2024-2025 M3/M4 Course Syllabi
Pediatrics
COURSE NUMBER:
16 01 63
TITLE:
Neonatal Intensive Care Unit (NICU) -ICE
The elective provides direct experience with all aspects of neonatal care, including delivery room resuscitation, daily management, and parent counseling. The student works as an intern with responsibility for their patients.
PREREQUISITES:
26961373 (PEDIATRICS CORE CLKSP), 26961373 (PEDIATRICS CORE CLKSP)

  • Must be a senior student who has completed the Pediatrics Core Clerkship, including a rotation on Newborn Service.
  • It must be taken in one 4-week consecutive block to meet ICE requirements.  It cannot take eight weeks  PT to fulfill ICE requirements.
expand all

GENERAL INFORMATION

COURSE YEAR:
M4
CREDIT HOURS:
8
CREDIT WEEKS:
4
DOMESTIC VISITING:
NO
INTERNATIONAL VISITING:
NO
GRADED:
Honors/High Pass/Pass/Fail
COURSE QUALIFICATIONS:
ICE
STATUS:
Full-Time   
OFFERED AS FULL-TIME AND PART-TIME: NO
ALLOWS OVERLAP: NO
COURSE LENGTH:
2 or 4 weeks
DIRECTOR:
Eric Raynal
Eric.Raynal@cchmc.org
(231) 881-5435
Burnet Campus, Bldg. T, T11.529
ADMINISTRATIVE SUPPORT PERSON:
Mimi Pence
Mimi.Pence@cchmc.org
513-636-0339
Kasota Building, 7th Floor at CCHMC, BN7.722
SITE(S):
UCMC
MAX ENROLL:
1 
ROTATIONS:
Rotation Dates Max
1 05/06/2024 - 05/17/2024 1
1 05/06/2024 - 05/31/2024 1
1 05/20/2024 - 05/31/2024 1
2 06/03/2024 - 06/14/2024 1
2 06/03/2024 - 06/28/2024 1
2 06/17/2024 - 06/28/2024 1
3 07/01/2024 - 07/12/2024 1
3 07/01/2024 - 07/26/2024 1
3 07/15/2024 - 07/26/2024 1
4 07/29/2024 - 08/09/2024 1
4 07/29/2024 - 08/23/2024 1
4 08/12/2024 - 08/23/2024 1
5 08/26/2024 - 09/06/2024 1
5 08/26/2024 - 09/20/2024 1
5 09/09/2024 - 09/20/2024 1
6 09/23/2024 - 10/04/2024 1
6 09/23/2024 - 10/18/2024 1
6 10/07/2024 - 10/18/2024 1
7 10/21/2024 - 11/01/2024 1
7 10/21/2024 - 11/15/2024 1
7 11/04/2024 - 11/15/2024 1
8 11/18/2024 - 11/29/2024 1
8 11/18/2024 - 12/13/2024 1
8 12/02/2024 - 12/13/2024 1
9 12/16/2024 - 12/27/2024 1
9 12/16/2024 - 01/10/2025 1
9 12/30/2024 - 01/10/2025 1
10 01/13/2025 - 01/24/2025 1
10 01/13/2025 - 02/07/2025 1
10 01/27/2025 - 02/07/2025 1
11 02/10/2025 - 02/21/2025 1
11 02/10/2025 - 03/07/2025 1
11 02/24/2025 - 03/07/2025 1
12 03/10/2025 - 03/21/2025 1
12 03/10/2025 - 04/04/2025 1
12 03/24/2025 - 04/04/2025 1
13 04/07/2025 - 04/18/2025 0
13 04/07/2025 - 05/02/2025 0
13 04/21/2025 - 05/02/2025 0

NOTE: If a rotation is offered in both 2 and 4 week slots, the max capacity is limited to the actual spots offered for the 4 weeks. (ie: the 2 week rotations listed share the max of the 4 week rotation)
WORKING HOURS:
8:00 a.m. - 5:00 p.m., Monday - Friday
REPORT 1ST DAY:
UCMC NICU is located on the third floor, right off the elevators. The unit is badge-locked. When you arrive, ask the unit clerk to direct you to the resident workroom. You should receive an email before the start of your rotation about expectations. Please get in touch with Janel Chris (Janel.Chriss@cchmc.org) if you have any issues with your badge or if you have any other questions.
COMMENTS:
Please feel free to contact Faris Al Gharaibeh (Faris.algharaibeh@cchmc.org) with any questions or concerns.

INSTRUCTION

LEARNING ACTIVITIES:
  • Case-Based Instruction/Learning
  • Clinical Experience - Inpatient
  • Conference
  • Demonstration (description, performance, or explanation of a process, illustrated by examples, observable action, specimens, etc)
  • Independent Learning (Instructor-guided learning activities to be performed by the learner outside of formal educational settings.)
  • Patient Presentation--Faculty
  • Patient Presentation--Learner
  • Self-Directed Learning (Learners take initiative for their own learning; diagnosing needs; formulating goals; identifying resources; implementing appropriate activities; and evaluating outcomes.)
LEARNING ENVIRONMENT POLICIES:
UCCOM strives to provide medical students with a learning environment that is conducive to their professional growth. All UCCOM and visiting medical students are encouraged to review the Student Handbook.

The Office of Student Affairs and Admissions is available to all UCCOM and visiting medical students to discuss any concerns/questions related to the learning environment. Please call 558-6796 to access faculty/staff that can assist you.
TEACHING:
50% Attending Physician
25% Senior Resident
5% Junior Resident
10% Other Faculty
10% Fellow Physician
FEEDBACK:
Attending neonatologist
ASSESSMENT:
Students will be evaluated based on their knowledge and skills in caring for infants in the Newborn Intensive Care Unit. 

The student should seek feedback from residents and faculty alike on areas they want to focus on early in the rotation and expect constructive feedback from the team.

ASSESSMENT METHODS:
Clinical Performance Rating/Checklist
Oral Patient Presentation
Participation
FINAL GRADE:
GRADE ASSIGNED BY: Principle instructor

OBJECTIVES

Curricular Resources :

  Neonatology:  Pathophysiology & Management of the Newborn
        Avery et. al.
  Care of the High-Risk Neonate
        Klause & Fanaroff
  Nelson's Textbook of Pediatrics
Instructional Methods:
  • Instructional
  • Clinical experience – INPATIENT ONLY
  • Conferences (Daily lecture series with the multidisciplinary team and the UC NICU attendings)
  • Clinical documentation review
  • Oral patient presentation
  • Participation in all aspects of patient care, including admission, daily rounding, discharge, and delivery room attendance 
Knowledge/Skills:
  1) Refine examination skills and understand the unique aspects of history, physical findings, and laboratory exams in the:
   a) preterm newborn
   b) infant of a diabetic mother
   c) full-term infant with sepsis, heart disease, or surgical pathologies
   d) Infants with genetic disorders or congenital malformations
  
  2) Understand the unique physiology and pathophysiologic characteristics of the fetal and neonatal period

  3) Experience with acute resuscitation and delivery room management of infants with:
   a) meconium aspiration
   b) prematurity 
   c) Fetal acidosis and hypoxia 

  4) Participate in daily management of sick newborns, including obtaining and evaluating laboratory data, assessing X-rays, managing fluids, electrolytes, and nutrition, and using appropriate medications.

  5) Discuss condition, management, and future expectations with parents.
Main Course Topics :
  • Respiratory distress in the newborn
  • Prematurity
  • Neonatal sepsis
  • Fluid & electrolyte management of newborn
  • Neonatal nutrition
  • Impact of major obstetrical problems during infancy 
  • Basics of newborn ventilation   
  • Necrotizing Enterocolitis
  • Hyperbilirubinemia
Procedures:
Procedures are not required, but learners are encouraged to voice their desire to learn common neonatal procedures.  

In the NICU, the following procedures are commonly performed under supervision from the attending, fellow, NP, or resident, depending on the skill level of the provider:

a- Elective intubationon 
b- Lumbar puncture 
c- Placement and removal of umbilical lines (venous and arterial)
d- Least invasive surfactant administration (LISA)  


In the delivery room, the following procedures are commonly performed: 

a- Suction by bulb or catheter 
b- Provision of CPAP by facemask 
c- Positive pressure ventilation by facemask 
d- Emergent intubation (This is reserved for the fellow and attending given the emergent situation)
Remediation Plan:
Students can choose to repeat the rotation to improve their performance at a later date


SAMPLE WEEK

Monday:
7:30AM 8:30AM Preround on inpatients
8:30AM 10:30AM Rounds: NICU
11:00AM 12:00PM Lecture Series
Tuesday:
7:30AM 8:30AM Preround on inpatients
8:30AM 10:30AM Rounds: NICU
11:00AM 12:00PM Lecture Series
Wednesday:
7:30AM 8:30AM Preround on inpatients
8:30AM 10:30AM Rounds: NICU
11:00AM 12:00PM Lecture Series
Thursday:
7:30AM 8:30AM Preround on inpatients
8:30AM 10:30AM Rounds: NICU
11:00AM 12:00PM Lecture Series
Friday:
7:30AM 8:30AM Preround on inpatients
8:30AM 10:30AM Rounds: NICU
11:00AM 12:00PM Lecture Series
1:00PM 2:00PM Neonatal Grand Rounds
SCHEDULE NOTE:
This is a patient care elective. Generally, the daily schedule is 8-5.  Of course, time demands will change depending on the patient load.

ATTENDANCE AND ABSENCE POLICY

 

Session Attendance for M4 Students

  • Students may miss no more than two days of planned excused absences on a four week rotation without being required to make-up the work, at the discretion of the clerkship/elective/course director or his/her designee.
  • Non-AI Rotations - Per the Student Duty Hours Policy, an average of one day (24 hours) in every seven must be free of clinical responsibilities (including seminars, clinic, rounds, lectures) averaged over a four week period. These days off are assigned by the clerkship director to best align with the site schedule. Students may request to schedule 1 or more of these 4 days for planned absences that fall under 1 of the categories listed below for excused absences during non-AI rotations, in consultation with the course/elective director, who may or may not approve such planned absences.
  • AI Rotations - Per the Student Duty Hours Policy, an average of one day (24 hours) in every seven must be free of clinical responsibilities (including seminars, clinic, rounds, lectures) averaged over a four week period. These days off are assigned by the course director to best align with the site schedule. Students may request to schedule 1 or 2 of these days for planned absences that fall under 1 of the categories listed below for excused absences during AI rotations, in consultation with the course director, who may or may not approve such planned absences. Students must avoid scheduling Step 2 examinations during an Acting Internship.
  • Excused Absences - The following will be considered excused absences:
    • Diagnostic, preventative, and therapeutic health services (e.g. doctor appointments, physical therapy, counselling, etc).
    • Personal illness, accident or a major catastrophic event
    • Death or serious illness of immediate family members. Immediate family members, as defined by UC, are Grandparents, Brother, Sister, Brother-in law, Sister-in-law, Daughter-in-law, Son-in-law, Father, Mother, Mother-in-law, Father-in-law, Step-sister, Step-brother, Step-mother, Step-father, Spouse or domestic partner, Child, Grandchild, legal Guardian or other person who stands in place of parent (in Loco Parentis)
  • Whenever possible, planned absences should be requested a minimum of six weeks in advance of the start of the clerkship/elective/course in which the absence will occur; this enables the clerkship/course/elective to help plan for educational event scheduling (e.g. a known appointment could be scheduled around with enough notice and the student might not have any required coursework to make up). Absences requested less than 1 week prior to the planned absence may not be considered for a possible excused absence unless extenuating circumstances prevented the student from providing timely notification per the policy. Students should first submit their request for a planned absence to the clerkship/elective/course director using the online MSSF. All planned/excused absences for any reason should be documented on the MSSF.
  • The COM abides by the UC Religious Observance Policy that respects the religious diversity of its students by providing opportunities, where possible, for accommodation in cases where conflicts exist between students’ religious beliefs/practices and educational activities. In clinical settings, such accommodations must honor the primacy of a commitment to patient care and avoid unduly burdening faculty, staff and the general student population involved in the affected educational and/or patient care activity.
  • The following items are explained in detail in the Medical Student Handbook:
    • Excused/unexcused/unplanned absence, religious holidays, jury duty, and make-up work

See Attendance and Absences Policy, Religious Observance Policy, Medical Student Handbook.




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