During their 3 years of training, fellows spend a total of 56 weeks on clinical service: 46 weeks on rotations in the two teaching hospital NICUs (Seattle Children's Hospital & University of Washington Medical Center), 8 weeks on clinical services including perinatology, cardiac ICU, and pediatric surgery, and 2 weeks in one of the division's community hospital NICUs. Fellows also attend NICU follow-up clinic 8 half days each year. Clinical rotations are generally 2 to 4 weeks duration and nearly half of these rotations (24 weeks) are scheduled in the first year. Night call is in-house at both hospitals and averages approximately 50 nights per year. During the first year, fellows focus on expanding their clinical knowledge base & skills. They participate as learners and then teachers in procedural skills labs, and they are required to take an ECMO training course. In the second year, in addition to continuing their life-long learning, fellows begin the transition from trainee to attending neonatologist, developing higher-level patient management and team leadership skills. In the third year, they complete this transition, including learning the administrative roles of the attending physician through "subattending" experiences. Fellows are required to attend their own weekly Core Curriculum conference. They regularly attend all division conferences and are required to lead one Journal Club and M & M review each year, as well as co-lead joint clinical conferences with pediatric surgery and perinatology.
(12 at UW, 12 at SCH)
|2 weeks perinatology||
(22 at UW, 32 at SCH)*
(6 at UW, 4 at SCH)
4 weeks CICU
2 weeks peds surgery
(20 at UW, 30 at SCH)*
(6 at UW, 6 at SCH)
|2 weeks PRMCE||
(18 at UW, 28 at SCH)*
(24 at UW, 22 at SCH)
= 276 days/2760 hrs total
(60 at UW, 90 at SCH)
= 2400 hours total
* = at jeopardy for additional calls (maximum 55 calls per year per fellow total)
Fellows choose their scholarly focus and type of scholarship (e.g. basic science/laboratory, clinical research, ethics, public health, global health, education) early in their first year. To choose an area of scholarship, fellows spend their non-clinical time meeting with the fellowship program's Research Director and with selected division and non-division faculty members to discuss potential projects. By October, fellows should have identified their scholarly focus and mentor(s). This will determine the composition of their Scholarship Oversight Committee (SOC) and will shape the content and direction of their 2nd and 3rd years of training. Training will include the formation of a hypothesis-driven research question, planning and execution of the project, data analysis and publication of the work. Fellows will learn to critically evaluate the relevant literature and will take necessary and relevant coursework, including biostatistics. For fellows choosing a basic science or clinical research focus, grant preparation will be emphasized in the 2nd and 3rd year so that funding is likely to be available for an optional 4th year. For fellows choosing a global health, education, or ethics scholarly focus, there is an opportunity to incorporate a Masters degree at University of Washington during training. To do so, fellows are strongly encouraged to take an additional year to complete all their requirements. Fellows present their scholarly work at regional and national research conferences such as the Pediatric Academic Societies (PAS), Society for Neurosciences or the Perinatal section of the American Academy of Pediatrics.
Basic Science Research
The research mission for the Division of Neonatology at UW is:
The Neonatal Neuroscience laboratory goals are to:
Active Faculty: Sandra Juul, MD, PhD, Colin Studholme, PhD, Christopher Traudt, MD, Ryan McAdams, MD.
Collaborators: Robert Synovec, PhD, David Goodlett, PhD, Todd Richards, PhD, Kathleen J. Millen, Patrick Heagerty, PhD, Thomas Burbacher, PhD
Fellows: Pat Tanya Chun, MD, Stacey Soileau, MD, Vijayeta Rangarajan, MD
Affiliations: Center for Integrated Brain Research (CIBR), Center on Human Development and Disability (CHDD), Neurodevelopmental Disorders Research Consortium, Washington National Primate Research Center (WaPRC)
Projects span the disciplines from basic, translational and clinical research.
Funded basic and translational studies:
Funded clinical studies include:
Pending (NIH U01s)
Our division has a long history of participation in both multi-center and single center clinical research trials. Areas of particular interest for this Division have included research on lung disorders [surfactant trials, high frequency oscillation trials, prevention of bronchopulmonary dysplasia (NO CLD)], as well as studies having to do with erythropoietin and iron balance. Ongoing projects, or those in the planning stages include the NEAT trial, a pilot study of high dose Epo treatment for hypoxia ischemia in term infants; the CRP study, a study to determine whether CRP is a valid tool to help establish the presence or absence of infection in surgical newborns, and surfactant booster trial, a study of late surfactant dosing to decrease bronchopulmonary dysplasia. In addition, our fellows participate in studies with the Infectious Disease Division, including studying the vertical transmission of HIV, and pathogenesis of streptococcal infections.
Biomedical and Health Informatics
Active Faculty: Peter Tarczy-Hornoch, MD
Dr. Peter Tarczy-Hornoch serves as Head of the Division of Biomedical and Health Informatics in the Department of Medical Education and Biomedical Informatics, Director for the UW Biomedical and Health Informatics Research Training grant, Director of the Biomedical Informatics Core of the Northwest Institute for Translational Health Sciences, Director of Web Services and Data Integration and Research for UW Medicine Information Technology Services, and Associate Director of the Northwest Institute for Genetic Medicine. Dr. Tarczy-Hornoch's NIH and NSF funded research has included: a) real time biomedical instrumentation control systems, b) bench research and mathematical modeling of liquid ventilation, c) clinical information systems, and d) electronic clinical knowledge resources. His current research on methods and models (in collaboration with computer scientists) focuses on data integration of biomedical and health data including looking at ways of handling semi-structured data, representing uncertainty at various levels in the system, and doing computerized reasoning over integrated data. The challenges and opportunities his research is applied to arise from collaborations with biologists, clinical and translational researchers looking at: a) large scale functional gene annotation of bacteria and protozoans, b) single nucleotide polymorphisms for elucidation of disease mechanisms, c) collaborative integrated analysis of a combination of clinical data, experimental biological data, and clinical/translational research study data. In addition there are very rich opportunities for research in other areas of biomedical and health informatics (BHI) with 18 core BHI faculty in the Division of BHI, 27 extended faculty, and 37 MS, PhD, and postdoctoral students.
Ongoing scholarly projects include establishment of essential neonatal care guidelines for referral-level neonatal care in developing country settings, development of educational programs in global health to address the unmet need in the global health workforce, and assessment of long-term neurodevelopmental outcomes developing country community-based settings. Joint research with Mongolian neonatologists is being done to better understand healthcare provider attitudes regarding antenatal counseling and neonatal resuscitation-related practices in Mongolia."
Faculty are also involved with the Child Health Epidemiology Reference Group (WHO/UNICEF) and the Global Alliance for the Prevention of Prematurity and Stillbirth. These groups are involved with global maternal, neonatal and child health policy.
Ongoing medical education research projects include: 1) simulation as an educational tool in neonatal resuscitation training; 2) evaluation of a web-based training and simulation program to improve pediatric trainee error disclosure proficiency.
There are opportunities for scholarly activity with a focus on such issues as the limits of parental autonomy or factors involved in clinical decision making. Fellows emphasizing biomedical ethics would be involved in the activities of the Pediatric Bioethics Center, institutional ethics committee activities, ethics consultations, teaching rounds, a targeted reading program, ethics/philosophy course work and, if appropriate, enrollment in a Masters of Ethics program.
The division is involved in scholarly work focused on improving the quality of care delivered in neonatal intensive care units and on medical education of care providers for newborn infants. Recent quality improvement projects include: collaboration with the Vermont Oxford Network of neonatal intensive care units to reduce nosocomial infections; and ongoing review of video-recorded neonatal resuscitations for quality improvement and education. Ongoing work includes the implementation of clinical standard work for care of the fetus and neonate with gastroschisis, developing multidisciplinary guidelines for managing complex neonatal problems, and work with simulation and debriefing to enhance team communication, leadership skills and competency at procedural skills.
All fellows are expected to complete a quality improvement project and a project which requires them to use our clinical database. They also participate in the development of our clinical care guidelines and are expected to "own" one during their training. Senior fellows manage their own weekly curriculum conference and are invited to attend the monthly division faculty business meeting.