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C.S. Mott Children's Hospital

Fellowship

Clinical Training | Research Opportunities | How To Apply | Eligibility and Selection | Supervision Policy

Fellowship Director:
Rachel L. Chapman, M.D.

Current Fellows

Mission and Overview

The Brandon Newborn Intensive Care Unit is a part of the C.S. Mott Children's Hospital and, being the largest ICU in the health system, is an integral component of the University of Michigan Medical Center. There are approximately 800 to 900 admissions annually to the 43-bed neonatal unit. The physically adjacent Von Voigtlander Woman's hospital delivers nearly 4,000 babies each year. The High Risk Perinatal Center serves to provide cutting edge therapy and as a result the unit sees large numbers of inborn babies with significant problems. In the last year nearly 100 infants with significant congenital heart disease were delivered and stablilized by our NICU team. Approximately 150 additional babies received prolonged transitional care in our Newborn Stabilization and Treatment area (NEST). Last year outborn admissions numbered 173 with 75 of these representing transfers from other level 3 units across the Midwest. The latter include infants with special problems such as congenital heart disease, complex surgical problems or unusual anomalies, need for extracorporeal membrane oxygenation (ECMO), high frequency ventilation, nitric oxide therapy, and whole body or selective head cooling for hypothermic neuroprotection.

The Neonatal-Perinatal Medicine Fellowship Program is designed to provide a solid background in clinical neonatology and research techniques, allowing trainees the flexibility and opportunity to develop a career in academic medicine. The program fulfills the requirements of the American Board of Pediatrics, Sub-Board of Neonatal-Perinatal Medicine, and is fully accredited.

The Neonatal-Perinatal Medicine Fellowship Training Program is three years in duration. Over the course of training, fellows spend approximately one-third of their time in clinical service and two-thirds in research, teaching, quality improvement, and administrative service. The clinical service includes rotations in Pediatric Surgery, the Pediatric Cardiology and Cardiovascular ICU, the High Risk Obstetrical (Perinatal) Program, and can also include self-designed clinical experiences. The program is under the direction of Rachel L. Chapman, M.D.

Clinical Training

Clinical activities include care for infants in the NICU where the fellow learns the skills necessary for running a busy unit while receiving graded levels of supervision from attending neonatologists. Included are patient care and teaching conferences, neonatal transport, direct supervision of house officers and medical students, and consulting services. Significant involvement in the management of ECMO, high-frequency ventilation, hypothermia, and nitric oxide therapy, are integral parts of the clinical experience. Fellows also participate in the care of patients on the Pediatric Surgery, Cardiology and Cardiothoracic Surgery, and Maternal-Fetal Medicine Services during required electives and as a consultant. Additional elective experiences are available in pediatric Palliative Care, ECMO, Radiology, and Renal Replacement Therapy. In addition, all fellows see patients in the Neonatal Neurodevelopmental Follow-Up Clinic under the supervision of specialists in Developmental and Behavior Pediatrics and Child Neurology.

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Special Clinical Service and Opportunities Include

B.R.A.I.N. Care
The Brain Research and Innovative Neurological Care for Newborns Program (known as B.R.A.I.N. Care) provides state-of-the-art care for newborns with neurological problems. Multidisciplinary teams evaluate and treat a variety of neurological problems and conditions, including birth asphyxia, hemorrhage, stroke, brain malformations, seizures, hypotonia, infections, hydrocephalus, and neurologic impairments that require newborns to be ventilator dependent. Fellows receive training in the use of cerebral function monitoring. A monthly series of neonatal neurology conferences complements this experience.

ECMO
As the flagship ECMO center of the world, UMMC offers fellows the opportunity to take advantage of decades of clinical experience. Fellows may participate in the ECMO Specialist Training Course given regularly to participants from around the world.

The Fetal Diagnosis and Treatment Center
Close ties with the Departments of Obstetrics, Pediatric Surgery, and Pediatric Cardiology allow for a rich experience in fetal diagnostics and a fetal surgery program. A weekly multidisciplinary conference supplements the fellow's experience obtained during the clinical rotations.

Family Centered Care
The Brandon Newbornl Intensive Care Unit strives to provide family centered care. Parents of former NICU patients are on staff to offer support and personal assistance to families through peer support, personal comfort, learning tools, and navigating the hospital environment. Fellows are standing members of the Family Centered Care Committee

Neonatal Transport
Fellows will participate in the management of inter-hospital transport of critically ill neonates. The Brandon Neonatal Intensive flightCare Unit serves as a referral center for a wide geographic area, receiving patients from throughout the state of Michigan and from surrounding states. Transports are completed by ambulance, helicopter, and fixed-wing aircraft and provide the fellow with valuable experience in transport medicine.

University of Michigan Survival Flight

Research Opportunities

Fellow involvement in scholarly activities is encouraged and fostered. Faculty members are involved in several different areas of both clinical, basic science, educational, bioethics and quality improvement research. The Division participates in multicenter collaborative clinical trials. Special areas of interest include high-technology respiratory support, evidence-based medicine, hypoxic-ischemic brain injury, perinatal ethics and chronic lung injury. In addition, fellows have the opportunity to work with faculty members throughout the Department of Pediatrics and Communicable Diseases, and throughout the Medical School. Competitively awarded grants are available to support research. Research seminars are held regularly to foster a critical and scientific attitude and to review ongoing research. Participation in regional and national scientific meetings is encouraged and supported. The Division encourages the submission of abstracts resulting from work conducted during fellowship and will provide financial support for travel to a meeting for which an abstract is accepted.

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The American Board of Pediatrics requires all fellows to engage in projects in which they develop hypotheses or projects of substantive scholarly exploration and analysis that require critical thinking. Areas in which scholarly activity may be pursued include basic, clinical, or translational biomedicine; health services; quality improvement; bioethics; education; and public policy.
The University of Michigan is an enormous resource, which provides a wide range of opportunities for fellows. Following are examples of these opportunities:

All fellows participate in a 10-session Research Educational Series sponsored by the Department of Pediatrics and Communicable Diseases. The emphasis is on study design, understanding the types, strengths, and limitations of research approaches in a clinical setting; and on biostatistics, understanding basic statistical measures used in the analysis and interpretation of clinical research. Achieving foundational skills in clinical epidemiology will enable participants to identify, distill, critically appraise, and apply practical information from the medical literature relevant to their clinical subspecialty practice in pediatrics. This series also includes teaching skills, advanced EBM skills, as well as manuscript and grant writing skills.

Michigan Institute for Clinical and Health Research (MICHR)
This program provides engaging and effective multidisciplinary education and effective mentoring that has increased the number of high quality clinical and translational researchers across a broad career continuum. This program offers courses and workshops as well as a Clinical Research Master's Program. Past neonatal fellows have obtained the tools necessary for a career in academic medicine.

The School of Public Health offers the On Job/On Campus Master's Degree in Clinical Research Design and Statistical Analysis Program. This program provides a means to develop expertise in research design and statistical analysis. Several fellows have received a degree through this program.
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Fellows with an interest in basic science may take advantage of a wide variety of research labs across the medical center. The Program in Biomedical Sciences is a combined graduate program with links to many labs in the medical school. Neonatal fellows have worked in pathology, pulmonology, and medical genetics labs. Courses are available for those who need to acquire the tools necessary for a successful bench career. The Cellular and Molecular Biology in Pediatrics Training Program is designed to prepare pediatricians for independent, research-oriented careers in academic medicine. Its specific goal is to provide new investigators with the powerful research tools of cellular and molecular biology that will allow them to explore in depth basic questions related to child health.

Fellows with an interest in health care administration may apply to the Graduate Medical Education Scholars Program. This innovative program provides participants with longitudinal training in healthcare administration. The primary goal is to prepare graduates to assume and succeed in academic positions with a focus in healthcare administration. The program allows participants to establish strong mentoring relationships in their chosen area of study, a network for future collaboration, and serves as a stepping stone to pursue further graduate study. Program participants will begin to develop the knowledge base and skill set required to be successful as the next generation of physician leaders. For additional details, please visit the web site.

The Division participates in the Vermont Oxford Quality Initiative Program and the Medical Center has active quality improvement programs (The Michigan Quality System) with educational opportunities available to interested parties. Recent presentations at national meetings attest to fellows’ success in this area.

Other Research-Related Informational Links

The Center for Human Growth and Development is a multidisciplinary unit including faculty from pediatrics, psychology, social work, education, public health, and more. The Center is subdivided into four research groups that focus on causes, prevention, and treatment of mental health problems, the impact of social disparities on child development, cognitive development across cultures, and brain-behavior relationships in the developing child. Many of the research projects have international connections. One fellow recently participated in this program and successfully established a research site in Ghana.

University of Michigan Medical School Global REACH (Research, Education and Collaboration in Health)
Global REACH's mission is to facilitate health research, education, and collaboration among University of Michigan Medical School faculty and students and our global partners to benefit patients worldwide.

Child Health Evaluation and Research (CHEAR) Unit
One major research component of General Pediatrics is devoted to Pediatric Health Services Research. Fellows and faculty from other subspecialty divisions with strong interests in health services research participate. There are potential opportunities for further training in health services research through combined training in Health Services and a Pediatric subspecialty.

Neuroscience Graduate Program
This program captures the excitement and interaction intrinsic to the field of neuroscience. Learners are attracted to the neuroscience graduate program by the breadth of the intellectual base, the variety of scientific approaches to studying the brain and nervous system, the richness in the choice of research topics, and the multiple levels of discourse ranging from the molecular to the cognitive.

Center for Organogenesis
This is a multidisciplinary pre- and post-doctoral program that focuses on developmental biology. It consists of an intercollegiate and interdisciplinary group of scientists whose work is directed toward a common goal: to understand the basic mechanisms by which organs and tissues are formed and maintained, and to use this knowledge to create long lasting artificial organs, stem cell therapies, or organ transplantation systems that will correct genetic and acquired diseases.

Educational Opportunities

Educational Conferences:

We offer a variety of conferences, workshops, and educational seminars which are complimented by abundant opportunities for self-directed learning and exploration.  Core divisional conferences are grouped together on Friday afternoons to allow dedicated time for education, with less frequent interruptions of research and/or clinical endeavors.  In addition, we offer regular multi-disciplinary conferences with our colleagues in Maternal-Fetal Medicine and Pediatric Surgery. Aside from the Divisional offerings, the Department of Pediatrics and Communicable Diseases, the Medical Center and the University offer countless lectures, seminars, courses, etc.  The fellows are encouraged to take advantage of the tremendous scope of opportunities. 

Core Divisional Conferences:

Neonatal Research  This is the neonatal conference where core topics are presented in addition to research in progress. Topics can be assigned by the program director but are often self-selected by the fellows.  Faculty and fellows regularly present their research in progress during this conference. In addition, a “Theme” is identified each quarter and a portion of the talks that quarter will be devoted to topics relevant to the theme (including speakers within and outside of the division). Themes are chosen to incorporate core knowledge learning objectives. Quarterly, a Perinatal Pathology conference also occurs in this venue, during which neonatal autopsy findings are reviewed by a Pediatric Pathologist.  This conference also includes the presentation of quality improvement projects, as well as seminars focused on topics in safety and quality.

Fellow Clinical Case Conference  This is a bi-monthly case-based conference where the on-service fellow chooses a case to discuss with the group. The goal of this conference is to facilitate discussion among all members of the group relevant to the specific learning objectives identified by the fellow.

Neonatal Morbidity, Mortality, and Improvement Conference   This conference consists of a review of specific episode of care utilizing a Healthcare Matrix with the goal of identifying potential areas for improvement in our system of healthcare delivery. Fellows, faculty, hospitalists, and nurse practitioners will be asked to present cases for discussion. This conference is held several times per year. 

Neonatal Quality Improvement Conference   Fellow review of QI projects and/or key outcome measure reviews, under the direction of Drs. Vartanian and Schumacher. This conference is held 4-6 times per year. 

Neonatal EBM Journal Club    Every other month, a fellow prepares an EBM Journal Club presentation under the mentorship of a faculty member with expertise in this area.  Preparation includes formulation of a clinical question, a detailed literature review in collaboration with a medical librarian, and a comprehensive critical appraisal of the key articles identified, followed by application to the clinical scenario.

Neonatal Pulmonary Conference   At this dedicated trainee conference, fellows meet with a faculty member to discuss topics related to the neonatal lung. Topics include: The Alveolar Gas Equation, Oxygen Therapy, Lung Volumes, Mechanical Properties of the Lungs, Neonatal Pulmonary Graphics, CPAP, Principles of Mechanical Ventilation, High Frequency Ventilation, Surfactant Replacement Therapy, Newer Modes of Mechanical Ventilation, Ventilator-Induced Lung Injury, Ventilator-Associated Pneumonia.

Multi-Disciplinary Conferences:

PeriCu   This is a weekly joint OB- Neonatal conference where upcoming and recent “High Risk” deliveries are presented as well as the subsequent course of  infants delivered from these pregnancies are discussed. In this working “case based” scenario both Obstetric and Neonatal House Staff interact with the goals of providing the best care to patients while learning when it matters.  There is always active staff and fellow participation, and frequently fellows will present short (5-10min) didactic mini presentations.

Fetal Development Conference  This conference is a multidisciplinary working conference where specialists from Neonatology, Maternal Fetal Medicine,  Pediatric Cardiology, Pediatric Surgery, and Genetics present, discuss and formulate care plans for upcoming high risk deliveries.

Neonatal Neurology Conference   A joint monthly conference sponsored by the Divisions of Neonatal/ Neurology where lectures and discussion of core topics are undertaken utilizing a 2 year curriculum outline. In addition, all neonatal neurology consultations are reviewed on a quarterly basis for both educational and quality improvement purposes.   Topics covered during the past two years include:  Amplitude Integrated EEG, IVH and PHVD, Brachial Plexus Injuries, Evaluation of the Floppy Baby, Developmental Assessment Tools, Neonatal EEG, Rehabilitation Care for Children with Cerebral Palsy, CNS Infections, Metabolic Encephalopathies and Newborn Screening, Management of Hydrocephalus, Neurologic Complications in Infants with Congenital Heart Disease, Malformations of Cerebral Development, Perventricular Leukomalacia, Hypoxic Ischemic Encephalopathy, Fetal/Neonatal Effects of Maternal Drugs, Neonatal Stroke, Long-Term Prognosis After Prematurity, and Neonatal Sleep.

Neonatal Surgery Combined Grand Rounds   Quarterly conference attended by both divisions covering a variety of neonatal surgical topics. Recent topics have included Approach to Imaging in Suspected Neonatal Bowel Obstruction and Feeding Practices Post-Necrotizing Enterocolitis.

Medical Ethical Social Stress Rounds One hour meetings are held monthly; “Urgent” meetings are held on an as-needed basis. Meetings are open to any member of the care team. There are 4 facilitators: a neonatologist, a social worker, and 2 nurse supervisors; 3 are members of the pediatric ethics committee. Meeting goals included: 1) Communication: To provide a safe environment in which any team member can raise and explore sources of moral distress, ethical concern, or social complexity and to frame these concerns and ideas using basic ethical principles to enhance communication using a shared language; 2) Patient Care: To identify cases that warrant consultation by the ethics committee and facilitate the formulation of specific ethical questions;  3) Education: To provide a forum for structured, multi-method bioethics and professionalism education, using a flexible curriculum designed to meet specific educational objectives for trainees.

Other Informational Links

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We are proud of our program. Graduating fellows have gone on to successful careers in clinical neonatology as well as academic careers at universities across the country. We hope you will consider us when making your fellowship (and career) choice.


How to Apply

Thank you for your interest in the University of Michigan’s Pediatric Neonatal-Perinatal Medicine Fellowship Program. Applications are accepted through the Electronic Residency Application Services (ERAS).

Applications for the 2014 academic year will be accepted through ERAS beginning November 15, 2012.

To be considered by the fellowship selection committee, applicants must meet our eligibility criteria and submit the required documents:

Applicants must submit the following required documents

We do not offer observerships, sponsor any visas, or accept H visas. To be considered for selection, eligible candidates must be a US citizen, have permanent resident status (green card), or have a J-1 visa, because of our funding sources.

Eligibility and Selection

Positions for fellowship training are offered through the National Residency Matching Program (NRMP). Applicants are eligible following completion of an accredited three-year residency training program in general pediatrics in The United States, Canada, or a foreign medical school that is listed by the World Health Organization (WHO). Applicants must have a current valid, unrestricted license to practice medicine in the US or Canada. Applicants without citizenship in the US must be on J-1 Visa. Interviews will be offered to select applicants after review of their application and supporting documents in ERAS.

Supervision Policy

Pediatric Neonatal-Perinatal Medicine complies with The University of Michigan Graduate Medical Education supervision policy. To view the policy, please click here.

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