Clinical Training

Clinical training occurs at the Level IV neonatal-intensive care unit at Monroe Carell Jr. Children's Hospital at Vanderbilt (Monroe Carell). Fellows spend a minimum of 12 months caring for patients on the high acuity teams and delivery unit. There are additional clinical experiences in the neonatal developmental clinic, The Fetal Center at Vanderbilt, and medical transport. Night call is in-house, around 55 calls per year. There are one to two faculty in-house each night.

Schedule Overview

Clinical Rotations

Over 1,500 newborns are admitted annually to the NICU, which consists of 123 intensive and intermediate beds. Medical teams care for a combined average daily census of around 112 patients.

NICU at Monroe Carell Jr. Children's Hospital at Vanderbilt

Fellows spend approximately two-thirds of their clinical experience in the state-of-the-art single patient room NICU, caring for critically ill infants with a wide range of medical and surgical conditions. Approximately two-thirds of infants are inborn. The full range of treatment modalities includes advanced respiratory support, ECMO, and therapeutic hypothermia. There is a high exposure to pre-operative congenital heart disease and surgical conditions. Babies with congenital heart disease are cared for in the NICU pre-operatively.

One-fourth of the clinical experience is spent on the Delivery Service. The delivery service is in Vanderbilt University Hospital, which is connected to Monroe Carell through an interior walkway. The delivery NICU provides neonatal support for an obstetrical service with more than 6,000 annual deliveries, including a substantial proportion of high-risk pregnancies (550 deliveries at less than 35 weeks' gestation each year). Fellows attend high-risk deliveries, become proficient in delivery room resuscitation and stabilization, and provide perinatal and newborn consultation.

The five teaching teams consist of an attending neonatologist, neonatal fellow, pediatric residents, neonatal nurse practitioners, physician assistants, and NICU hospitalists. Under attending supervision, the fellow directs patient care and provide bedside teaching for pediatric residents and medical students. Multidisciplinary rounds are conducted daily and include dieticians, pharmacists, respiratory therapists, lactation consultants, social workers, and case managers.

Neonatal Transport

Fellows provide medical control for neonatal transport. Fellows receive focused didactic and simulation education in transport physiology and management and participate in transports during their one-week transport rotation each year. Additional tailored experience in transport medicine is available for fellows who wish to pursue this as a career focus.

Fetal Center

During this clinical experience rotation in The Fetal Center at Vanderbilt, fellows observe the evaluation and management of high-risk pregnancies in the ambulatory setting and participate in the multidisciplinary counseling of families anticipating the birth of a baby with medical complexities; women with high-risk pregnancies in The Fetal Center at Vanderbilt; observe ultrasounds and fetal interventions; and attend a weekly multidisciplinary fetal conference. Additional tailored experience in fetal medicine is available for fellows who wish to pursue this as a career focus.

Neonatal Development

The Neonatal Development rotation includes one day per week caring for infants and young children in the pulmonary clinic with bronchopulmonary dysplasia. The other days of the week are spent in the Neonatal Development Clinic where fellows perform developmental assessments.