaluation of performance, help with research efforts, and provide critiques of work in progress. Research preceptors can be selected from within the Division of Neonatology or other Michigan State University academic units. The preceptor will also discuss evaluations provided by the NICU attending after each clinical rotation.

By the end of the first year, the Fellow is expected to have a complete research proposal prepared in collaboration with the Research Mentor and an IRB or Animal Care approval for the project. The Fellow must also complete the Biostatistics and Research Design course offered on a bi-anniual basis. Additionally, the Department of Epidemiology offers an Introduction to Descriptive and Analytical Epidemiology, which Fellows would do well to attend.

The Fellow is strongly encouraged to have an abstract ready by November of their second year, so that they submit their research to a National Meeting (usually PAS in May). In preparation, the Fellow should present work-in-progress at local and regional meetings (Midwest SPR, Pediatric Research Day, Lansing Research Day).

With input from their Research Mentor and the Program Director, the Fellow should be preparing manuscripts for publication by the middle of their third year.

 

RESEARCH MENTORS

Current research mentors include:

  • Bruce Uhal, PhD and Ira Gewolb, MD—Advising Chintan Gandhi, MD (2018) and Prasanth Thiruvenkataramanai, MD (2020)
  • Said Omar, MD—Advising Nageshwar Chauhan, MD (2018)
  • Mark Kadrofske, MD, PhD—Advising Jenny Bellodas, MD (2019)
  • Almudena Veiga-Lopez, PhD—Advising Visa Sethuraman (2020)

 

Current IRB approved Projects within the Division of Neonatology
Project TitleFunding SourceFaculty Investigator(s)
Preterm infants with persistent ductus arteriosus (PDA_: Is there a role for prolonged indomethacin therapy in achieving permanent closure?  

Awonuga—Principal Investigator

Gewolb—Co-Investigator

Using Simulation to Teach Procedural Skills in Neonatal Medicine  

Awounga—Principal Investigator

Gewolb—Co-Investigator

Assessing the association between entrustable professional activities, competencies, and milestones in the pediatric subspecialties  

Awounga—Principal Investigator

Gewolb—Co-Investigator

Using In-Situ Simulation to teach the implementation of Team Sterategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS).  

Awonuga—Principal Investigator

Olomu—Co-Investigator

An alternative strategy of nasogastric infusion feeding in premature newborn infants  

Gewolb—Principal Investigator

Awonuga—Co-Investigator

MI VON quality collaborative Michigan Department of Community Health Karna—Principal Investigator
MDCH for MI VON quality collaborative Michigan Department of Community Health Karna—Principal Investigator
A Randomized Trial of the Use of Human Milk Cream to Decrease Length of Stay in Extremely Premature Infants Prolacta Bioscienc®

Karna —Principal Investiagor

DeVitto—Co-Investigator

Omar—Co-Investigator

Gestational Diabetes, Placental Microbiome and Neonatal Outcome: A Plot Study  

Olomu—Principal Investigator

Mulks—Co-Investigator

Tonsil Microbiome - From Birth to Two Years of Life  

Olomu—Principal Investigator

Mulks—Co-Investigator

Placental Pathology, Clinical Chatacteristics and Neurodevelopmental Outcomes in Full-Term Infants with Cerebral Infarcts  

Olomu—Principal Investigator

Omar—Co-Principal Investigator

Ex Vivo expansion of Hematopoietic Stem Cells from Cord Blood   Omar—Principal Investigator
Measurements of Prostacydin (PGI2) Urinary Metabolite to Determine the Severity of Respiratory Syncytial Virus (RSV) Infection in Children   Omar—Principal Investigator
Effect of witholding feeds on the incidence of late onset necrotizing enterocolitis among premature neonates receiving Packed Red Blood Cells (PRBC) transfusion   Omar—Principal Investigator
Sparrow CME Funds to support Fellows in Neonatology Sparrow Hospital GME Department Fellows and Mentors

The Fellow will be expected to participate in several teaching experiences throughout the course of their studies.

WEEKLY

  • Pediatric Grand Rounds
  • Neonatology Physiology Seminar (Formal lectures and seminars presented weekly throughout the three-year program)
  • Faculty/Fellow Meetings:
    • Journal Clubs
    • Quality Assurance Reviews
    • State-of-the-Art Talks
    • Case Reviews/M&M/Protocol Reviews
  • Teleconference rounds with MetroHealth Neonatology Program in Cleveland (twice weekly).

 

MONTHLY

  • Neonatology Research Seminars (Fellows present research updates once or twice a year)
  • Neonatology M&M Conference
  •  

    BI-MONTHLY

    • Maternal-Fetal Medicine Rounds

     

    ANNUAL

    • Introduction fo Epidemiology
    • Neonatal-Perinatal Core Competency Series

    BI-ANNUAL

    • Statistics and Research Design Course

    The Neonatology Fellowship program provides an elective cardiothoracic rotation through the University of Michigan. The participating Fellow will be a part of the University of Michigan cardiothoracic surgery team, participating in rounds and pre-, peri-, and post-op management of pediatric cardiosurgical patients, with a special focus on conditions presenting in the newborn period. The Fellow will also participate in the care of ECMO patients. As appropriate, the Fellow will also participate in outpatient clinics for follow-up of post-operative patients. They will also participate in imaging rounds for both prenatal and postnatal consultations.

     

    OBJECTIVES AND GOALS

    The Fellow will enhance their ability to recognize and understand:

    • Diagnosis and medical management of various cardiac defects.
    • Surgical management of simple and complex cardiac defects.
    • Invasive and non-invasive cardio-respiratory monitoring.
    • Use of pharmacologic agents in pediatric cardiology.
    • The mechanics and functioning of ECMO/Bypass systems.
    • Management of multi-organ failure/dysfunction.
    • Counsel parents of children with cardiac issues diagnosed prenatally and postnatally.

     

    The attending physician(s) will provide program officers with evaluations of the Fellow's performance. The Fellow will also be expected to provide feedback on the elective experience, with an eye towards improving the rotation to best meet the educational needs of the program.

    OUTPATIENT ROTATION:

    Fellows Chintan Gandhi and Jenny Bellodas greet an infant child.

    DEVELOPMENTAL ASSESSMENT CLINIC

    Neonatal fellow acquires outpatient follow-up experience in the Developmental Assessment Clinic (DAC). This is a multidisciplinary outpatient clinic that performs developmental screening evaluations on high-risk infants discharged from the Regional Neonatal Intensive Care Unit (RNICU) to ensure early identification of cognitive, motor, behavioral, or social developmental deficits.

    The clinic team includes a Neonatalogist, a Child Psychologist, a Physical Therapist, and a Pediatric Nurse. The children have their hearing evaluated at the Audiology Clinic located in the same building prior to their visit to the DAC.

    OBJECTIVES AND GOALS FOR OUTPATIENT CLINIC

    YEAR 1
    Know the indications for referral to the DAC [MK, PC, SBL]
    Early in the 1st year, the Fellow must watch a CD on the performance and scoring of the Denver Developmental Screening Scale /tests for infants. The fellows watch a demonstration of the test by Faculty or Child Psychologist [MK, PC].
    The Fellows must demonstrate competence on the Bayley III exam at the 6 and 18-month level. [MK, PC, PBLI].
    The Fellow should know the basic primitive reflexes and when they should disappear [MK].
    Fellows must observe the Child Psychologist perform the Bailey III test on children more than 1year old’ (12, 24, 36 months) to get a sense of the various components of and the scoring of the test [MK, ICS].
    The fellow learns to obtain an interval medical history from the child’s parent(s) or legal guardian(s) [ICS, PC, P].
    Fellows must become familiar with the resources available to families with developmentally delayed children in Michigan (Early On) [SBP].
    Fellows should become familiar with web-based resources available to families with developmentally challenged children (support group; information websites, etc.)[SBP, PC].
    Under the supervision of the Attending staff, the fellow must be able to formulate a plan for referral to community rehabilitation services and/or subsequent follow-up in DAC [PC, P, ICS, SBP].
    Fellows should know the indications for, and the interpretation of, audiologic testing in high-risk newborns [MK, PC].

     

    YEAR 2
    Fellows should become familiar with literature on neonatal follow-up results [MK, PBLI].
    Fellows should understand the correct research principles involves in designing and understanding a follow-up portion of an interventional trial [MK PBLI].
    The fellow must be able to formulate a follow-up plan with little supervision. [PC, P, ICS, SBP].
    Fellows should become familiar with various tests (including those not used in our clinic) for evaluating an infant’s progress [MK].
    Fellows should become more familiar with long-term follow-up resources (Head Start, school-based resources) [PC, SBP, ICS, P].

     

    YEAR 3
    Fellows should become Preceptors for medical students and residents rotating through the Developmental Assessment Clinic [P, ICS].
    Trainees should be able to function in a leadership role in the clinic [P, ICS].

    Clinical experiences will take place predominantly at Sparrow Hospital in downtown Lansing. The Fellowship makes extensive use of the following Sparrow facilities:

     

    Regional Neonatal Intensive Care Unit (RNICU)

    The Sparrow Hospital Regional Neonatal Intensive Care Unit, a 35-bed unit (+ 12 new step-down beds), admits approximately 600 sick neonates each year. Approximately 85% of these admissions are inborn; the remaining 15% are transported from our referral centers throughout Mid-Michigan. Sparrow Hospital has ≈ 4000 annual deliveries.  A full range of state-of-the-art ventilatory modalities is available in the NICU, including nitric oxide therapy, high-frequency ventilation, NAVA, etc. Pediatric Residents, NNPs, and Physician Assistants are fully integrated into the daily routine in the NICU. 

    On‑Call Schedule: Every sixth night in‑house call in the Sparrow NICU, with an attending on call as back‑up from home. Approximately 12 follow-up clinics/year.

    Developmental Assessment Clinic (DAC) The DAC is a weekly clinic organized to provide coordinated follow‑up assessment and care for infants discharged from the NICU and considered to be at risk for residual handicap or developmental delay.  Infants are followed for up to 3 years post-NICU discharge. In-depth assessment is provided by neonatologists, neonatal fellows, nurse coordinators, psychologists, occupational and physical therapists, and audiologists.  Approximately 12 infants are seen each week. 
    Sparrow Regional Neonatal Transport Program A highly trained Neonatal Transport Nurse team, with support from Respiratory Therapists and EMTs, staffs the Sparrow-MSU Neonatal Transport Program, which serves the entire Mid-Michigan region.  For critically ill infants, or those with complex or multiple system disorders the neonatal fellow (or Neonatal Nurse Practitioner) accompanies the primary team.
    Computerized Neonatal Database A computerized electronic medical record system (EPIC) is in use in the NICU. In addition, the MSU Program is part of the Vermont-Oxford Network. Access to archived data is available for fellows for research and/or quality improvement projects.  Each fellow is expected to utilize the database as a resource to complete a review of a pertinent clinical issue.

     

     

    FIRST YEAR

    Month/4wk

    1

    2

    3

    4

    5

    6

    7

    8

    9

    10

    11

    12

    Rotation

    NICU

    RES

    NICU

    RES

    NICU

    RES

    NICU

    RES

    NICU

    VAC

    RES

    RES

    Duty Hours

    80

    70

    80

    70

    80

    70

    80

    70

    80

    --

    70

    70

     

    SECOND YEAR

    Month/4wk

    1

    2

    3

    4

    5

    6

    7

    8

    9

    10

    11

    12

    Rotation

    RES

    NICU

    RES

    RES

    NICU

    RES

    RES

    NICU

    RES

    RES

    NICU

    VAC

    Duty Hours

    70

    80

    70

    70

    80

    70

    70

    80

    70

    70

    80

    --

     

    THIRD YEAR

    Month/4wk

    1

    2

    3

    4

    5

    6

    7

    8

    9

    10

    11

    12

    Rotation

    NICU

    RES

    Cardiac

    Surg (U of Mich/

    VAC

    RES

     NICU

    RES

    NICU

    RES

    Fellow-Attending NICU

    RES

    RES

    Duty Hours

    80

    70

    65

    --

    70

    80

    70

    80

    70

    80

    70

    70

     

    Total Number of Clinical Months: 14

    Total Number of Research Months: 19

    Total Number of Vacation Months: 3

    The Developmental Follow-Up Program occurs each Monday (whole day); fellows do ≈12 days in clinic each year. Extra clinical electives (Pediatric Surgery, Perinatology, Genetics, etc.) can be done in the 2nd or 3rd year.

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