Neonatal-Perinatal Medicine
Subspecialty Fellowship Program

The Neonatal-Perinatal Medicine Training Program is sponsored by the University of Colorado and The Children's Hospital. This is a three-year postdoctoral training program in Neonatal-Perinatal Medicine and is approved by the Residency Review Committee of the Accreditation Council for Graduate Medical Education. The program is directed by Thomas Parker, MD, and is based at the University of Colorado Denver and The Children's Hospital in Denver, both of which opened entirely new facilities in 2007 on one large medical campus in Aurora, Colorado. Fellows are supervised by faculty within the Section of Neonatology and the division of Perinatal Medicine and Research. The program includes 12 months of clinical training with 21 months of research activity.

We are primarily interested in helping trainees in Neonatal-Perinatal Medicine develop successful careers, based on excellence in research, scholarship, and clinical medicine. Historically, we have trained many successful academic Neonatologists and are very interested in receiving applications from individuals committed to scholarship, research, and the development of an academic career.

Our Training Program provides all of the clinical experience necessary to be eligible for certification by the Sub-Board in Neonatal-Perinatal Medicine. Clinical experience is broad and emphasizes physiology and evidence-based practice. All trainees participate fully in the structured activities of the program, including:

1. Nursery and obstetric rounds
2. Clinical case review conferences
3. Core clinical curriculum
4. Weekly division noon conference

Clinical Training occurs at two sites, each of which is staffed by University of Colorado neonatology faculty.

1. University Hospital (60-bed NICU)
   

   The hospital is the active site of a Maternal Fetal Medicine training program and a referral center for the Rocky Mountain Region for antenatal diagnosis and complications of pregnancy.

   1. Almost exclusively inborn
      
   2. Greater than 3,000 deliveries per year
      
   3. Common problems
      
   1. Prematurity and its associated problems
      
   2. Prenatally diagnosed medical and surgical conditions
      
   3. Many infants with common disorders of the preterm infant
      
   
   
2. The Children's Hospital (60-bed unit)
   

A large, intensive care service that functions as a tertiary referral center for neonates born throughout the Eastern Rocky Mountain region.

1. Quaternary care referral center
   
2. Approximately 700 admissions per year
   
3. Services include: HFV, surgery (including all pediatric surgical subspecialties), ECMO, active cardiothoracic surgery program, inhaled nitric oxide, head-cooling for prenatal asphyxia
   

Half of the clinical attending time for the trainees is in the first year (6 months). During each attending month, the Neonatology trainee is paired with faculty neonatologists who act as the senior-attending physician. The trainee assumes graduated authority and responsibility as experience and ability advance. Initially, this experience will involve participation in work rounds with the residents, teaching rounds given by the trainee and the faculty attending, and participation in all clinical management issues at the bedside and in conferences. Occasionally in the second year, but certainly by the third year, the trainee will function as the attending (although always with formal back up). The trainee will take call approximately 65 times per year. Approximately half of call is "in-house" at The Children's Hospital and half is from home (for University Hospital). A faculty neonatologist will always be assigned to cover "on call" with the trainee. Each trainee participates regularly in the Neonatal Follow-up clinic to learn techniques of development assessment and the medical care of NICU "graduates".

Our Training Program interacts closely with many other training programs. In particular, there is considerable overlap in training with the Maternal-Fetal Medicine Training Program that is based at University Hospital in the Department of Obstetrics and Gynecology (Henry Galan, M.D., Director). Maternal-fetal Medicine trainees attend on the high-risk obstetrics service and participate in the high-risk antepartum clinic; they work jointly with the Neonatology trainees in educational and research projects. Close working relationships between Obstetrics and Neonatology in clinical services, education and research, has long been a tradition at our program and a significant strength in all aspects of training in both fields.

In addition to the many clinical conferences, trainees join the faculty at weekly Neonatology-Perinatology basic science and research conferences. These include core curriculum didactic lectures as well as seminars. In addition, considerable importance is given to the development of individual learning and scholarship. Each trainee will have a research mentor and a clinical mentor to ensure that core material is properly learned. Reading assignments and selected consultations with faculty in the University of Colorado Denver are integral to this educational program. Each trainee must become proficient in biostatistics based on previous training/experience or by successfully completing a biostatistics course taught during the second year. Tutorial or classroom teaching of computer use is an integral part of the program and a variety of computers and software are provided in the trainees' offices. Many trainees also take courses in the graduate school depending on their particular clinical and/or basic research project. Our Training Program also occasionally includes trainees from Ph.D. programs, anesthesiology, pediatric surgery, pediatric gastroenterology, pediatric cardiology, pediatric pulmonology, pediatric critical care medicine, pediatric endocrinology, nutrition, and nursing, as well as a large variety of students, visiting scientists, and distinguished faculty from other centers in the US and from abroad.

All trainees participate in original research that may involve clinical, laboratory, or animal investigation. Research is the fundamental cornerstone of our training program which is strongly oriented to developing productive and competitive research capacities for successful academic careers. Research time and opportunity are highly valued and protected. Research opportunities are available in new and on-going investigations at all levels of biological investigation. We are particularly interested in helping trainees develop research, technical and intellectual skills that will place them at the cutting edge of modern biomedical research. We design all research programs for trainees to be vertical as well as broadly based, allowing the trainee to appreciate the many levels of investigation that are important to solve fundamental basic and clinical problems, as well as to work in one or a few areas in enough depth to become expert and thus competitive. Within the Section of Neonatology and the Division of Perinatal Medicine and Research, a large variety of research programs are available, including studies involving: