Educational Environment
Fellowship Tracks
We are wholly committed to educating our trainees to become exemplary neonatologists who can provide outstanding neonatal-perinatal clinical care for premature babies and newborns exhibiting all levels of illness. Several of our graduating fellows wish to embark upon an academic career; many are inspired to become innovative physician scientists or passionate educators. To support our Neonatal-Perinatal Fellows in finding their area of expertise, we encourage them to choose from one of three tracks individualized to fit their primary interests. Each of these tracks have been carefully designed by our experienced faculty in the Division of Neonatology so that fellows can develop the skills to become experts in their chosen professional careers.
- Research Fellowship Track
- Medical Educator Fellowship Track
- Clinical/QI Fellowship Track
Clinical Block Schedules
FIRST YEAR BLOCK DIAGRAM
| 4 week block | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Orientation 75% Clinical 25% | UH NICU Clinical 100% | Research 80% Clinical 20% | Delivery Team Clinical 100% | Research 80% Clinical 20% | Research 60% Clinical 15% Vacation 25% | MFM Clinical 100% | Research 75% Vacation 25% | UH NICU Clinical 100% | Research 80% Clinical 20% | Research 80% Clinical 20% | Research 60% Clinical 15% Vacation 25% | Peds Cardiac ICU Clinical 100% |
SECOND YEAR BLOCK DIAGRAM
| 4 week block | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Research 80% Clinical 20% | UH NICU Clinical 100% | Research 80% Clinical 20% | Research 60% Clinical 15% Vacation 25% | Delivery Team Clinical 100% | Research 80% Clinical 20% | UH NICU Clinical 100% | Research 75% Vacation 25% | BAMC NICU Clinical 100% | Research 80% Clinical 20% | Research 80% Clinical 20% | UH NICU Clinical 100% | Research 60% Clinical 15% Vacation 25% |
THIRD YEAR BLOCK DIAGRAM
| 4 week block | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Research 80% Clinical 20% | Research 60% Clinical 15% Vacation 25% | Delivery Team Clinical 100% | Research 80% Clinical 20% | Research 80% Clinical 20% | Research 60% Clinical 15% Vacation 25% | UH NICU Clinical 100% | Research 80% Clinical 20% | UH NICU Clinical 100% | Research 80% Clinical 20% | Research 80% Clinical 20% | UH NICU Clinical 100% | Research 75% Vacation 25% |
Sick: 10 days per year
Fellows attend PREMIEre Clinic on average of 20 half days per year
Call averages 1x/week with one call free block per year
Conferences
| Frequency | Conference Name | Time | Brief Description |
|---|---|---|---|
| 1st Monday | Prenatal Diagnosis Multidisciplinary Conference (PDMC) | 0730-0830 | Combined conference with MFM fellows and faculty. Discussions of maternal/fetal high risk list followed by case presentation from MFM and Neonatology fellow. |
| All Tuesdays | Medical Knowledge/Fellow Didactic | 0800-0900 | During medical knowledge review, fellows receive protected time to read/study or prepare presentations. During fellow didactic, faculty give fellows didactic on topics following the fellow curriculum schedule. |
| All Tuesdays | BPD Rounds | 1200-1300 | The inpatient BPD team is a multidisciplinary team (Neonatology, Pulmonology, Otolaryngology, Cardiology, Palliative Care, Pharmacy, Dietary, Care Coordinators, Therapists, and Child Life Specialists). Team rounds on and discusses care for patients needing mechanical ventilation via endotracheal tube or tracheostomy, and nasal cannula. Rounds focus on respiratory support, nutrition, developmental milestones and family-centered care. |
| 4th Tuesday | Thematic Journal Update | 1500-1700 | Presenter (fellow or faculty) chooses pic of interest and chooses 8-10 articles to review. All fellows/faculty in attendance choose an article to review and give short presentation of article to the group. This conference allows continual review and practice of evidence-based medicine. |
| All Wednesdays | Morning Report | 0830-0930 | Fellow on service will present patients of high interest with ongoing diagnostic or therapeutic issues in the NICU. Fellows, faculty, NNPs in attendance participate in discussions and provide ideas, questions, interpretations and recommendations. |
| 3rd Wednesday | Pediatric Surgery Conference | 0730-0830 | Fellow presents surgical case and discussion of surgical management ensues with the pediatric surgeon in attendance. The goal is to obtain better understanding of surgical management pre- and post-operatively as well as review quality improvement initiative and patient reviews with the surgical team. |
| 4th Wednesday | Journal Club | 0730-0830 | Fellows and faculty from UTH-SA and BAMC attend the combined activity. One fellow and staff are responsible for selecting appropriate article for review. Goal is to practice the methodology of reviewing articles and evaluating them based on scientific method, validity and appropriateness, as well as the context and potential impact on practice. |
| All Wednesdays | Discharge Planning | 1400-1500 | Weekly meeting attended by on-service fellow, faculty, NNP, social work, CPS caseworker, PT/OT/ST, Premiere clinic coordinator and continuity care coordinator. Each patient is reviewed in terms of family support, psychosocial, and discharge planning needs. |
| 2nd and 4th Thursday | Combined Fellow Curriculum | 1200-1300 | Attended by all pediatric and medicine subspecialty fellows to cover common fellowship requirements (i.e. teaching skills, ACGME common requirements, sleep and fatigue, wellness, biostatistics and epidemiology, etc.). |
| 1st Thursday | Morbidity Case Conference | 1300-1400 | Fellows present interesting clinical cases to Pediatric residents, Neonatal fellows and faculty in the form of didactic lecture on selected topic. Fellows review current literature and incorporate this into their talk. |
| All Thursdays | Neonatal Nutrition and GI Multidisciplinary Rounds | 1200-1300 | Multidisciplinary rounds (Neonatologist, dieticians, GI team, Pharmacist, and nutrition research team) to discuss all patients with nutrition and GI needs. Time is dedicated to review and implement guidelines and research protocols. |
| All Thursdays | Fellow Board Review | 1400-1600 | Fellows and one faculty member meet weekly to go over board review questions. Questions are chosen by the PD to coincide with the ABP content specifications topic of the month. |
| 3rd Thursday | Mortality Conference | 1600-1700 | Cases of patient deaths are discussed monthly with OB/MFM, Neonatology, and Pathology. Maternal history and delivery are reviewed by MFM fellows and neonatal course reviewed by NICU fellows. Autopsy or placental path result are reviewed by a pathologist. |
| 4th Thursday | Resident Morning Report: Neonatal Cases | 0800-0830 | Residents hold morning report 4 days a week, but Thursdays are dedicated to reviewing Neonatal cases. Residents present an interesting neonatal case reviewing the differential diagnosis, management and treatment options. |
| All Fridays | Pediatric Grand Rounds | 0730-0830 | Invited speakers present cutting-edge information in pediatric clinical care, research, education, community service and global health. |
| Quarterly | Neonatal Fellow Simulations | Quarterly interprofessional team training with Neonatal fellows, NICU nurses, NNPs, RTs, and pharmacy residents. | |
| Quarterly | Neonatal Scholarly Oversight Committee Meetings | Fellows present their research progress, future plans, and timeline for work product completion to the Neonatal Scholarly Oversight committee quarterly. All faculty are encouraged to attend to keep up to date with fellow research endeavors. | |
| Quarterly | Wellness Breaks | Wellness chief fellows coordinate one afternoon quarterly to focus on wellness. | |
| Throughout the year | Invited Speakers | Throughout the year we have invited speakers from around the world give lectures to the division. While here the speakers spend a morning with the fellows to discuss their research projects and career goals. |
Additional Certificates of Training
Master of Science in Clinical Investigation and Translational Science
Clinical Safety and Effectiveness Course
Grant Writing Seminars
Certificate in Translational Science (CTS)
Certificate in Biomedical Data Science (CBDS)
Simulation
The UT Health’s Neonatology Fellowship Simulation Program is a simulation based training program started in January of 2017. The program’s primary objectives are:
- Quarterly interprofessional team training with UT Neo Fellows, University Hospital NICU nurses and respiratory therapists
- Drill scenario and learning objectives dealing not only with cognitive and technical knowledge review and affirmation but to emphasize behavioral knowledge practice
The program’s focus on acute crisis management is in the form of efficient teamwork actions, acknowledged communication and vital leadership skills in accordance with the goals of the team training program TeamSTEPPS™. These acquired behavioral knowledge skills benefit from practice in simulated clinical scenarios.
The program also emphasizes a professional business-like approach to post-event debriefing & how team performance is affected by individual actions, which in turn ultimately affects patient care.
The program has been able to evaluate the need for a delivery room checklist by neonatology fellow led delivery room teams for Extremely Low Birth Weight (ELBW) infant births. The data has been presented at an international pediatric simulation conference and will soon be submitted for publication.
Our future goals include incorporating Rapid Cycle Deliberate Practice simulation methodology into the program as well as expand the role and participation of ancillary providers.
Neonatal-Perinatal Research Conference at Alamo City
UT Health San Antonio’s Division of Neonatology holds an annual Neonatal-Perinatal Research Conference intended for Neonatal-Perinatal Fellows and Pediatric Residents with an interest in Neonatology who want to share their research with leaders in neonatal nutrition in a relaxed but scientific environment. Trainees submit an abstract and application. Up to 30 fellows and 5 residents from across the country are selected to attend this meeting. Scholars are invited to present their research in a 10 minute platform presentation. Information pertaining to our upcoming conference can be found here.
Flipped Classroom
Dr. Vasquez is a member of the Organization of Neonatal Training Program Directors (ONTPD) National Neonatology Curriculum (NNC) executive committee. The committee is working on pooling resources to develop a shared standardized, high quality, peer reviewed national physiology curriculum for Neonatal-Perinatal Medicine fellows using online videos for knowledge acquisition paired with flipped classrooms. Content is based on the American Board of Pediatrics (ABP) content specifications for Neonatal-Perinatal Medicine board certification. The Neonatal-Perinatal “NeoFlip” curriculum can be found here.
National Board Review Conferences
There are currently two national Neonatology Board Review courses offered every two years in alignment with the years of the American Board of Pediatrics Neonatal-Perinatal Medicine board certification. Each of our Neonatal Fellows are given the opportunity to attend one of the two courses in the years they are offered.