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Fellowship Program Overview

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Program Overview

Overview

Program Overview

We admit 350-400 patients per year to Loyola Medicine's neonatal intensive care unit (NICU), with an average daily census of 20-25. About 15% of our admissions are <28 weeks gestation, and about 40% are term giving the fellows a wide range of clinical exposure. About 15% of admissions are outborn transfers.

Our program is supported by the following pediatric subspecialists:

Cardiology
Dermatology
Endocrinology
ENT
Gastroenterology
Genetics
Hematology-Oncology
Infectious Disease
Nephrology
Neurology
Neurosurgery
Nutrition
Ophthalmology
Orthopedics
Palliative Care
Pediatric Surgery
Urology

Our program has a strong working relationship with the Maternal-Fetal Medicine Fellowship program and the Department of Obstetrics and Gynecology. A doctor of pharmacy and neonatal nutritionists help manage our patients.

Loyola Medicine's occupational therapy, physical therapy, speech therapy, audiology, social work and spiritual care teams are also actively involved in educational program as well as in the daily care of our patients.

As part of our active quality improvement activities, we are part of the Vermont-Oxford Network. We also review quarterly neonatal and maternal morbidity and mortality issues for our Regional Perinatal Network as well as help initiate and implement both the regional and state of Illinois ongoing quality projects.

Loyola University Chicago's Neiswanger Institute of Ethics, located on Loyola University Medical Center's campus, is another resource with a full range of ethics offerings in academics, lectures, consultation and research.

Follow-Up Clinic

We have an excellent NICU BPD clinic once a month and high-risk newborn developmental follow-up clinic once a week. Fellows participate approximately one to two times per month in these clinics. The clinic is supported by a neonatologist, neonatal nurse practitioner and OT/PT trained in early intervention.

On-Call Schedule

On-call responsibilities are consistent through all three years, averaging five in-house calls per month. While attendings are in-house overnight for call; our fellows are responsible for primary critical decision-making and provide ongoing reports to the attending. Attendings and fellows share weekend NICU team rounds.

Training

Fellowship Training

Our NICU is divided into two clinical teams: a rounding team and a DR/consults/transport team. The rounding team comprises of an attending neonatologist, a fellow, a nurse practitioner, 2-3 pediatric and internal medicine-pediatrics residents, and fourth year medical students. Fellows act as team leaders with support from their attendings.

The DR/consults/transport team attend high-risk deliveries, provide prenatal consults as requested by the OB/MFM team, and furnish physician coverage on neonatal transport.

Medical rounds are in the morning and fellows huddle twice a day with OB staff to keep apprised of labor and delivery, antepartum, and postpartum concerns.

Fellowship training at Loyola includes:

12 months of clinical neonatology
One month rotation in neonatal cardiology
Two to four months of electives such as infectious disease, neonatal pharmacology, and radiology
16-18 months of research
Three months of vacation/conference

Other electives may be accommodated.

Fellows are trained in procedures such as endotracheal intubation, chest tube placement/thoracentesis, point-of-care ultrasound (POCUS), umbilical catheterization, placement of peripheral arterial lines and PICCs, paracentesis, and exchange transfusion. Bedside procedural opportunities are supplemented with high-fidelity simulation sessions held in-situ within the unit as well as at the Loyola University Center for Simulation Education. Fellows are coached in teaching and are NRP instructors by the end of their training.

At the start of the academic year, our first-year fellows participate in a large regional Simulation Boot Camp geared towards preparing new fellows for fellowship. Senior fellows take part in an annual regional Senior Fellow Boot Camp to push and solidify various procedural and communication skills.

Research/Scholarly Activity

Program Research/Scholarly Activity

The fellowship requires research/scholarly activity following the guidelines outlined by the American Board of Pediatrics’ scholarly activity requirement. An individualized scholarly oversight committee for each fellow is formed and will mentor each fellow through his/her scholarly activity. research fellows

Research conferences presented by fellows and attendings are designed to present results of current projects, discuss new protocols and critique proposed research design. Fellows are expected to present their research at a regional and national research meeting such as the Society for Pediatric Research meeting or an appropriate subspecialty society research meeting. Fellows are encouraged to attend national in-person conferences with generous reimbursement if their abstract(s) is accepted for presentation.

A manuscript submitted to a peer-reviewed journal is expected for completion of the scholarly activity. The design, implementation and completion of a fellow CQI project is expected prior to program completion.

The fellow with the guidance of an attending neonatologist, will also design and implement a quality improvement project, usually through several cycles. These are often presented at regional and national quality congresses, such as VON Annual Conference and Illinois Perinatal Quality Collaborative Conference.

Scholarly Activity (snapshot)

Presentations/Posters
American Academy of Pediatrics National Conference and Exhibition (AAP NCE)
AAP Perinatal & Developmental Medicine Symposium
Central Association of Obstetricians and Gynecologist (CAOG) Conference
Envision Neonatology Fellows Conference
International Meeting on Simulation in Healthcare (IMSH)
Pediatric Academic Society (PAS)

Publications

Marty D, Sorum K, Smith K, Nicoski P, Al-Sayyed B, Amin S. "Nosocomial Infections in the Neonatal Intensive Care Unit" Neoreviews. 2024;25(5):e254-e264

Holthaus E, O'Neil M, Jeske W, DeChrstopher J, Goodman J, Glynn L, Levin S, Muraskas J. "Endocan: A biomarker for endothelial dysfunction and inflammation, linking maternal obesity and pediatric obesity in a cohort of preterm neonates. Eur J Ob Gyn. 2024;297:132-137

Goldsmith J, Muraskas J. "Nucleated Red Blood Cells and the Timing of Hypoxic Ischemic Encephalopathy." Neonatal Today. 2023;18(11):164-165.

Cheng E, George AA, Bansal SK, Nicoski P, Amin S. "Neonatal Hypocalcemia: Common, Uncommon, and Rare Etiologies." Neoreviews. 2023;24(4):e217-e228.

Manalastas M, Shine KC, Yuan A, DeChiaro BA, Weiss MG, Amin S, Dina P, Muraskas JK. "Neonatal serial creatinine levels as an adjunct biomarker in timing of fetal neurologic injury." Euro J Ob gyn. 2023;18:100191.

Manalastas M, Zaheer F, Nicoski P, Weiss MG, Amin S. "Acetaminophen Therapy for Persistent Patent Ductus Arteriosus." Neoreviews. 2021;22(5):e320-331.

Maclean J, Katebian R, Suh E, Mirza K, Amin S. "Neonatal Hemophagocytopathic Lymphohistiocytosis." Neoreviews. 2019;20(6):e316-325.

Conferences

Program Conferences

Our weekly and monthly conferences provide an ample and varied educational experience including:

Three year cycled neonatal didactic lecture series
Pediatric grand rounds
Perinatal M&M case review and M&M teaching conferences
Neonatal ethics
Neonatal journal club
Neonatal physiology seminar
Case management
Neo board review

The neonatal didactic lecture series provides a thorough review of various neonatal topics reflecting the ABP neonatal perinatal content outline presented by neonatologist, fellows and pediatric subspecialist.

Pediatric grand rounds provides updates of various pertinent pediatric subjects. Attendings and fellows present critical reviews of recent articles in our monthly journal club.

Case management and ethics conferences offer the opportunity to discuss and review interesting problem cases.