The Maturation of a Proficient Neonatologist: From the Delivery Room to Independent Practice.

Abstract

* Abbreviations: ACGME — : Accreditation Council for Graduate Medical Education ELBW — : extremely low birth weight GME — : graduate medical education NPM — : neonatal-perinatal medicine VLBW — : very low birth weight A critical question for all pediatric fellowship training programs is whether the clinical experiences and education provided prepare trainees for “life after fellowship.” One essential potential exposure gap for fellows in neonatal-perinatal medicine (NPM) is in delivery room resuscitation of extremely preterm infants. These deliveries are rare (∼1% of all deliveries), and numbers vary considerably between training sites. Accreditation Council for Graduate Medical Education (ACGME) program requirements for graduate medical education (GME) in NPM include the provision of patient care experiences that are necessary for fellows to acquire skill in delivery room stabilization and resuscitation of critically ill neonates.1 Graduated pediatric residents enter NPM fellowships with wide variation in previous neonatology exposure for both knowledge and procedures because of both decreased exposure and increased supervision. NPM fellowship program directors report perceived deficiencies in preparedness for incoming NPM fellows across multiple domains.2 This variation in preparedness leaves NPM program directors with a complicated problem to tackle: individualized educational training, some of which is at the mercy of available clinical experiences and luck of the draw. The ACGME educational milestones were developed to describe developmental progression through medical training and provide individualized feedback on progression toward competency. However, clear and consistent definitions of competency … Address correspondence to Eric Eichenwald, MD, Division of Neonatology, Children’s Hospital of Philadelphia, 3401 Civic Center Blvd, Suite 2NW28, Philadelphia, PA 19118. E-mail: eichenwald{at}email.chop.edu