An initiative of
Dr. Ayman Sheta
Program Director
Hannah Mance
This residency program is for 2 years.
Program length of training does not exceed the Royal College or College of Family Physicians of Canada standard.
The Neonatal-Perinatal Medicine Fellowship Program at the University of Manitoba is a two-year program (extendable to a third year, provided for exceptional candidates to support and develop their Academic/Research expertise) with full accreditation from the Royal College of Physicians and Surgeons of Canada. Fellows also may be eligible to take the American Board of Pediatrics examinations.
We currently have 15 Neonatologists at the University of Manitoba. There are 2 primary training sites in Winnipeg, the new Women’s state-of-art Hospital commissioned in December of 2019 with a 60 bed mixed acuity Neonatal Intensive care unit and the St. Boniface Hospital 33 bed mixed acuity Neonatal Intensive Care Unit
Our Fellowship program concentrates equally on clinical and research skills and in addition provides an opportunity to acquire clinical neonatal transport skills with an objective of training the future leaders in neonatal- perinatal medicine. The entire faculty in the section of Neonatology is invested in the success of the Fellowship program, with strong support from the Department of Pediatrics and Child Health, University of Manitoba and the Shared Health.
Fellows participate in a formal teaching curriculum including a biweekly academic full-day and bi-weekly newborn /subspecialty education rounds. Participation in research (clinical or basic science) is expected; with Fellows oriented to research in their first year and joining on-going research projects or starting their own projects early in their second year.
Opportunities for internal and faculty wide mentorship in research in a wide variety of areas including multicenter clinical trials, research in quality and safety, neonatal sleep laboratory, high risk follow-up, basic science and translational research with opportunities to work with researchers at the Children’s Health Research Institute of Manitoba (CHRIM).
An exciting educational curriculum incorporating clinical simulation both in a dedicated In-Unit Simulation room as well as at the Clinical Learning and Simulation Facility at the University of Manitoba is available for developing competency in and mastering procedural, crisis management, leadership and research skills.
A structured program in developing skills in Neonatal Hemodynamics including TnEcho, innovative point of care lung ultrasound and integrated neonatal neuro-intensive care training is part of the program. Using ultrasound to evaluate babies with Necrotizing enterocolitis is one of the important training assets for our trainees.
Our Neonatology units routinely look after infants 23 weeks and/over(resuscitating babies ≥22 weeks gestation is starting soon). We utilize pressure-limited, volume regulated ventilation with Drager ventilators/VN-500 and also routinely use both Nasal High frequency Oscillatory ventilation, High Frequency Jet Ventilation and Inhaled Nitric Oxide. We are not an ECMO center, however efforts have been going on to establish ECMO prior to transfer. We receive these infants back for post-operative care.
Neonatal Fellows in our program undergo a clinical first year (NICU, Neonatal Follow-up, Perinatology Clinic and neonatal transport). Those who are successful in their first year complete a more research-oriented second year. An optional 3rd year is available, for those interested in academic neonatology, granted upon approval of the Scholarly Oversight Committee. Applicants must show success in each year in order to be considered for a second or third year of funded training. Faculty Mentorship and oversight is provided to each of the fellows to help them achieve their full potential.
* Please note Neonatal- Perinatal Medicine Program moved to a RCPSC competency curriculum in July 2021. The description provide below is an overview of existing program for the current year.
GENERAL DESCRIPTION OF PROGRAM
| Program Year |
Content and Sequence of Rotations Number of Months (or 4-week blocks) |
||||||||||||
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | |
|
First |
Clinical Neonatology |
Research or Elective | High Risk Follow up | Maternal Fetal Medicine |
Vac |
||||||||
|
Second |
Clinical Neonatology |
Perinatal Research |
Vac |
||||||||||
| Third | Opportunities to Develop Academic/ Research Excellence | Vac | |||||||||||
FIRST YEAR
Clinical Neonatology (9 periods)
Sites:
Women’s Hospital, Health Sciences Centre
St. Boniface Hospital NICU
The first year in the neonatal residency program concentrates on development of clinical neonatal skills. The subspecialty resident undergoes a total of 9 periods of clinical neonatology split between the level II/III NICUs at the Women’s Hospital (Health Sciences Centre) and St. Boniface General Hospital. At both institutions the trainee attends high-risk deliveries and takes part in the subsequent management of sick neonates in the intensive care nurseries, including care of the general surgical neonate. Women’s Hospital (Health Sciences Centre) as well as the SBH NICU provides further experience in care of chronic infants, healthy growing premature newborns, and additional exposure to Neonatal resuscitation at the labour and delivery floor. Junior residents from Pediatrics, Obstetrics/Gynecology, Family Medicine and Anesthesia also rotate in these services. The Neonatal resident is expected to develop a supervisory role over the course of the year. In addition, consultations to other subspeciality services are assigned to the Neonatal resident under supervision by the attending Neonatologist.
Maternal-Fetal Medicine (1 Period)
Sites:
Fetal Assessment Clinic at Women’s Hospital
Fetal Assessment Clinic at St. Boniface Hospital
The first year includes a 1 period exposure to Maternal-Fetal medicine through the Fetal Assessment Unit which is involved in outpatient high-risk obstetric care. Residents are involved in the antepartum care of high-risk obstetrics patients (high risk due to maternal health or fetal anomalies). Residents participate in consultations to the neonatology under supervision by an attending Neonatologist.
Newborn Follow-up Rotation (1 Period)
Sites:
Newborn Follow-up Clinic at Children’s Hospital
Newborn Follow-up Clinic at St. Boniface General Hospital (located at the SCCY Center)
The first year also includes a 1 period exposure to developmental follow-up of NICU graduates through the High-Risk Follow-up Program. Residents are exposed to the practice of Developmental Pediatrics as it applies to graduates of the NICU. They are exposed to the day-to-day function of the multi-disciplinary clinic and the use various tools for developmental and neurologic assessment (BINS and Bayley, etc.). The resident is also exposed to the function and utility of the follow-up database.
Research or Elective (1 Period)
The first year includes a period of either elective or dedicated research time. Elective can be taken in all fields of clinical and subspecialty Pediatrics available at the University of Manitoba. Electives in other teaching centres (Canadian and abroad) are allowed on consideration by the residency program committee. Such electives must be supervised and must have formalized objectives and evaluations.
SECOND YEAR
Research (6-9 periods)
The second-year concentrates on exposure to research and the development of research skills. 9 periods are dedicated to research. Participation in on-going research projects is encouraged in the first year. During the second year, the resident is expected to be participating in an on-going research project, as well as development of their own research idea and project. Research projects in both basic science (lab) and clinical are accommodated. It is an expectation that the resident will enter the local Pediatric resident and fellow research competition in the second year of the program and to submit an abstract to the Canadian Paediatric Society and/or American Society for Pediatric Research conferences for presentation.
Clinical Neonatology (3-6 blocks)
Sites:
Health Sciences Centre Children’s NICU Women’s Hospital
St. Boniface Hospital NICU
The clinical component in the second year involves 3-6 periods of clinical Neonatology. Emphasis is placed on graduated responsibility. The resident is expected to provide less role in direct hands-on patient care and more supervisory role of junior residents including junior Neonatal residents. The resident is also assigned weeks of junior attending where they provide the day-to-day management of patient care in the NICU and carry out the responsibility of decision-making. During all such exposures, the resident is under the supervision of an attending Neonatologist.
THIRD YEAR
For those residents who plan to pursue an academic career, a third year of training is strongly encouraged. A separate application is required detailing specific goals and objectives for a third year of training as well as sources of funding. Not all residents will be approved for a third year of training. The structure of the third year is variable to fit the varied academic goals.
Applying Competency-based practices to residency education
Residents entering the Neonatal- Perinatal Subspecialty program in July 2021 and beyond, experience competency-based training.
To contribute to the success of Canadian physicians and the delivery of high-quality patient care, the Royal College of Physicians and Surgeons of Canada has embarked upon an initiative to introduce competency-based medical education (CBME) in Canadian postgraduate specialty training and in professional practice in Canada. This initiative, called
Competence by Design (CBD), aims to enhance patient care by aligning medical education and lifelong learning with evolving patient needs and empowering learners to more fully engage in their education process.
CBD will use time as a framework rather than the basis for progression. It is not anticipated that the duration of training will change for the majority of trainees. Residency programs will be broken down into stages, and each stage will have a series of milestones based on required competencies. These milestones will create more targeted learning outcomes and involve more frequent, formative assessments within the clinical workplace to ensure residents are developing and receiving feedback on the skills they need.
All programs implementing CBD will continue to undergo the same rigorous accreditation processes as traditional programs. All CBD programs (and traditional programs) will continue to lead to Royal College approved certification. Certification for trainees in both CBD and traditional programs will include the completion of a Royal College examination; however, residents in CBD programs will also be assessed against program milestones throughout their training. Within a CBD program, all milestones and the Royal College examination must be successfully completed to achieve certification.
For more information, please contact cbd@royalcollege.ca
MANDATORY ACADEMIC COURSES AND REQUIREMENTS
In addition to the clinical and academic requirements outlined in the rotation objectives, the Neonatal subspecialty resident MUST complete the following courses as part of their subspecialty training. The list is compiled by year of training.
Completion by First Year of Training
Principles of Epidemiology
NRP Provider Status
CAMATA (Canadian Aerospace Medicine and Aeromedical Transport Association) Air Medical Training Course
TIPS Course
PICC (percutaneously inserted central catheter) Certification
Completed by Second Year of Training
NRP Instructor Status
-must be completed within 2 years of training
-must have completed team teaching to obtain full NRP Instructor Status
-courses offered at Health Science Centre
-information available from Manitoba NRP Advisory Group
Biostatistics Level I Course
-must be completed by 2nd year of training
-recommended to take course in 2nd year
-course offered at University of Manitoba
