Rotations in the NICU

[FutureBabyDoc]

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What different residencies and fellowships do rotations in the NICU? I know Peds Residencies and Neonatal Fellowship, but are there others as well? Just curious.

 

[TexasRose]

I know pedi cards sees patients in the NICU, as do many other specialties like ophtho, pedi ID, pedi GI, pedi surg, etc. ( all of which are fellowships except ophtho)

 

[oldbearprofessor]

What different residencies and fellowships do rotations in the NICU? I know Peds Residencies and Neonatal Fellowship, but are there others as well? Just curious.

I think the question you are asking is what residencies actually do a month rotation in an NICU?

I am aware of OB/Gyn, family medicine and of course med/peds that routinely do rotations in an NICU settings. Except for med/peds (which is peds), I think in most places the others will do Level 2 primarily, although this may not be true everywhere, especially in hospitals without a pedi residency.

Sometimes pedi surg fellows will spend a month with us also.

Rarely, EM fellows may have some nursery time.

You didn't ask this, but about the only pedi specialty that DOESN'T see patients in an NICU is rheum (well, adol medicine too, I suppose...). Whenever we get a baby with heart block from lupus I call rheum just to let them know and see if I can get them to come down.

 

[Apollyon]

Rarely, EM fellows may have some nursery time.

My EM residency was going to do NICU time in the 3rd year, until cooler heads prevailed. My "peds" inpatient rotation was in the level 2 nursery at a community hospital, with also covering any peds patients that hit the ED (about 1/call day or night - it was 10hr/14 shift work). Beyond my hands and arms being the cleanest EVER, I learned more than I needed (and now have forgotten) about formula feeds. Otherwise, the yield (for me as EM resident, and now attending) was low.

The residents now do either 1 or 2 weeks of well-baby nursery ("10 fingers, 10 toes, and an ***hole, NEXT!" <-- verbatim quote), and split the other half with the peds floor (I think). No NICU. Even when I rotated in the PICU, still, the NICU stayed separate - on the other side of the wall, and I never went there once.

 

[oldbearprofessor]

My EM residency was going to do NICU time in the 3rd year, until cooler heads prevailed. My "peds" inpatient rotation was in the level 2 nursery at a community hospital, with also covering any peds patients that hit the ED (about 1/call day or night - it was 10hr/14 shift work). Beyond my hands and arms being the cleanest EVER, I learned more than I needed (and now have forgotten) about formula feeds. Otherwise, the yield (for me as EM resident, and now attending) was low.

The residents now do either 1 or 2 weeks of well-baby nursery ("10 fingers, 10 toes, and an ***hole, NEXT!" <-- verbatim quote), and split the other half with the peds floor (I think). No NICU. Even when I rotated in the PICU, still, the NICU stayed separate - on the other side of the wall, and I never went there once.

I agree that an NICU would be low yield for an EM residency. What they need is to become comfortable with two things. First is the occasional premie who drops in unannounced, usually in the middle of nowhere and always between 2 and 5 AM.😳 A level 2 week or so could accomplish this, I suppose, but it would be low-yield time.The other is the differential and management of a < 10 day old baby who shows up shocky in the ER. This is an extremely difficult differential to make quickly (sepsis/cardiac/metabolic/RARELY if ever trauma) but crucial to get right quickly or at least cover all the bases completely and quickly. I don't think that a month rotation in the NICU will help much with this, it takes experience and a clear approach to evaluation. For better or worse, this isn't common (well, I get involved in a case that presented to an ER almost every week I'm on service, but that covers a lot of referring hospitals), so it isn't easy to get the experience.