Training Overview

Our training program consists of 12 - 15 months of clinical service (including 1 month of Maternal-Fetal Medicine, one month of Cardiology / Cardiothoracic Surgery), 15 - 19 months for research, and time in a continuity clinic. Each year, the fellow has four weeks of vacation.

Clinical Opportunities

Our fellows attend high-risk inborn service at two different Level III NICUs that provide challenges in caring for all types of sick infants. Care starts with involvement in prenatal case conferences about difficult patients and perinatal consults. The teams are available 24 hours a day for calls to the delivery room. Care is provided in a Neonatal Intensive Care Unit with up-to-date equipment and an excellent nursing staff.

Block Schedule

Rotation NameRotation GoalsRotation Length
Level IV NICU rotation at SCHC

Fellows will become competent in:

  • Procedural skills (arterial, umbilical and central venous catheters, intubation, chest tubes, exchange transfusion)
  • Differential Diagnosis and treating complex medical and surgical cases
  • Veno-venous and Veno-arterial ECMO
  • Teaching residents and medical students
Two to four weeks per rotation
Level III NICU rotation at Abington

Fellows will become competent in:

  • Resuscitation of term and preterm infants in the delivery room
  • Treatment of critically sick term and preterm infants
  • Neonatology-related procedural skills
Two to four weeks per rotation
MFM rotation at Einstein Medical Center

Fellows will:

  • Broaden their knowledge in prenatal diagnosis
  • Become familiar with prenatal Ultrasound
  • Become competent in prenatal consults
Three weeks
CICU rotation at AI DuPont Hospital

Fellows will:

  • Understand anatomy, physiology, and hemodynamics in normal heart and congenital heart diseases
  • Become familiar with Electrocardiography and Echocardiography 
  • Become familiar with the treatment of cardiac patients (surgery and medication commonly used in cardiology, i.e. vasopressors, digoxin, adenosine, etc.)
Four weeks
High Risk follow-up Clinic (“Next Step”)

Fellows will become competent in: 

  • Assessment and management of the post-hospital care of the NICU graduate (including infants in need of gastric tube, tracheostomy, oxygen via nasal cannula, ventriculoperitoneal shunt, etc.)
  • Developmental assessment (Bayley score)
One afternoon every six weeks
Point of Care Ultrasound

Fellows will become competent in: 

  • Understanding knobology
  • Understanding anatomy and hemodynamics in normal newborn
  • Utilizing POCUS in resuscitative, diagnostic, and procedural guidance in neonates
One day every four weeks

Educational Opportunities

There is a strong commitment to fellow education. There are daily NICU attending teaching conferences and rounds with staff radiologists. One afternoon a week, there is protected time for fellow education that covers topics in clinical medicine, perinatal physiology, and research. We also hold evidence-based medicine and Journal Club conferences. Monthly, there are conferences with our obstetrical colleagues. The educational experience is augmented by participation in simulations using high-fidelity mannequins that apply what is taught at other times through a structured curriculum. Similarly, the material is reviewed using a Board Course format.

In addition, St. Christopher's Hospital offers a comprehensive Core Curriculum for the education of the fellows. At these meetings, the Neonatal-Perinatal fellows are able to interact with their peers/fellows from all of the other disciplines. The faculty fully supports each fellow to meet all of the American Board of Pediatrics requirements for Scholarly Activity. By having joint educational meetings with fellows from other programs in Philadelphia, the fellow's experience is enriched. Fellows are encouraged to attend meetings of the Philadelphia Perinatal Society and present their research in the annual Boggs Award competition.

Research Opportunities

Ample time spread over three years is available to formulate a research project, collect data, write abstracts for national and international meetings, and prepare manuscripts for publication in competitive scientific journals. Research is important to the future improvement of newborn care and to understanding the disease processes that affect babies.

Members of our division are currently investigating:

  • Brain injury induced by:
    • Hypoxia
    • Hyperoxia
    • Drugs
    • Systemic inflammation
  • Understanding the pathogenesis of bronchopulmonary dysplasia:
    • Utilizing in vitro and in vivo hyperoxia-induced lung injury models
    • Utilizing genetic gain-of-function (transgenic mice) and loss-of-function (null mutant mice; siRNA) models
    • Utilizing in vitro and in vivo sepsis-induced lung injury models 
  • Collaborative clinical projects to enhance clinical care:
    • Impact of preterm formula on bone mineralization
    • Understanding the inflammatory milieu in ECMO 
    • Sedation practices in Hypoxic Ischemic Encephalopathy
  • Healthcare disparities:
    • Understanding the influence of social determinants of health on neonatal feeding outcomes
    • Assessing language disparities in the NICU
  • Mechanisms of fetal programming of adult-onset diseases by investigating:
    • Impact of maternal nutrition on modulating hypothalamic gene expression in offspring
    • Interaction of maternal stress and diet on the development of metabolic dysfunction in offspring
    • Neonatal immune response to infection
    • Mechanisms that the neonate uses to fight the influenza virus
  • Simulation as an educational tool:
    • Quantitatively measure critical thinking skills of neonatology fellows

Quality Improvement in the NICU

Fellow-led projects

  • I-Pass: Handoff tool
  • Timely Administration of Antibiotics in High-risk Admission
  • Accuracy of Hands-off information
  • Improvement of Discharge summaries
  • Oxygen targets
  • Improvement of MRI slots for NICU patients
  • Improve placement of umbilical catheters
  • Prevention of unplanned extubation events in Neonates
  • Consult Documentation
  • Improving discharge communication between well-baby nursery physicians and community 
    primary care providers
  • Improving adherence to AAP recommendations for the prevention of perinatal GBS
  • Improving physician documentation in the medical record of central line placement and removal
  • Vancomycin use in Neonatal patients
  • Newborn Resuscitation Program Compliance
  • Medication Reconciliation 'NPSG8'
  • Reducing opioid use in critically ill neonates 
  • Reducing antibiotic utilization in a Level IV NICU
  • Reducing Osteopenia of Prematurity-related factors in a Level IV NICU
  • Reducing intubation and related risks in neonates with ROP undergoing laser photocoagulation
  • Implementation of a Nasogastric Tube Discharge Program

Teaching Opportunities

In addition to a structured academic curriculum, fellows have ample opportunities to lead and share knowledge by serving as educators. Teaching is important to solidify the knowledge acquired through self-study, clinical experiences, and educational sessions. 

Our fellows:

  • Teach rotating medical students, pediatric residents, as well as emergency medicine, anesthesia, and surgical fellows
  • Attain an academic appointment as a Clinical Instructor of Pediatrics available at Drexel University College of Medicine
  • Can participate in training to become a simulation facilitator and an NRP instructor

Awards and Grants

Our training program is committed to the professional development of our fellows. As such, our fellows, mentored by faculty, apply for competitive grants and receive honorable distinctions for their teaching throughout training.

Recent Fellow Awards
Reema Paul, DO; 2024 The Angelo M. DiGeorge Teaching Award, presented by the House-staff of St Christopher’s Hospital for Children to a graduating outstanding fellow teacher.
Michelle Mejia, MD; 2024 Philadelphia Perinatal Society Boggs Award; Research titled "ECMO Circuit: Rogue or Hero in ECMO Induced SIRS?"
Michelle Mejia, MD; 2024 GME Award of Excellence in Promoting Diversity, Equity, and Inclusion: recognizes a faculty and/or resident/fellow who has demonstrated passion, leadership, and effectiveness in promoting diversity, equity, and inclusion in the GME community. 
Reema Paul, DO; 2024 GME Award of Excellence in Wellness and Resilience: Recognizes a faculty, program coordinator/manager, and resident/fellow in promoting wellness and resilience in the GME community. 
Michelle Mejia, MD; 2023 Robert H. Bartlett Award for best research abstract at the 33rd annual ELSO Conference "The role of the Extracorporeal Membrane Oxygenation circuit in inducing inflammation Ex vivo”.
Linsey Cromwell, DO; 2023 The Angelo M. DiGeorge Teaching Award, presented by the House-staff of St Christopher’s Hospital for Children to a graduating outstanding fellow teacher.
Recent Fellow Grants
  • Htay Aung, MD; 2024 Tower Health GME Resident and Fellow Research Travel Award. To present “Donor blood Interaction with ECMO circuit does not initiate rather augments the inflammatory milieu” at the Annual Children's National Symposium: ECMO and the Advanced Therapies for Cardiovascular and Respiratory Failure in Keystone, Colorado.
  • Michelle Mejia, MD; 2023 Tower Health GME Resident and Fellow Research Travel Award; To present "Blood prime-circuit interactions do not induce inflammatory cytokine response in an ex-vivo ECMO circuit model” at the Annual Children's National Symposium: ECMO and the Advanced Therapies for Cardiovascular and Respiratory Failure in Keystone, Colorado.