Rotations

Fellowship Overview

Fellows will have 13 one-month rotations on the NICU clinical service during the three year fellowship. Each year, there is a 1 month rotation in Neonatal Transport where the fellow joins the neonatal transport team as they bring patients to the NICU from referring hospitals. Additionally, there is a 1 month rotation in Maternal-Fetal Medicine and another month for electives on other services in Kentucky Children’s Hospital. The on-call schedule is not more often than every fifth night. Fellows will become certified instructors in neonatal resuscitation and as such will participate in teaching resuscitation courses.

All Graduate Medical Education Programs at the University of Kentucky are required to remain in compliance with the residency duty hour restrictions as described by ACGME. These restrictions apply to all residency and fellowship programs within the University. More information can be found on the GME webpage.

Sample Rotation Schedule

LEVEL SERVICE RESEARCH FOLLOW UP CLINIC MFM TRANSPORT ELECTIVE VACATION
PGY-4
5
(One as orientation)
5 1 day per month 1 1 - 3 weeks
PGY-5 4 7 1 day per month - 1 - 3 weeks
PGY-6 4 6 1 day per month - 1 1 3 weeks

First Year

The first year of fellowship will consist of one orientation month and four service months. These months will be divided between the resident team (3 months) and the delivery team (1 month). While on the resident team, the fellow is responsible for supervising resident physicians and our neonatal physician assistant (PA) residents as well as providing teaching on rounds. Research projects may occur within the division of neonatology or with another department at the University of Kentucky. Both basic science and clinical research opportunities are available. The Maternal Fetal Medicine rotation occurs within the first year and is designed to give fellows exposure to prenatal care for high risk pregnancies and an understanding of prenatal ultrasounds. Fellows complete a transport rotation each year which is designed to give fellows experience with pre-hospital care of infants transferred to Kentucky Children's Hospital from surrounding areas.  

Second Year

During the second year of training, fellows gain increasing autonomy and experience. Service time during the second year also consists of four service months, albeit with a slightly different distribution, as fellows begin to cover the advanced practice provider (APP) team. This team is comprised of neonatal nurse practitioners, neonatal nurse practitioner students, physician assistants who have completed a neonatal residency program, and physician assistant residents. Service months in the second year include the APP team (2 months), resident team (1 month), and delivery team (1 month). Having spent the first year of fellowship developing a research project, second year fellows will begin to conduct research on their projects. This involves presenting their proposed project to the faculty, fellows and APPs as well as submitting the research plan to the University of Kentucky's Institutional Review Board. Duties during the transport month remain the same.

Third Year

The third year of fellowship is designed to be the culmination of two years of training and research. Fellows complete their service months with the APP team (3 months) and delivery team (1 months), acting as junior attending. Fellows are responsible for conducting team rounds with the APPs and reviewing their assessments and plans with the attending neonatologist separately. The remaining service months are spent on the delivery and transport teams. During this year, the fellows should also be finalizing their research and preparing a manuscript for publication. 

Call Schedules

During the months on service, fellows take no more than one-two calls for the month. Night and weekend call is divided between the fellows on research, MFM and transport and decreases by seniority. 

Neonatal Developmental Follow-up Clinic

Our Neonatal Graduate Clinic is under the direction of Nirmala S. Desai, MD. Dr. Desai has over forty years of experience in caring for critically ill neonates and following their development in the outpatient setting. The clinic is located off campus, but close to the medical center complex. Infants are evaluated by attending Neonatologists, Neonatal Fellows, Physical Therapists, Occupational Therapists, Speech and Language Pathologists, Nutritionists, and Social Services personnel.  The clinic provides developmental follow-up for infants who were extremely low birth weight, diagnosed with neonatal abstience syndrome, hypoxic ichemic encephalopathty, and those who underewent ECMO. Infants are followed in the clinic through 36 months. Fellows average approximately one-two days per month. 

Transport Team

During this month the fellow is a member of the Neonatal Transport Team and will travel to referring facilities to assist in the transfer of infants to our NICU. Our transport teams consist of specialized nurses who have been trained in neonatal and pediatric transport medicine as well as a paramedic or pilot depending on the mode of transport. Kentucky Children's Hospital operates both ground and air transport teams.