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Neonatal-Perinatal Fellowship Clinical Training

 The Johns Hopkins NICU is the site for the majority of clinical experiences during the training program. The NICU is a 45-bed unit, with admissions that include newborns of all gestational ages, with a full range of medical and surgical problems, including those requiring surgical subspecialty care, cardiac surgery and ECMO. Potential ECMO candidates are stabilized and managed in the NICU; when the need for ECMO is determined, infants are transferred to the PICU for ECMO management. After decannulation, they are transferred back to the NICU. The NICU admits approximately 700 infants per year, 60% from the delivery room and full-term nursery, 40% through transport from hospitals throughout the state of Maryland and the mid-Atlantic region. Nighttime coverage is provided by the fellows who are not on service, in a night float schedule.

A secondary site for the training program is The Johns Hopkins Bayview Medical Center NICU, a community based, 25-bed tertiary care nursery that cares for high-risk infants. The patients are primarily inborn infants with a variety of conditions, but also transport patients from other Maryland hospitals. A special area of expertise includes management of infants born to substance abusing mothers. The Johns Hopkins Bayview NICU generally does not care for infants who require general or subspecialty surgery. It offers the experience of working in a unit run entirely with the help of nurse practitioners rather than pediatric residents. While on service, the fellow takes call on Sundays and Thursdays.

Rotations occur as two-week blocks: First-year fellows have 7 to 8 blocks, second-year fellows have 5 to 6 blocks, and third-year fellows have 4 to 5 blocks. Approximately two-thirds of the rotations are at the Johns Hopkins Hospital NICU, with the remainder at Bayview.

The outpatient high-risk follow-up clinic is directed by Dr. Marilee Allen, who is board certified in both Neonatal-Perinatal Medicine and Developmental Pediatrics. The follow-up clinic is adjacent to The Johns Hopkins Hospital in the Kennedy Krieger Institute, which provides resources for outpatient and inpatient care of children with developmental disabilities. Psychometric testing is provided, along with occupational and physical therapy assessments. One fellow is assigned to participate in the clinic each week.

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