Fellowship Training Program

Introduction

The Neonatal Division at Rainbow Babies & Children's Hospital is widely regarded as playing a leadership role in this subspecialty at the regional and national level. This prominence comes from several decades of high quality clinical care, acquisition of new therapies from well designed clinical trials, basic physiologic and biologic studies encompassing the developing nervous and respiratory systems, pioneer studies in the neurodevelopmental outcome of low birth weight infants, and high quality text books written and edited by division faculty.

Clinical Program

The Neonatal Intensive Care Unit (NICU) is a centerpiece of the Neonatology Division's program. The survival rate equals the best for high-risk newborns in the nation. We are a founding member of the National Institutes of Health (NIH) Research Network which has performed landmark clinical trials providing the foundation for practice of evidence-based medicine. The NIH also supports numerous studies by Rainbow's NICU physician-scientists, and is an important setting for translational research from bench to bedside. The work of Rainbow's researchers and the quality of clinical care have earned the NICU program the reputation of one of the best of its kind in the world. The NICU has approximately 1200 admission each year, including close to 200 infants with birth weights below 1.5 kilograms, and a broad variety of complex patients often referred from other tertiary units.

The Division of Neonatology at University Hospitals Health Systems, Inc. comprises 18 faculty, of whom 16 participate in clinical care at Rainbow and University Hospitals Health System's affiliated sites. Many other professionals complement the care-giving team. The strength of the unit is this outstanding team of physicians and support staff, including neonatal nurse practitioners, nurses, respiratory therapists, social workers, and physical and occupational therapists. The NICU is a major referral source for infants in cardiorespiratory failure, including candidates for ECMO and nitric oxide therapy. Furthermore, the Department of Pediatrics at Rainbow has a full cadre of subspecialists who are supported by pediatric surgical subspecialists.

Education

The Division of Neonatology at Rainbow is internationally recognized as a leading educator of pediatricians, with the ability to recruit and retain talented doctors from around the world. It is the superior training provided by Rainbow's neonatologists that attracts the brightest young pediatricians to the fellowship program in our area. This training has helped Rainbow fellows to go on to hold senior positions in neonatology at leading medical institutions worldwide. To date over 60 neonatologists have been trained, of whom over 25 are in academic medicine in the United States. Apart from the usual teaching initiatives, this Division has a rich tradition of writing and editing text books. Four texts are currently active: Neonatal/Perinatal Medicine [Fanaroff & Martin], Care of the High Risk Neonate [Klaus & Fanaroff], Yearbook of Neonatal/Perinatal Medicine [Fanaroff, Maisels and Stevenson], and Procedures in Infants and Children [Walsh-Sukys & Krug].

Research

A research project is a required part of the fellowship. High quality clinical and biologically-based scientific pursuits are an essential feature of the Division. Dr. Fanaroff has played a leadership role in the NICHD Neonatal Research Network since its inception and is ably supported in this endeavor by Drs. Walsh-Sukys and Hack. Our continued Network participation provides us access to comparative clinical data from comparable academic centers nationwide, allows participation in pioneering clinical trials, and provides us a prestigious designation among our peers.

Dr. Maureen Hack holds a unique position among only a handful of leaders in studying the long term neurodevelopmental outcome of low birth weight infants. She is highly productive and well-funded and has mentored many fellows in performing landmark studies of follow-up on the developmental and growth outcomes of the survivors of neonatal intensive care. Dr. Richard Martin is a leader in the field of neurobiology of breathing, focusing on control of breathing and airway maturation in neonates. He has been continuously funded by the National Institutes of Health for over 20 years. Research interests include the epidemiology of neonatal apnea and the role of nitric oxide in modulating airway contraction as it pertains to neonatal lung injury. Dr. Cynthia Bearer's research is nationally funded to characterize the basic mechanisms whereby environmental toxins and, in particular, fetal ethanol exposure adversely affect fetal brain maturation. In addition to this diversity of NIH-supported research, numerous faculty members are performing creative clinical studies with the potential for significant impact in understanding neonatal pathophysiology and its management. The situation of Rainbow on the Case Western Reserve University campus makes for ready access to a wealth of scientific collaborators within the medical school. Faculty members within the Division hold joint appointments in Neuroscience and Physiology.

For more information, contact Cynthia Bearer, MD, PhD, Director, Fellowship Program.

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