Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Perspective
  • Published:

Essentials of Neonatal–Perinatal Medicine Fellowship: careers in Neonatal–Perinatal Medicine

Journal of Perinatology volume 42, pages 1135–1140 (2022)Cite this article

Subjects

Abstract

The clinical and academic landscape of Neonatal–Perinatal Medicine (NPM) is evolving. Career opportunities for neonatologists have been impacted by shifts in compensation and staffing needs in both academic and private settings. The workforce in NPM is changing with respect to age and gender. Recruiting candidates from backgrounds underrepresented in medicine is a priority. Developing flexible positions and ensuring equitable salaries is critically important. Professional niches including administration, education, research, and quality improvement provide many opportunities for scholarly pursuit. Challenges exist in recruiting, mentoring, funding, and retaining physician–scientists in NPM. Creative solutions are necessary to balance the needs of the NPM workforce with the growing numbers, locations, and complexity of patients. Addressing these challenges requires a multi-faceted approach including adapting educational curricula, supporting trainees in finding their niche, identifying novel ways to address work/life integration, and attracting candidates with both diverse backgrounds and academic interests.

Access through your institution
Buy or subscribe

This is a preview of subscription content, access via your institution

Access options

Access through your institution

Buy this article

  • Purchase on SpringerLink
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Philip AG. The evolution of neonatology. Pediatr Res. 2005;58:799–815.

    Article  Google Scholar 

  2. Alpert JS, Coles R. Careers in academic medicine. Triple threat or double fake. Arch Intern Med. 1988;148:1906–7.

    Article  CAS  Google Scholar 

  3. Conti CR. Can the triple-threat academic physician exist in the new millennium? Clin Cardiol. 1999;22:499.

    Article  CAS  Google Scholar 

  4. Stark AR. American Academy of Pediatrics Committee on Fetus and Newborn. Levels of neonatal care. Pediatrics. 2004;114:1341–7.

    Article  Google Scholar 

  5. American Academy of Pediatrics Committee on Fetus and Newborn. Levels of neonatal care. Pediatrics. 2012;130:587–97.

    Article  Google Scholar 

  6. Kourembanas S, Steinhorn R. In-house neonatology: what are we waiting for? Am J Respir Crit Care Med. 2010;182:728–9.

    Article  Google Scholar 

  7. Horgan M. Neonatal outcome: role of change from on-call to in-house coverage model. Pediatr Res. 1997;41:153.

    Article  Google Scholar 

  8. Bensouda B, Boucher J, Mandel R, Lachapelle J, Ali N. 24/7 in house attending staff coverage improves neonatal short-term outcomes: a retrospective study. Resuscitation. 2018;122:25–8.

    Article  Google Scholar 

  9. Johnston L. Neonatology on-call models: a survey of members of the Organization of Neonatal Training Program Directors. unpublished data, 2019.

  10. Wood AM, Jones MD Jr., Wood JH, Pan Z, Parker TA. Neonatal resuscitation skills among pediatricians and family physicians: is residency training preparing for postresidency practice? J Grad Med Educ. 2011;3:475–80.

    Article  Google Scholar 

  11. Freed GL, Boyer DM, Van KD, Macy ML, McCormick J, Leslie LK. Variation in part-time work among pediatric subspecialties. J Pediatr. 2018;195:263–8.

    Article  Google Scholar 

  12. Horowitz E, Feldman HA, Savich R. Neonatologist salary: factors, equity and gender. J Perinatol. 2019;39:359–65.

    Article  Google Scholar 

  13. Freed GL, Moran LM, Althouse LA, Van KD, Leslie LK, Research Advisory Committee of American Board of Pediatrics. Jobs and career plans of new pediatric subspecialists. Pediatrics. 2016;137:e20153298.

    Article  Google Scholar 

  14. Clarke TA, Maniscalco WM, Taylor-Brown S, Roghmann KJ, Shapiro DL, Hannon-Johnson C. Job satisfaction and stress among neonatologists. Pediatrics. 1984;74:52–7.

    Article  CAS  Google Scholar 

  15. Register F. Medicare Program. CY 2021 payment policies under the physician fee schedule and other changes to part B payment policies (CMS-1734-P). 2020. https://www.policymed.com/2020/09/cms-2021-proposed-physician-fee-schedule-updates-to-telehealth-quality-payment-program-and-specialist-reimbursement.html.

  16. Freed GL, Dunham KM, Loveland-Cherry C, Martyn KK, Moote MJ. Private practice rates among pediatric subspecialists. Pediatrics. 2011;128:673–6.

    Article  Google Scholar 

  17. American Board of Pediatrics. Pediatric physicians workforce data book, 2018-2019.

  18. Macy ML, Leslie LK, Turner A, Freed GL. Growth and changes in the pediatric medical subspecialty workforce pipeline. Pediatr Res. 2020;89:1297–303.

  19. National Resident Matching Program. Results and data: specialties matching service 2020 appointment year. Washington, DC: National Resident Matching Program; 2020.

    Google Scholar 

  20. Institute for Healthcare Improvement. IHI Open School. 2021. http://www.ihi.org/education/IHIOpenSchool/Courses/Pages/OpenSchoolCertificates.aspx.

  21. Wall J, Wynne E, Krummel T. Biodesign process and culture to enable pediatric medical technology innovation. Semin Pediatr Surg. 2015;24:102–6.

    Article  Google Scholar 

  22. American Medical Informatics Association. Clinical informatics fellows vital to future of value-based care. 2020. https://www.amia.org/news-and-publications/press-release/clinical-informatics-fellows-vital-future-value-based-care.

  23. Ahn J, Martin SK, Farnan JM, Fromme HB. The Graduate Medical Education Scholars Track: developing residents as clinician-educators during clinical training via a longitudinal, multimodal, and multidisciplinary track. Acad Med. 2018;93:214–9.

    Article  Google Scholar 

  24. Fleming VM, Schindler N, Martin GJ, DaRosa DA. Separate and equitable promotion tracks for clinician-educators. JAMA. 2005;294:1101–4.

    Article  CAS  Google Scholar 

  25. Greenberg L. The evolution of the clinician-educator in the United States and Canada: personal reflections over the last 45 years. Acad Med. 2018;93:1764–6.

    Article  Google Scholar 

  26. Thomas PA, Diener-West M, Canto MI, Martin DR, Post WS, Streiff MB. Results of an academic promotion and career path survey of faculty at the Johns Hopkins University School of Medicine. Acad Med. 2004;79:258–64.

    Article  Google Scholar 

  27. Buckley LM, Sanders K, Shih M, Hampton CL. Attitudes of clinical faculty about career progress, career success and recognition, and commitment to academic medicine. Results of a survey. Arch Intern Med. 2000;160:2625–9.

    Article  CAS  Google Scholar 

  28. Varpio L, Gruppen L, Hu W, O’Brien B, Ten Cate O, Humphrey-Murto S, et al. Working definitions of the roles and an organizational structure in health professions education scholarship: initiating an international conversation. Acad Med. 2017;92:205–8.

    Article  Google Scholar 

  29. Frank JR, Snell LS, Cate OT, Holmboe ES, Carraccio C, Swing SR, et al. Competency-based medical education: theory to practice. Med Teach. 2010;32:638–45.

    Article  Google Scholar 

  30. Nasca TJ, Philibert I, Brigham T, Flynn TC. The next GME accreditation system–rationale and benefits. N Engl J Med. 2012;366:1051–6.

    Article  CAS  Google Scholar 

  31. The Future of Medical Education in Canada – Post-graduate Project. The future of medical education in Canada: a collective vision for postgraduate medical education in Canada. 2012.

  32. Sherbino J, Frank JR, Snell L. Defining the key roles and competencies of the clinician-educator of the 21st century: a national mixed-methods study. Acad Med. 2014;89:783–9.

    Article  Google Scholar 

  33. Simpson D, Brownell Anderson M. Educational scholarship: how do we define and acknowledge it? 2006. www.aamc.org/professional-development/affinity-groups/gfa/faculty-vitae/defining-educational-scholarship.

  34. Bauserman M, Vasquez M, Chess PR, Carbajal M, ONTPD Fellowship Directors Writing Group, Good M.J Perinatol. 2021. https://doi.org/10.1038/s41372-021-00957-3. Online ahead of print.

  35. Good M, McElroy SJ, Berger JN, Wynn JL. Name and characteristics of National Institutes of Health R01-funded pediatric physician-scientists: hope and challenges for the vanishing pediatric physician-scientists. JAMA Pediatr. 2018;172:297–9.

    Article  Google Scholar 

  36. Escobar GJ, Fischer A, Kremers R, Usatin MS, Macedo AM, Gardner MN. Rapid retrieval of neonatal outcomes data: the Kaiser Permanente Neonatal Minimum Data Set. Qual Manag Health Care. 1997;5:19–33.

    Article  CAS  Google Scholar 

  37. Spitzer AR, Ellsbury D, Clark RH. The Pediatrix BabySteps(R) Data Warehouse–a unique national resource for improving outcomes for neonates. Indian J Pediatr. 2015;82:71–9.

    Article  Google Scholar 

  38. Capan M, Hoover S, Jackson EV, Paul D, Locke R. Time series analysis for forecasting hospital census: application to the neonatal intensive care unit. Appl Clin Inf. 2016;7:275–89.

    Article  Google Scholar 

  39. DeChant PF, Acs A, Rhee KB, Boulanger TS, Snowdon JL, Tutty MA, et al. Effect of organization-directed workplace interventions on physician burnout: a systematic review. Mayo Clin Proc Innov Qual Outcomes. 2019;3:384–408.

    Article  Google Scholar 

  40. Accreditation Council for Graduate Medical Education. ACGME program requirements for graduate medical education in pediatric hospital medicine. 2020. www.acgme.org/Portals/0/PFAssets/ProgramRequirements/334_PediatricHospitalMedicine_2020.pdf?ver=2020-06-29-163350-912020.

  41. Toronto Centre for Neonatal Health. Advanced neonatal training: neonatal hemodynamics subspecialty fellowship. Toronto Centre for Neonatal Health. 2021. https://torontocentreforneonatalhealth.com/education-opportunities/fellowships.

  42. University of Iowa Healthcare. Neonatology Hemodynamics Fellowship. 2022 https://gme.medicine.uiowa.edu/neonatology-hemodynamics-fellowship2021.

  43. Boston Children’s Hospital. Heart Center Cardiovascular Intensive Care Clinical Fellowship. 2022. https://www.childrenshospital.org/centers-and-services/centers/heart-center/education-and-training/cardiology-fellowship-program/cardiovascular-intensive-care-clinical-fellowship2021.

  44. Children’s Hospital of Philadelphia. Pediatric Cardiac Critical Care Medicine Fellowship. Children’s Hospital of Philadelphia. 2021 https://www.chop.edu/pediatric-fellowships/pediatric-cardiac-critical-care-medicine-fellowship.

  45. McGill University. Neonatal Hemodynamics Clinical Research Fellowship Program. 2022. https://www.mcgill.ca/peds/education-training/pgme/programs/neonatology/fellowship2021.

  46. Association of Medical School Pediatric Department Chairs. Physician Scientist Development Program. Association of Medical School Pediatric Department Chairs. 2021. https://amspdc-psdp.org/.

  47. Collins JW Jr., David RJ. Racial disparity in low birth weight and infant mortality. Clin Perinatol. 2009;36:63–73.

    Article  Google Scholar 

  48. Lu MC, Halfon N. Racial and ethnic disparities in birth outcomes: a life-course perspective. Matern Child Health J. 2003;7:13–30.

    Article  Google Scholar 

  49. Greenwood BN, Hardeman RR, Huang L, Sojourner A. Physician-patient racial concordance and disparities in birthing mortality for newborns. Proc Natl Acad Sci USA. 2020;117:21194–200.

    Article  CAS  Google Scholar 

  50. Hoffman AM, Lapcharoensap W, Huynh T, Lund K. Historical perspectives: telemedicine in neonatology. Neoreviews. 2019;20:e113–e23.

    Article  Google Scholar 

  51. Lantos JD, Meadow WL. Costs and end-of-life care in the NICU: lessons for the MICU? J Law Med Ethics. 2011;39:194–200.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatrics, Division of Neonatology, University of Connecticut School of Medicine/Connecticut Children’s, Hartford, CT, USA

    Jennifer M. Trzaski

  2. Department of Pediatrics, Division of Neonatology, West Virginia University School of Medicine, Morgantown, WV, USA

    Autumn S. Kiefer

  3. Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Patrick Myers

  4. Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Yale University School of Medicine, New Haven, CT, USA

    Lindsay C. Johnston

  5. Department of Pediatrics, The University of North Carolina, School of Medicine, Chapel Hill, NC, USA

    Melissa Bauserman & Jennifer Wambach

  6. Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    Heather French & Mackenzie Frost

  7. Texas Children’s Hospital, Baylor College of Medicine, Houston, TX, USA

    Kris Reber

  8. Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA

    Erin Cicalese & Robert Angert

  9. Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    Karena Lawrence

  10. Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Brittany Schwarz

  11. Department of Pediatrics, UH Rainbow Babies and Children’s Hospital, Case Western Reserve University School of Medicine, Cleveland, OH, USA

    Allison Payne

  12. Department of Pediatrics, Vanderbilt University Medical Center, Vanderbilt University, TN, USA

    Maria Gillam-Krakauer

  13. Department of Pediatrics, Children’s Mercy Kansas City, University of Missouri School of Medicine, Philadelphia, PA, USA

    Jotishna Sharma

  14. Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA

    Elizabeth Bonachea

  15. Department of Pediatrics, Division of Neonatology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA

    Margarita Vasquez

  16. Department of Pediatrics and Biomedical Engineering, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA

    Patricia Chess

  17. Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA

    Rita Dadiz

  18. Division of Neonatology and Developmental Biology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA

    Josephine Enciso

  19. Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA

    Alison Falck

  20. Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA

    Megan Gray & Taylor Sawyer

  21. Division of Neonatology, Duke University Medical Center, Durham, NC, USA

    Susan Izatt

  22. Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA

    Sara Kane

  23. Department of Pediatrics, Section of Neonatology, Baylor College of Medicine/Texas Children’s Hospital, Houston, TX, USA

    Melissa Carbajal

  24. Division of Newborn Medicine, Department of Pediatrics, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA

    Kristen Leeman

  25. Division of Neonatology, Department of Pediatrics, Joseph M. Sanzari Children’s Hospital; Hackensack Meridian Health School of Medicine, Hackensack, NJ, USA

    Sabrina Malik

  26. Division of Newborn Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA

    Misty Good

  27. Department of Pediatrics, Division of Neonatology, University at Buffalo, Buffalo, NY, USA

    Jayasree Nair

  28. Department of Pediatrics, Robert Larner, MD College of Medicine, University of Vermont, Burlington, VT, USA

    Deirdre O’Reilly

  29. Department of Pediatrics, West Virginia University School of Medicine, Morgantown, WV, USA

    M. Cody Smith

  30. Department of Pediatrics, University of Michigan Medical School, Michigan Medicine, Ann Arbor, MI, USA

    Kate Stanley

Authors
  1. Jennifer M. Trzaski
    View author publications

    Search author on:PubMed Google Scholar

  2. Autumn S. Kiefer
    View author publications

    Search author on:PubMed Google Scholar

  3. Patrick Myers
    View author publications

    Search author on:PubMed Google Scholar

  4. Lindsay C. Johnston
    View author publications

    Search author on:PubMed Google Scholar

Consortia

ONTPD Fellowship Directors Writing Group

  • Melissa Bauserman
  • , Heather French
  • , Kris Reber
  • , Erin Cicalese
  • , Karena Lawrence
  • , Brittany Schwarz
  • , Allison Payne
  • , Robert Angert
  • , Maria Gillam-Krakauer
  • , Jotishna Sharma
  • , Elizabeth Bonachea
  • , Margarita Vasquez
  • , Patricia Chess
  • , Rita Dadiz
  • , Josephine Enciso
  • , Alison Falck
  • , Mackenzie Frost
  • , Megan Gray
  • , Susan Izatt
  • , Sara Kane
  • , Melissa Carbajal
  • , Kristen Leeman
  • , Sabrina Malik
  • , Misty Good
  • , Jayasree Nair
  • , Deirdre O’Reilly
  • , Taylor Sawyer
  • , M. Cody Smith
  • , Kate Stanley
  •  & Jennifer Wambach

Contributions

JMT, ASK, PM, and LCJ conceptualized, drafted, reviewed, revised, and approved the manuscript as submitted, and agreed to be accountable for all aspects of the work. BS, JE, MG, DO, MCS, KS, and AP critically reviewed the manuscript. Consortium authors conceptualized the manuscript.

Corresponding author

Correspondence to Jennifer M. Trzaski.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Trzaski, J.M., Kiefer, A.S., Myers, P. et al. Essentials of Neonatal–Perinatal Medicine Fellowship: careers in Neonatal–Perinatal Medicine. J Perinatol 42, 1135–1140 (2022). https://doi.org/10.1038/s41372-022-01315-7

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue date:

  • DOI: https://doi.org/10.1038/s41372-022-01315-7

This article is cited by

Search

Advanced search

Quick links