Neonatal Surgery Fellowship

[damusiel]

can anyone tell me where are the neonatal surgery fellowships in the country?
What about fetal surgery fellowships?

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[ThoracicGuy]

can anyone tell me where are the neonatal surgery fellowships in the country?
What about fetal surgery fellowships?

Seeing as you are still in high school, I'm not sure how relevant this is.

 

[Winged Scapula]

Seeing as you are still in high school, I'm not sure how relevant this is.

True but it is an interesting question.

Pediatric surgery would include neonatal surgery; I think we all spent some time in the NICU during Peds Surgery rotations.

If one is interested in fetal surgery, I believe that to be a super fellowship after Peds Surgery or perhaps MFM. I believe Baylor has one, as done Cincinnati Children's.

 

[aalamruad]

True but it is an interesting question.

Pediatric surgery would include neonatal surgery; I think we all spent some time in the NICU during Meds Surgery rotations.

If one is interested in fetal surgery, I believe that to be a super fellowship after Peds Surgery or perhaps MFM. I believe Baylor has one, as done Cincinnati Children's.

Could also be done through nsg + peds fellowship (wouldn't have to do a super fellowship that way)

 

[AdmiralChz]

Interesting question, I did a very quick google search for fetal surgery fellowships and found a few. There are only a handful of places around the country that even DO true fetal surgery.

Perinatal Surgery Fellowship
- Baylor (Texas Children's) looks like they accept both MFM and Peds Surg graduates.

Curriculum | Fetal Surgery Fellowship Program
- Looks like only for MFM graduates.

Pediatric Surgery Fetal Fellowship - University of Michigan Pediatric Surgery
- For Peds Surg graduates.

I bet there are more, but this is a pretty tiny field.

can anyone tell me where are the neonatal surgery fellowships in the country?
What about fetal surgery fellowships?

When you say "neonatal" I would think that many (most?) Pediatric Surgeons would be comfortable with neonates and preemies as well, but to me (as an almost anesthesiologist) this is fundamentally different from true in-utero fetal surgery.

 

[TraumaLlamaMD]

TE fistulas, diaphragmatic hernias, etc (on a child who has been born!) where I work are all done by pediatric surgeons - the same ones doing appendectomies on 17 year olds. There's a separate track for congenital heart defect repair, and I've never seen the two cross over.

Some of these problems are in fact identified in utero these days, but in most cases it's safer to wait for the baby to be born and stabilize before operating. There don't seem to be a lot of indications for fetal surgery - especially considering the risk to the mother - which is why, I think, there are so few training programs. It's a very interesting field in concept, and sure generates some sexy news headlines, but there's a huge world of medicine out there. I'd try not to let yourself get fixated on one incredibly niche subspecialty before you've been to medical school and had more exposure to the rest of the medical world.

 

[Winged Scapula]

Could also be done through nsg + peds fellowship (wouldn't have to do a super fellowship that way)

Is that FETAL surgery or pediatric neurosurgery (which is a different)?

 

[aalamruad]

Is that FETAL surgery or pediatric neurosurgery (which is a different)?

Pediatric neurosurgeons can do some fetal surgery. For something like fetal myelomeningocele repair, the peds surgeons start the operation and open the uterus, at which point the peds neurosurgeons take over and do the actual operation on the fetus. That's how it works at my school, at least.

But the more important point is that you don't even need to do a fetal surgery fellowship after peds surgery in order to do fetal surgery; pediatric surgeons can operate on fetuses, and in fact most people who perform fetal surgery only have done general surgery residency + peds surgery fellowship (without any specific fetal surgery training).

 

[Winged Scapula]

Pediatric neurosurgeons can do some fetal surgery. For something like fetal myelomeningocele repair, the peds surgeons start the operation and open the uterus

Really, not an Ob-Gyn?

It doesn't seem like you need a Pediatric Surgeon (whom may not have "opened a uterus" since medical school), if that's all they're doing.

..., at which point the peds neurosurgeons take over and do the actual operation on the fetus. That's how it works at my school, at least.

But the more important point is that you don't even need to do a fetal surgery fellowship after peds surgery in order to do fetal surgery; pediatric surgeons can operate on fetuses, and in fact most people who perform fetal surgery only have done general surgery residency + peds surgery fellowship (without any specific fetal surgery training).

Fair enough. Im aware that pediatric surgeons can operate on fetuses, its just extremely rare outside of a few centers and its not the question the OP asked (he asked where the fellowships were).

 

[aalamruad]

Really, not an Ob-Gyn?

It doesn't seem like you need a Pediatric Surgeon (whom may not have "opened a uterus" since medical school), if that's all they're doing.

Yeah, I'm not sure why the peds surgeons do it, and maybe ob/gyns do it sometimes, but peds surgeons are typically more experienced in fetal surgery than peds neurosurgeons so perhaps they're there to help with potential complications that the peds neurosurgeons aren't as familiar with

Fair enough. Im aware that pediatric surgeons can operate on fetuses, its just extremely rare outside of a few centers and its not the question the OP asked (he asked where the fellowships were).

Agreed, I'm just saying that it's probably pretty pointless for OP to even think about fetal surgery super-fellowships given that 1) s/he's 16+ years away from that, and 2) you don't even need the fetal surgery fellowship to do fetal surgery, but point well taken

 

[Winged Scapula]

Yeah, I'm not sure why the peds surgeons do it, and maybe ob/gyns do it sometimes, but peds surgeons are typically more experienced in fetal surgery than peds neurosurgeons so perhaps they're there to help with potential complications that the peds neurosurgeons aren't as familiar with

Likely just local cultural differences.

The peds surgeons are going to be more comfortable in the abdomen but usually not around the uterus, but if it works, who's to complain?

 

[Buzz Me]

Cardiothoracic surgery (peds/congenital) will also operate on neonates. But not fetuses.

 

[aalamruad]

Cardiothoracic surgery (peds/congenital) will also operate on neonates. But not fetuses.

There are a handful of doctors operating on fetal hearts (but they're probably not CT surgeons). I know of some intrauterine procedures for aortic stenosis being done in LA, and last year the head of the Fetal Heart Program at CHOP removed a heart tumor at 24 weeks of gestation. Pretty incredible stuff, but it's a ridiculously tiny field right now.

 

[Buzz Me]

There are a handful of doctors operating on fetal hearts (but they're probably not CT surgeons). I know of some intrauterine procedures for aortic stenosis being done in LA, and last year the head of the Fetal Heart Program at CHOP removed a heart tumor at 24 weeks of gestation. Pretty incredible stuff, but it's a ridiculously tiny field right now.

Don't know much about this...but that's terrifying if they're not cardiothoracic surgery trained.

 

[aalamruad]

Don't know much about this...but that's terrifying if they're not cardiothoracic surgery trained.

Actually upon reading up on the case again it looks like a congenital heart surgeon was involved in the tumor resection, but it's generally just peds interventional cardiologists treating fetal aortic stenosis, not CT surgeons

 

[Buzz Me]

Actually upon reading up on the case again it looks like a congenital heart surgeon was involved in the tumor resection, but it's generally just peds interventional cardiologists treating fetal aortic stenosis, not CT surgeons

Ah, that's a little different. May involve percutaneous valvuloplasty (or something similar) then. Not quite "fetal surgery."

 

[aalamruad]

Ah, that's a little different. May involve percutaneous valvuloplasty (or something similar) then. Not quite "fetal surgery."

True