Neonatal-Perinatal Medicine Fellowship

Overview 

The three year program meets the requirements of the subspecialty board in Neonatal-Perinatal Medicine. Training in clinical management, research and teaching provides the opportunity to acquire understanding of the physiology and pathophysiology of the fetus and neonate. The training program combines clinical focus with opportunities in clinical and basic science research experiences and is supplemented by many weekly conferences, seminars and meetings. A brief summary of the educational experience is noted below.

First Year of Training

The fellowship training begins with a one-month orientation during which time the fellows round in the RWJUH NICU in an observatory capacity while receiving introduction to the NICU, transport services, Labor and Delivery services, High-risk Infant Follow-up and Apnea services. During this time the new trainees attend a month long Introduction to Clinical Neonatology, which is followed in August by Introduction to Academic/Scholarly Neonatology which includes a 12-hour introduction to statistics course. The course provides training in research methodology, medical statistics and computer-assisted techniques of data analysis. During this time the trainees are asked to read Studying a Study and Testing a Test as part of this orientation activity.

The emphasis during the first year is clinical training with two months spent in each of the three NICU’s supplemented by eight sessions in outpatient services. The trainees works closely with attending neonatologist, supervising and teaching pediatric residents, medical students and Neonatal Nurse Practitioners in the direct care of patients. This comprehensive clinical experience covers the entire scope of newborn care from neonatal emergencies, to the use of high frequency jet ventilation and nitric oxide. In addition, the trainee gains expertise in the insertion of central and peripheral lines, placement of thoracotomy tubes, performance of peritoneal taps, etc. and participates in the assessment and management of high risk antepartum and intrapartum patients as well as high risk deliveries.

The remainder of the year is devoted to the research experience with a focus on a wide range of research opportunities. During the first half of the academic year, fellows identify an area of interest for research and, with the aid of the Program Director, identify a mentor in that area.

Second and Third Years of Training

The senior years are characterized by uninterrupted protected time for research training and scholarly activities. During the second year the trainees spend six weeks in each NICU and in the third year four weeks. The third year fellows also spend time at the Morgan Stanley Children’s Hospital of New York Presbyterian Medical Center to gain expertise in the management of pre and post op cardiac surgical patients.

The non-clinical months’ goal, under the immediate supervision of a mentor, is the completion of a research project, followed by presentation at local and regional research meetings and finally the publication of a manuscript in a peer reviewed medical journal.

• Neonatal Intensive and Special Care Units, RWJUH/CUH/UH
• High-risk Infant Follow-up Programs, RWJUH/UH
• Infant Apnea Center, RWJUH/CUH
• Infant ECMO Program
• International Education Program, RWJMS
• Neonatal Research Laboratory, RWJMS
• Center for Performance Improvement, RWJUH
• Delivery Room Service, RWJUH/CUH/UH

Conferences

Core Lecture Series

The Division of Neonatology has established a comprehensive educational program that exposes the trainees to a core base of information in neonatal-perinatal medicine. This program involves the participation of all trainees, neonatal attendings, and consultants. Each core section of study is divided into several parts including Embryology, Physiology, Pathology, Diagnosis, and Therapeutics. The study sections last one to three months with the core program repeating every 36 months.

Embryology topics utilize standard textbooks, physiology topics are reported from Polin & Fox and pertinent review articles, pathology, pathophysiology and clinical areas deal with clinical problems and use standard neonatology texts and current literature, diagnosis discussions and therapeutic topics are based on recent articles and texts .This core curriculum will begin in September of each year, since the two months beginning each academic year are devoted to 'Introduction to Neonatology'. The core study sections include Cardiovascular Physiology, Developmental Pharmacology and Toxicology, Dysmorphology-Genetics, Hematology, Bilirubin, Infections Diseases, Metabolic-Endocrine Disorders, Nephrology, Nutrition, GI, and Liver, Respiratory Physiology, The Brain, and Transition-Perinatal Medicine.

Overview

The training program in NPM at Rutgers Robert Wood Johnson Medical School is a regional program encompassing three collaborative institutions in New Jersey, Bristol-Myers Squibb Children’s Hospital of Robert Wood Johnson University Hospital in New Brunswick, Cooper University Hospital in Camden, and University Hospital in Newark, New Jersey. These three regional perinatal centers admit over 1500 high-risk infants into their intensive care nurseries, staffed by a full complement of medical and surgical subspecialists, pediatric residents, nurse practitioners and physician assistants.

Bristol-Myers Squibb Children’s Hospital

The neonatal facility of the Department of Pediatrics is located in the Bristol-Myers Squib Children’s Hospital of Robert Wood Johnson University Hospital, the primary teaching hospital of Rutgers Robert Wood Johnson Medical School. All pediatric subspecialties are represented including nephrology, infectious disease, pulmonary medicine, neurology, allergy/immunology, genetics, developmental pediatrics, psychology, cardiology, gastroenterology and nutrition, hematology/oncology, endocrinology, rheumatology, radiology, ethics and ambulatory pediatrics. The pediatric surgical services include general pediatric surgery, neurosurgery, urology, orthopedics and otolaryngology. The pediatric anesthesia and pathology services are very active.

Children’s Regional Hospital Cooper University at Cooper University Hospital

The Children’s Regional Hospital at Cooper University Hospital is the major academic medical center and the Regional Children’s Hospital for 7-10 counties in southern New Jersey. The Cooper University Hospital is a Regional Perinatal Center staffed by 7 full-time perinatologists. Cooper is also home of the Mid-Atlantic Neonatal Individualized Developmental Care and Assessment Program (NIDCAP) Center – one of only sixteen such Centers in the world. Approximately 2,500 babies are born at Cooper annually of which 450-500 high risk babies are admitted to the Neonatal Intensive Care Unit (NICU). The NICU is a 37 bed, state-of-the-art facility that was recently completely renovated in 1999. The Division of Neonatology currently has 6 full-time neonatologists, a PhD nurse scientist (Director of the NIDCAP Center), and a PhD physiologist (in our research laboratory) with academic appointments through Rutgers Robert Wood Johnson Medical School at Camden. The NICU is staffed by faculty neonatologists who are in-house 24 hours a day in addition to Neonatal fellows, Cooper pediatric residents and neonatal nurse practitioners. The Division of Neonatology also runs an active high risk infant follow-up program and apnea clinic.

Saint Peter's University Hospital

St. Peter’s University Hospital is a partner teaching hospital in New Brunswick, New Jersey. Its Division of Neonatology is a component of the hospital's State-designated Level III Perinatal Center. The Division specializes in the delivery of sophisticated care to distressed newborns with emphasis on the care of very low birthweight infants. It provides 24-hour transport service for neonatal referrals from outlying hospitals using a specially trained transport team. The staff is available for physician-to-physician consultation regarding problem cases. Attending board-certified neonatologists work closely with referring physicians in planning ongoing care following the immediate crisis, with return of the infant to the local hospital when feasible. 

In addition to low birthweight cases, the division cares for infants with sepsis, blood loss, seizures, respiratory distress syndrome, congenital anomalies, hyperbilirubinemia, surgical conditions, and diagnostic problems. Its Neonatal Intensive Care Unit offers opportunities in expanding research programs for fellows. The Division provides long-term follow-up care of neonatal intensive care graduates in collaboration with pediatric neurology, child development, social services, and nutrition.

Mentors can be selected from within the Division of Neonatology, the Department of Pediatrics, the Division of Maternal-Fetal-Medicine, or throughout Robert Wood Johnson Medical School and Rutgers University. Division of Neonatology faculty members are among those available as well as associated faculty outside of the Division.

Associated Faculty

• Lauren Aleksunes, PharmD, PhD
• Zhiping Zang, PhD
• Andrew Gow, PhD
• Deborah Laskin, PhD
• Jeffrey Laskin, PhD
• Maria Gloria Dominguez, PhD
• Arnold Rabson, MD
• Grace Guo, PhD
• Derek Sant'Angelo, PhD
• Max Tischfield, PhD

Overview

A major goal of the training program is to develop future academic neonatologists. Since many residents joining the program have had limited exposure to research, the fellowship program provides all the training and experience necessary for achieving their research goals.

Training

Research training begins in August of each year as fellows attend a month long introduction to academic neonatology, which covers the following scholarly topics:

Selection of Area of Research and Mentor

During the first year, fellows identify research areas of interest and, in consultation with the Program Director, meet investigators working that field. Mentors can be selected from within the Division of Neonatology, the Department of Pediatrics, the Division of Maternal-Fetal-Medicine, or throughout Robert Wood Johnson Medical School and Rutgers University.

Scholarly Oversight Committee

Once a research project and mentor are selected, a Scholarship Oversight Committee is appointed for each fellow to monitor progress during the course of training and to approve the training in scholarly activities upon completion of the fellowship program. The committee will:

• Determine whether a specific activity is appropriate to meet ABP guidelines for scholarly activity
• Determine a course of preparation beyond the core fellowship curriculum to ensure successful completion of the project
• Evaluate the fellow’s progress as related to scholarly activity
• Meet with the fellow early in the training period and regularly thereafter
• Require the fellow to present/defend the project related to his/her scholarly activity
• Advise program director on the fellow’s progress and assess whether the fellow has satisfactorily met the guidelines associated with the requirement for active participation in scholarly activities

Project Completion

The anticipated research progress will result in project/mentor selection by December 31 of the first year and protocol completion and IRB submission by June 30 of the first year. The second and part of the third years are devoted to data collection and analysis and the last six months of the training is reserved for abstract and presentation preparation, manuscript and, possibly, grant submission.

• Vadim Ten, MD, Chief of the Division, Professor
• Thomas Hegyi, MD, Program Director, Professor
• Deepak Jain, MD, Associate Program Director, Associate Professor
• Rajeev Mehta, MD, Professor
• Surasak Puvabanditsin, MD, Associate Professor
• Barbara Ostfeld, PhD, Professor
• Arun Kashyap, MD, Assistant Professor
• Swapna Borole, MD, Assistant Professor
• Nancy Reichman, PhD, Professor
• Alexander Feldman, MD, Assistant Professor
• Jeffrey Suell, MD, Assistant Professor
• Manan Shah, MD, Assistant Professor
• Subhasri Sangam, MD, Assistant Professor

• Vineet Bhandari, MD - Division Head, CUH
• Melissa Micallef, MD - Medical Director, CUH
• Vishwanath Bhat, MD
• Alla Kushnir, MD
• Rakesh Sharma, MD
• Sara Davenport, MD
• Pragnya Das, PhD
• Ilana Jerud, MD

• Mark Hiatt, MD
• Mujahid Anwar, MD
• Shakuntala Chandra, MD
• Raquel Gomez, MD
• Neera Prakash, MD
• Miry Shim, D.O.
• Michael Melek, MD
• Manne Murali, MD
• Olga Sudol, D.O.