Neonatal-Perinatal Medicine Fellowship
The neonatal-perinatal medicine fellowship at the 91女神 School of Medicine provides trainees the training required to become key policy, educational and research leaders of the future.
Welcome
Dear candidate,
Welcome to 91女神 and SSM Health and thank you for taking the time to consider the 91女神 Neonatal-Perinatal Medicine Fellowship Program. We hope you find something to interest and inspire you during your time with us. I鈥檓 sure you鈥檒l enjoy meeting people from SSM Health Cardinal Glennon Children鈥檚 Hospital.
Over the last 60 years, the neonatology program and the hospital have evolved into
a world-class leader in children鈥檚 health care. In our neonatology program, we have
worked hard to create a collaborative multiprofessional program that provides the
highest quality care to the sickest neonates alongside an outstanding clinical and
scholarly education for motivated, high-performing trainees. We would like to invite
you to be part of that ongoing journey. Please do not hesitate to ask if you have
questions or concerns during your interview day or during the match process.
Whether you pursue further training at 91女神 or match at another program, we believe
you will find neonatal-perinatal medicine a challenging, rewarding field that makes
a difference in the lives of children, their families, and their communities every
day. We wish you the best!
Rebecca Petersen, M.D.
Associate professor
Neonatal-Perinatal medicine
Program director
Who We Are
The mission of the Neonatal-Perinatal Medicine (NPM) fellowship at 91女神 is to provide the highest quality education and experience to train future neonatologists to deliver the best care for vulnerable neonates and their families. We aim to do this in a humanistic, collegial, interdisciplinary environment that fosters the lifelong ability to excel in scholarship and discovery, teaching and leadership.
To achieve this, we value and prioritize the participation of fellows in every part of the clinical experience, placing fellows at the bedside and on the management team for all critical neonates in the delivery room and ICU. We recognize the importance of the technical aspect of neonatology and emphasize procedural experience and the demonstration of developing competence. We welcome the expanding awareness of the complexity of critical illness and promote the active participation of individuals with a variety of clinical backgrounds and professions in the development of plans of care.
We believe that excellence in neonatal-perinatal medicine requires a disciplined, scientific approach. Time for fellows to participate in learning experiences is valued and protected. Opportunities abound to learn about neonatal physiology and other aspects of critical care medicine; about the conduct, analysis, and presentation of research; about the rigorous and innovative construction, delivery and evaluation of educational programs and curriculum; and the systems of care delivery.
We seek out opportunities to mentor and participate with fellows in scholarship in many fields and help to produce fruitful connections throughout the university and the field of neonatology. Neonatal physicians are leaders in pediatrics. High quality care requires continual testing and improvement, which we reflect by teaching the critical tools of quality improvement and by promoting fellow leadership of quality improvement activities. Most of all, we respect fellows as colleagues and unique human beings. We strive to recognize each fellow鈥檚 individual challenges and gifts and to help them achieve success to the benefit of all neonates.
Facilities
The 65-bed level IV NICU featuring all private rooms for families is located in our stand-alone children鈥檚 hospital and serves not only the St. Louis area, but also large portions of southern Illinois, central Missouri, and southeast Missouri.
The NICU at Cardinal Glennon admits and manages neonates with a wide variety of single and multi-system disease. Advanced management techniques include in-unit ECMO, dialysis, therapeutic hypothermia, and invasive and non-invasive pulmonary support. In order to more fully serve the needs of patients in the NICU, the daily rounding team includes advanced practice providers, a dedicated NICU pharmacist and a critical illness nutritionist. A dedicated Child Life specialist is an integral part of the team as are Social Workers, Wound Care specialists, therapy services, and nurse practitioners associated with other pediatric sub-specialty services.
Preoperative care for neonates with cardiac lesions are cared for in our level IV NICU, with primary management led by Neonatology in consultation with Cardiology and Cardiothoracic surgery. Patients recover postoperatively in the PICU, but do return to the NICU if other complex organ systems are involved. Extra-corporeal Membrane Oxidation is offered at our Level IV NICU, and primary management is led by Neonatology.
Fast Facts
- Average daily NICU census ~ 60 babies
- 65-bed Level IV NICU with all private rooms
- Ranked by US News & World Report as the #1 NICU in Missouri for 2023-2024
- 200 cardiothoracic surgeries each year鈥� neonates are managed pre-operatively in the NICU
- Neonatal ECMO team designated by ELSO as a Gold Center of Excellence
Our 35-bed level III NICU is located at SSM Health St. Mary鈥檚 Hospital, located 5.2 miles west from Cardinal Glennon. St. Mary鈥檚 also houses our high-risk OB services, with a high volume of high-risk deliveries each year. Neonatology not only manages infants in the level III NICU at St. Mary鈥檚 but also provides antenatal consultation services for expecting parents, to provide guidance and recommendation regarding prematurity, growth restriction, and other antenatal risk factors.
Fast Facts
- 35-bed level III NICU with all private rooms
- Designated baby-friendly hospital
- 200 ELBW deliveries annually
- Prenatal consult service
- 3,400 deliveries each year
Fellow Curriculum
Underlying all of the formal curriculum is the mission-based focus of Cardinal Glennon. Ingrained in the community we serve, we strive to improve the health and wellness of the most vulnerable of neonates and their families.
| Core Conference (Twice Monthly) | Didactic lecture covering Neonatal-Perinatal Medicine Sub-specialty board content. Lectures are given by Neonatology faculty as well as faculty from other subspecialities such as cardiology or genetics to lend their expertise. Fellows also have opportunities to give lectures to further their own knowledge and practice didactic teaching skills. |
| Case Conference (Monthly) | Discussion of a recent neonatal case and the relevant pathophysiology, epidemiology, diagnosis, and management, led by a fellow. |
| Journal Club (Monthly) | With the help of an assigned faculty mentor, a fellow presents a recent peer-reviewed article of interest to neonatal practice. Fellows have the opportunity to dive deeper into the background, methods, and statistics related to the article to educate colleagues and discuss how current literature may affect future clinical practice. |
| Morbidity and Mortality (Monthly) | Neonatology faculty present recent cases of patient deaths or significant safety events for review and discussion |
| Video Review (Quarterly) | Video footage from resuscitation of a high-risk delivery is analyzed and critiqued with guided discussion regarding NRP practices, effective leadership and communication in medical emergencies, delivery room management, and quality improvement. |
| NeoPath Conference (Monthly) | In a joint conference with clinical pathology faculty and trainees, recent patient cases with relevant pathological findings (such as autopsy, placental pathology, etc.) are discussed. Clinical aspects of the case are presented by Neonatology faculty, and laboratory aspects of the case, such as histology and gross dissection of tissues, are presented by pathology faculty. |
| Fetal Care Institute Conference (Weekly) | In a joint conference with colleagues in Maternal-Fetal Medicine, prenatal findings, such as ultrasound images and genetic testing, are presented for patients followed by the Fetal Care Institute and discussed. Additionally, there is discussion regarding delivery planning for high-risk fetal diagnoses, as well as discussion of neonatal outcomes of these high-risk infants after delivery. |
| Neonatology, Maternal-Fetal Medicine, and Pathology joint conference (Twice Yearly) | In this joint conference, fellows from the Neonatology and Maternal Fetal Medicine programs and a Pathology faculty member present and discuss a clinical case, reviewing the relevant peripartum and post-partum diagnosis and management, as well as pathological findings such as histology for the case. |
| Pediatric Grand Rounds (Weekly) | Both Department of Pediatrics Faculty as well as invited guest speakers present relevant topics to pediatrics, including evidence-based clinical management of disease, ethics, disparities in healthcare, and advances in translational and clinical research. |
| Introduction to Academic Medicine (Twice Monthly) | Longitudinal curriculum for all pediatric subspecialty fellows covering topics pertinent to work as a fellow as well as career planning, such as research methods, financial planning, mentorship, and effective communication. 1st year fellows also complete the Stanford Teaching Curriculum to develop skills needed to be an effective clinical educator. |
Other Education includes:
- Procedure Bootcamp at Washington University School of Medicine
- ECMO Bootcamp at Washington University School of Medicine
- ECMO In-service Training
- Simulation Learning
Clinical Rotations
Fellows receive training at both the SSM Health Cardinal Glennon Children鈥檚 Hospital NICU as well as the SSM Health St. Mary鈥檚 Hospital NICU and take call at both locations during their training. Rotations are one month long and the number rotations varies by year of training. The clinical experience includes 13 clinical months, eight months at the Cardinal Glennon Level IV NICU and five months at the Level III NICU at St. Mary鈥檚.
In the second year, fellows complete a one-month rotation in perinatal medicine. This includes rounding on high-risk antepartum patients and outpatient experiences with the maternal fetal medicine group, medical genetics and the fetal care institutes. During this time fellows get extensive experience with perinatal consultation. In addition to the required rotations, many options exist for elective experiences. In their third year, fellows are encouraged to design an elective to address their specific interests. For example, recent fellows have completed electives with the transport team and in nutrition.
Nursery Follow-Up Clinic
Fellows have an active role in our nursery follow-up clinic in providing care to high-risk infants after discharge from the NICU. Fellows are in clinic on Thursday afternoons, averaging about two clinics per month throughout the duration of fellowship. This multidisciplinary clinic is led by neonatologists and also includes pediatric ophthalmologists, a neonatal dietician, a pediatric neurologist, pediatric psychologists, physical therapists, occupational therapists, social workers and nurse navigators, who all work to provide holistic post-discharge care for high-risk NICU graduates. Neurodevelopmental assessments are provided as well as home oxygen management, nutritional management, and screening and treatment of retinopathy of prematurity.
Fellow Call
Fellows take overnight in-house call at both the Cardinal Glennon and St. Mary鈥檚 NICUs. Calls at Cardinal Glennon are on Saturday or Sunday from noon to 7 a.m. and calls at St. Mary鈥檚 are on Wednesday or Thursday from 6 p.m. to 6 a.m.
Fellows average about three to four calls per month, with about an equal number of calls at each location throughout the year.
While on call at St. Mary鈥檚, the fellow is with a neonatal advanced practice practitioner (APP), with the on-call neonatologist at Cardinal Glennon as back-up. The fellow manages all NICU patients on the resident team at the St. Mary鈥檚 NICU, as well as the patients in the well-baby nursery, and also attends any high-risk deliveries.
While on call at Cardinal Glennon, the fellow is with two neonatal APPs overnight, with a back-up neonatologist available by phone if needed. The fellow oversees management of all patients in the Cardinal Glennon NICU, provides medical control for new admissions coming via transport and also attends high-risk deliveries at St. Mary鈥檚, if needed.
Mentorship
Each fellow is assigned a faculty mentor from the Division of Neonatology to provide guidance in their growth throughout fellowship as clinicians, scholars and future neonatologists. Additionally, each fellow is also assigned a mentor from the Neonatal APP group to provide both clinical and practical guidance during fellowship training.
Research
Neonatology faculty are engaged in basic science, translational, and clinical research, and encourage fellows to become involved in these ongoing projects as part of their scholarly work. Neonatology fellows also have ample opportunity to work with faculty members outside of the Division of Neonatology for research as well as other scholarly work.
Fellows involved in basic science and translational research make use of Saint Louis University鈥檚 state-of-the-art Doisy Research Center, which provides 206,000 square footage of research space shared among the 91女神 Department of Biochemistry and Molecular Biology as well as other researchers across campus. Neonatal faculty-led labs include large animal-based research on lung disease with Noah Hillman, iron metabolism studies with Robert Fleming, and developing research topics with junior faculty.
Fellows have access to other 91女神 medical school resources for research, including the School of Public Health and the Taylor Geospatial Institute, which have been vital in studying social determinants of health.
Those interested in careers in medical education are encouraged to seek out the services of the Reinert Center for Transformational Teaching and Learning as well as the many robust pedagogical programs within the School of Medicine.
Past Fellow Research Projects
- Effect of inhaled budesonide on adrenal insufficiency VLBWs
- Methods of transitioning from hospital ventilators to portable home ventilators in infants requiring chronic respiratory support via tracheostomy
- Effect of fetal inflammation on immune system development
- Implications of neonatal microbiome on gut health and neurodevelopment using a piglet model
- Biomarkers for cardiovascular disease in mucopolysaccharidosis Type IVA
- Association of chorioamnionitis and delayed cord clamping practices
- Effect of antenatal corticosteroids and post-natal budesonide on lung and brain tissue in a lamb model
- Efficacy of surveillance testing on methicillin-resistant staphylococcus aureus in the NICU
- Use of combined surfactant and budesonide administration for respiratory distress syndrome
- Differences in responses to erythropoietin administration on maternal and neonatal iron metabolism
- Effect of positive sensory experiences and music therapy on amplified-EEG findings in neonates