Program Description
The two-year program is accredited by the Royal College of Physicians and Surgeons of Canada. NPM Subspecialty Residents are trained to become independent Neonatologists. The program involves learning opportunities through clinical practice in the NICU, outpatient clinics, academic classroom curriculum, scholarly activities, and leadership positions.
The emphasis of our curriculum is to teach trainees to be life-long learners, to be adept in the self-directed learning process with appropriate support and coaching from faculty. We expect trainees to be able to be self-driven in learning medical content and literature. The emphasis is not on didactic classroom teaching, but on how to maximize learning at every bedside and patient encounter, learning from our entire interdisciplinary team, applying medical knowledge to the clinical expertise shared by teachers.
The program is built on competency-based medical education, where NPM subspecialty residents are trained to be competent in 24 entrustable professional activities in 4 stages over their training period.
Site
The training program is located at the Children's Hospital, London Health Sciences Centre. The NICU is a 52-bed level 3 and level 2 unit. The NICU team collaborates with our Neonatal Hemodynamics team, Obstetrics, Maternal-Fetal Medicine, Developmental Follow-up Clinic, Post Discharge Infant Nutrition Clinic, Perinatal Outreach program, General Paediatrics, Subspecialty Paediatrics, Paediatric Surgery and Paediatric Surgery Subspecialties. With over 6,000 births per year in our center, approximately 800-1000 newborns require admission to the NICU. Approximately 10% of our admissions are transported from referring hospitals. We have a dedicated Neonatal/Paediatric transport team that serves the Southwestern Ontario region.
Rotations
This is a 2-year training program, made up of 13 blocks each year, each 4 weeks in length. NPM subspecialty residents complete 6 NICU blocks, 6 longitudinal blocks and 1 elective block per year.
During NICU blocks, residents have the opportunity to lead the interdisciplinary team in daily patient care, become proficient at procedures, lead resuscitations, develop communication skills in talking to families, and teaching junior trainees on a daily basis.
Longitudinal blocks are comprised of outpatient clinics - Fetal Development Clinic, Post Discharge Infant Nutrition Clinic, Developmental Follow-up Clinic, Maternal-Fetal Medicine Clinic, Perinatal Outreach site visits to referring hospitals and Level II NICU experience. There is also time built into these blocks for scholarly activities of research, quality improvement projects, or medical education.
Elective blocks are completely individualized, based on each resident's interests and career goals. Electives can be done anywhere locally or internationally, as long as there are clear learning objectives, an identified supervisor, and assessments completed. Electives must be approved by the Program Director.
Call
NPM subspecialty residents do approximately 66 in-house NICU calls in first year and 60 in-house calls in second year, plus 8 junior consultant home calls. On call responsibilities include: patient care in the NICU, attendance at deliveries, consultations from high risk obstetrics and the mother-baby unit, and management of transport calls. Starting in the second half of first year, fellows are trained to manage Neonatal transport calls, and respond to external requests for consultation. During the latter half of the second year, trainees have the opportunity to practice as a Junior Neonatal Consultant during two NICU rotations.
Academic Curriculum
NPM subspecialty residents participate and lead discussions in all the daily academic rounds. There is 1 hour of dedicated classroom teaching time each day. Additionally, trainees participate in the Fellow Seminar Series on academic half-days, Cross Canada Neonatal rounds and paediatric grand rounds. Residents are involved both as learners and teachers in the academic curriculum. Additionally, there are routine simulations run in our on-site high-fidelity simulation education center.
Assessment
Trainees are assessed through feedback and specific assessment forms for entrustable professional activities. They also participate in the annual national Neonatal OSCE, American Board of Pediatrics SITE exam, and annual National Structured Oral exam. Our Competence Committee reviews trainee portfolios and makes assessment decisions on progression through the 4 stages of the program.
Each trainee is assigned a faculty coach, who assists the trainee with setting individualized goals.
Academic Scholarship
Residents are involved in a scholarly project during their training. This could involve research, quality improvement projects, and medical education initiatives.
Our training program is affiliated with Western University. Trainees have the opportunity to participate in education and research initiatives offered by our Neonatal Division, the University, and Department of Paediatrics.
The areas of expertise of our Neonatal faculty include: clinical trials and epidemiology, neonatal database, fetoplacental development, neuroimaging, neonatal resuscitation, pulmonary physiology, neonatal gastroenterology and nutrition, TNE and neonatal hemodynamics, medical bioethics, and medical education.
Leadership and Administration
There are many opportunities for NPM subspecialty residents to explore administrative and leadership duties. All trainees are required to participate in the Evidence-Based Practice for Improving Quality (EPIQ) Committee. Additionally, trainees join at least one other administrative council. Among the NPM subspecialty resident group, two representatives are selected by the group to act as Chief Fellow, who is responsible for on-call scheduling; and Education and Wellness Fellow, who is responsible for scheduling education sessions and resident wellness initiatives.
