Neonatal-Perinatal Medicine

Department of Neonatal Perinatal Medicine Website

Program Description

The goal of our program is to provide the trainee with:

  • A solid foundation in clinical neonatal pediatrics and in the scientific basis of the subspecialty.
  • Methodologic skills in clinical investigation. Thus, the program attempts to provide the prerequisites for the trainee's continuing contribution as a clinical subspecialist, teacher and scientist.

The Neonatal-Perinatal Medicine Program is designed to meet the needs of a variety of individuals. For those committed to a career in academic neonatology, we offer a 2 - 3 year program that combines clinical and research training. This program is accredited by the Royal College of Physicians and Surgeons of Canada and satisfies the requirements for subspecialty training in neonatal-perinatal medicine of the American Board of Pediatrics. The Program is also suitable for individuals who wish to complete 1 or 2 years of neonatal training prior to general pediatric/Level II nursery practice or for those with previous neonatal training in other centres who wish to broaden their experience. The Program is flexible to meet individual objectives.

Trainees are based at the Neonatal Intensive Care Unit at the McMaster University Medical Centre. This unit is situated at the Children's Hospital at the Hamilton Health Sciences Corporation and the regional perinatal centre.

The Children's Hospital provides a wide scope of pediatric subspecialty services including perinatology, pediatric surgery, genetics, hematology, cardiology, nutrition, and gastroenterology among others. About 3,000 deliveries per year occur at the Medical Centre; many of these cases are high-risk and have been referred for care to the regional centre. The neonatal unit is a 47 bed tertiary unit that serves as a regional centre for the southwestern region of Ontario. The neonatal unit has approximately 1000 admissions annually, including 400 very low birth-weight babies. Seventy percent of neonatal unit admissions are born on site. The remainder are transferred after birth from the surrounding region which extends about 112 kilometres (70 miles) around Hamilton; the region has about 27,000 deliveries annually. Each neonatal transport team consists of two specially trained neonatal intensive care nurses, supplemented by neonatal fellows where indicated. The transport nurses perform delegated sanctioned medical acts (e.g. intubation) and have advanced clinical and communication skills. The transport team receives 400 - 500 calls each year.

The perinatal centre provides experience in antenatal consultation and in the delivery room management of high risk neonates, including preterm infants, multiple gestations, and an increasing number of infants with antenatally diagnosed anomalies.

The Neonatal Follow-up Clinic conducts the follow-up of infants of birthweight less than 1500 grams or high-risk infants born in the region.

There is an emphasis on evidence based medicine in clinical practice, teaching, and research. Through our Program's strong links with the Department of Clinical Epidemiology and Biostatistics that has an international reputation, formal training in Health Research Methodology is facilitated and encouraged for all trainees.

The Neonatal Unit is part of an integrated perinatal unit that includes the obstetric suite and post-partum ward with rooming-in. The Program has responsibility for maternal and neonatal transport, regional perinatal education, as well as perinatal intensive care.

Clinical Service and On-Call Duties

During the first year of the program, clinical rotations include NICU, neonatal follow-up, and maternal-fetal medicine. Opportunities are available to rotate through a community-based Level II unit based at St. Joseph's Hospital in Hamilton.

For the first 2 years of the program, trainees in the Program spend 3 to 5 months per year providing clinical service in our NICU. The precise numbers of months will depend on past clinical experience and will be determined for each individual at the beginning of the academic year. Trainees are expected to participate in the on-call schedule one night in five, during which their responsibility is the supervision of residents and/or Clinical Nurse Specialist/Nurse Practitioners in-house, as well as the coordination of transport by the Nurse Transport Team. Trainees completing 3 years in the program will dedicate the majority of their third year to research activities.

Research

During a 2-year fellowship, at least 12 months will normally be spent in research training and activity. This may be in association with any of the faculty members both inside and outside the Neonatal Division who are actively involved in basic and/or applied research in Neonatal-Perinatal medicine.

Research activities include:

  • Pulmonary function studies in ventilated infants
  • Studies of aerosol delivery to infants
  • Systematic review of controlled trials in neonatal care
  • Multi-centre trial of red cell transfusions in preterm neonates
  • Multi-centre trial of caffeine for apnoea of prematurity
  • Long-term follow-up of high risk children
  • Preferences and perceptions of quality of life of extremely low birthweight infants
  • Bioethics & quality of life, communication to parents about to undergo preterm delivery
  • Proxy consent for neonates
  • Studies in neonatal nutrition
  • Studies in perinatal hematology
  • Breast feeding outcomes in very low birth weight infants
  • Population studies of perinatal outcomes, rates, variations and determinants of premature birth
  • Early discharge of healthy newborn infants and resource utilization
  • Participation in multi-centre trials of nitric oxide, and of the effectivesness of SNAP/CRIB databases

Animal and laboratory research facilities are available at McMaster University site.

Education

Neonatal educational sessions consist of:

  • Neonatal seminars
  • Journal club
  • Maternal/Fetal-Neonatal rounds
  • Pediatric surgery-neonatal rounds
  • Neonatal teaching sessions for core pediatric residents
  • Neonatal ultrasonography rounds
  • Perinatal mortality rounds
  • Neonatal transport rounds
  • Pediatric grand rounds
  • Psychosocial rounds

Prerequisites

Canadian graduates: Completion of three years of postgraduate training in pediatrics.

International Medical Graduates: Successful completion of the Medical Council of Canada Evaluating Examination (MCCEE). More information about the exam can be obtained from your local Canadian Embassy or by requesting a copy of the Medical Council of Canada information pamphlet on the Evaluating Exam. The address is:

The Medical Council of Canada
P.O. Box 8234, Station T
Ottawa, Ontario, Canada K1G 3H7
Tel: (613) 521-6012 Fax: (613) 521-9417

Exemption from the MCCEE can be obtained in some circumstances by those individuals who hold specialty certification in their own country.

If the language of medical instruction was not English/French, successful completion of Test of Spoken English (TSE) and Test of English as a Foreign Language (TOEFL). TSE - pass rate of 50, TOEFL - pass rate of 580. For more information contact:

TOEFL/TSE Registration Office
P.O. Box 6151
Princeton, New Jersey
08541-6151, USA
email address: toefl@ets.org

For more information, please contact :

Dr. Dr. Prashanth Murthy
Program Director
Neonatal/Perinatal Medicine
Department of Pediatrics, Room 4G40
McMaster University
1200 Main Street West
Hamilton, Ontario, Canada L8S 4J9

Telephone: (905) 521-2100 Extension 76486
Fax: (905) 521-5007
Email: murthyp@mcmaster.ca

Minimum 6 months prior to start date