There are various conferences that occur at regular intervals throughout the entire Neonatal fellowship training. Fellows are required to attend all conferences unless they are on vacation, post call, or if the conferences would put them in violation of their duty hours. Faculty are to cover clinical and patient care so fellows may attend the conferences.
All available staff, NNPs, and fellows attend this report. The fellow on service will be primarily responsible for presenting patients.
The fellow is expected to present
New level III admissions since the last morning report
High interest patients with ongoing diagnostic or therapeutic issues in the NICU
Unresolved topics of interest discussed at the prior morning report
The on-service fellow and staff will decide the main focus of patient/issue discussion prior to the morning report. Fellows will be evaluated based on ability to present complex patients efficiently, completely and accurately, ability to focus and expand on pertinent issues involving diagnosis (diagnostic tests and differentials) and therapy (standard and experimental) and ability to discuss current literature. All fellows are required to participate in discussions and provide ideas, questions, interpretations and recommendations. The goal is for fellows to develop a strong sense of teamwork in medicine. Additionally, topics discussed will include ethical, psychosocial and medical-economic aspects of care. Staff is encouraged to provide clarifying and guiding questions, but to allow fellows to work out questions and issues before providing input.
Combined morning report
This conference is attended by all available SAMMC and University Faculty as well as by all fellows from both programs. Fellows on service at University, SAMMC, and Santa Rosa will present interesting patients for review and discussion among the entire group. This conference allows fellows to see the various management styles at the different institutions and provides forum for discussion of cases.
This conference is designed to enhance communication between Obstetrics (OB) and Pediatrics. The OB residents under supervision of the MFM staff will present all inpatient OB patients. Aside from simple information sharing, discussions will focus on diagnosis and therapy, as well as anticipated complications. Fellows are encouraged to ask questions of the MFM staff and to target reading based on anticipated upcoming admissions. The on-service fellow will then be expected to provide a brief update of those NICU patients delivered at UH of interest to the OB team.
Morbidity Case Conference
All fellows and available neonatologists attend this conference. In addition the pediatric residents on the NICU and Newborn service as well as the medical students attend this conference. The assigned Neonatal Fellow presents an interesting case and provides additional teaching in the form of lecture and power point on the selected topic. Fellows are expected to review current literature and incorporate this into their talk. The presentation will then lead to a discussion among the group. The presenting fellow is encouraged to invite appropriate subspecialists to highlight discussion. Fellows will be evaluated based on presentation efficiency and accuracy and the ability to target the discussion.
Patient deaths for the previous month will be discussed at this conference. OB residents will discuss the mom’s history and delivery and the Neonatal fellow will discuss the infant history. A pathologist will review with the group any pertinent pathological information. If an autopsy is done, the pathologist will review the pictures and slides of the autopsy. Cases and cause of death will be discussed among the OB, pathology, and NICU staff and fellows.
All available neonatal staff and fellows from SAMMC, UTHSCSA, and affiliated SRCH faculty will attend this combined activity. One fellow and one staff will be responsible for selecting appropriate articles and disseminating them to the groups at all teaching hospitals in sufficient time before the journal club. The goal is to teach fellows the methodology of reviewing individual articles and evaluating them based on scientific method, validity and appropriateness, as well as the context and potential impact on practice. Presentations will be evaluated based on thoroughness and depth of analysis.
Fellow Didactic Lectures
These lectures will be given by neonatal staff UTHSCSA as well as invited guests presenting topics of perinatal interest. In addition, all fellows will be responsible for giving one didactic lecture per year. Topics are based on the content specifications outlined by the ABP. During the first three months of the academic year, essential lectures will be given (ventilator management, fluid management, etc.) annually with remaining material being covered on a rotating three-year schedule. The goal of the core lecture series is to cover basic pathophysiology and clinical material pertinent to the neonatal-perinatal subspecialty board exam, as well as to touch on “state of the art” clinical practice and ongoing research for selected topics. Fellow lectures will be evaluated based on clarity and content of material, as well as the ability to effectively present to the target audience.
Fellow research updates will be given to the division in the fall and spring of each year, to coincide with upcoming presentations to be given at regional and national meetings. The purpose is to allow for staff and fellow input and guidance, as well as ensure steady progress and setting of realistic goals and objectives. Additional meetings will be arranged for fellows to practice their upcoming presentations at meetings, to include combined research conferences with UTHSCSA and SRCH affiliated faculty. Fellows will be evaluated based on ability to meet the individual goals set out by the fellow and research mentor, to present a hypothesis and present their plans and, when available, supporting data and interpretations.
This weekly meeting is attended by the on-service fellow and staff, social work, CPS caseworker, PT/OT/ST, Premiere clinic coordinator and continuity care coordinator. During this meeting each patient in the NICU will be discussed in terms of family support needs, psychosocial needs and discharge planning needs.
There are two board review conferences. The first is at SAMMC, this is a fellow-driven conference, currently based on the NeoReviews and the questions from NeoReviews Plus. The second board review is at UH. This board review is based off of readings from Fanaroff and Martin. Neonatal attendings rotate leading these reviews. Fellows are expected to do the readings and be involved in the discussions on the topic. Fellows also answer board type questions to further their education and prepare for the board exam.
Prenatal Diagnosis Multidisciplinary Conference
This is a combined conference with MFM fellows and faculty. All neonatal fellows and faculty attend. MFM and Neonatal fellows are required to present a case. The respective fellows discuss maternal, fetal and neonatal aspects in the case presentations. Following 30 minutes of case presentation, MFM and Neonatal faculty and fellows hold discussions on the topic. The goal of this conference is to keep open communication between MFM and Neonatology as well as for fellows to get a better understanding of maternal and fetal care.
Pediatric Surgeons Conference
Neonatal faculty and fellows as well as 1-2 pediatric surgeons attend this conference. The neonatal fellow presents a surgical case and discussion of surgical management ensues with the pediatric surgeon. The goal of this conference is to obtain a better understanding of surgical management pre and post-operatively as well as to maintain good communication with our pediatric surgeons.
Thematic Journal Update
The presenter of this conference (fellow or faculty) chooses a topic of interest. They review all current literature on the topic of choice and select 10-15 articles to review. All fellows and faculty in attendance chooses one of the articles to present to the group in approximately 5 minutes. This conference allows continual review and practice of evidence-based medicine.