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 and 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. 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 clinical care guidelines and are expected to "own" one set of guidelines during their training.
(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)
(60 at UW, 90 at SCH)
Fellows choose their scholarly focus and type of scholarship (e.g. neonatal neuroscience, global health, clinical research, ethics, public health, education, etc.) 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. Scholarly activity generally includes the formation of a hypothesis-driven research question, planning and execution of the project including IRB or IACUC submission as appropriate, data analysis, and publication of the work. During their research time, fellows learn to critically evaluate the relevant literature and can take 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 Master’s 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 District VIII section on Perinatal Pediatrics meeting and Pediatric Academic Societies (PAS) meeting.
Faculty Mentors: Sandra Juul, MD, PhD; Colin Studholme, PhD; Christopher Traudt, MD; Ryan McAdams, MD.
Collaborators: Robert Synovec, PhD; Todd Richards, PhD; Kathleen J. Millen, PhD; Patrick Heagerty, PhD; Thomas Burbacher, PhD; , Theo Bammler, PhD
Affiliations: Center for Integrated Brain Research (CIBR), Center on Human Development and Disability (CHDD), Neurodevelopmental Disorders Research Consortium, Washington National Primate Research Center (WaPRC), Institute of Translational Health Sciences (ITHS), Center for Ecogenetics and Environmental Health (CEEH).
Neonatal neuroscience research projects span the disciplines of basic, translational and clinical research. Our research includes the development and use of clinically-relevant animal models to investigate new approaches to protect the brain of high-risk neonates. Research also focuses on developing and testing the efficacy of neuroprotective strategies and determining mechanisms by which they function. Additional research goals are to determine mechanisms by which neurodevelopment is impaired by stress and/or drugs used to treat stress in the neonatal period and to determine biologic correlates to MRI.
Funded basic and translational studies:
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 neuroprotective strategies, lung disorders (surfactant trials, high frequency oscillation trials, prevention of bronchopulmonary dysplasia trials), as well as studies having to do with erythropoietin and iron balance.
Funded clinical studies:
Ongoing scholarly projects include the establishment of essential neonatal care guidelines for referral-level neonatal care in developing country settings, the development of educational programs in global health to address the unmet need in the global health workforce, and the assessment of long-term neurodevelopmental outcomes in developing country community-based settings. Additional studies are being conducted in Kenya to examine the impact of maternal immune status and prematurity on transplacental transfer of antibodies to respiratory pathogens and clinical correlates. 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), the UW Kenya Research Program, and the Global Alliance for the Prevention of Prematurity and Stillbirth (GAPPS). If appropriate, trainees may enroll in the UW Masters of Public Health (MPH) program.
Funded clinical studies:
Ongoing medical education research projects include: 1) simulation as an educational tool in neonatal resuscitation training; and 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 the UW 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: 1) collaboration with the Vermont Oxford Network of neonatal intensive care units to reduce nosocomial infections; and 2) ongoing review of video-recorded neonatal resuscitations for quality improvement and education. Continuing 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.
Faculty Mentors: Peter Tarczy-Hornoch, MD
Dr. Peter Tarczy-Hornoch serves as Head of the Division of Biomedical and Health Informatics in the Department of Biomedical Informatics and Medical Education. 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.