The Neonatal-Perinatal Subspecialty Residency Program training at McGill University is two years in length for a total of 26 rotations. A majority of the core rotations are completed at the Montreal Children’s Hospital (MCH) Neonatal Intensive Care Unit and the Jewish General Hospital (JGH) Neonatal Intensive Care Unit. An additional Transport Core Rotation was introduced in 2016. Examples of elective rotations include Maternal Fetal Medicine, Neonatal Follow-up clinic, Pediatric Intensive Care and Cardiology. In addition, trainees must select a field of interest and a research mentor and complete a scholarly activity.
Both hospitals cover nearly 8,000 deliveries, have over 400 transports per year and over 1,500 admissions. We are Quebec’s most important hypothermia treatment center which we cool on average 25-30 patients per year. The Montreal Children's Hospital provides intensive care experience in all illnesses of the newborn infant, but especially in respiratory care, neonatal surgical problems and congenital heart diseases. It is a postnatal referral center for many hospitals in Montreal and surrounding communities.
The two-year program places a major emphasis on clinical and basic science research. Residents in the program are expected to develop investigative interests. Areas of particular research activities are pulmonary physiology and pathophysiology, including longitudinal studies of neonatal intensive care survivors, respiratory muscle function, control of breathing, management of very low birth weight infants and epidemiology, health economics and quality improvement, bronchopulmonary dysplasia and pulmonary hypertension. Residents in the joint program are encouraged to seek research mentors either within or outside the Division of Neonatology.
Program length: 2 years (total of 26 rotations)
Average number of trainees per year: 5-6
The Neonatal-Perinatal Medicine Subspecialty Residency Program follows the training requirements set by the Royal College of Physicians and Surgeons (RCPSC).
PRIOR to 1 July 2020:
Twenty-four (24) months of approved residency in Neonatal-Perinatal Medicine, one (1) year of which may be undertaken concurrently with the final year of Pediatrics with joint approval of the program director in Pediatrics and the program director in Neonatal-Perinatal Medicine.
1. The twenty-four (24) months of Neonatal-Perinatal Medicine residency training must include the following:
1.1. A minimum of twelve (12) months of clinical Neonatal-Perinatal Medicine:
1.1.1. A minimum of six (6) months of clinical neonatal experience in a level III neonatal intensive care unit associated with an on-site university-affiliated perinatal unit (i.e., maternal fetal unit or tertiary obstetric high-risk unit)
1.1.2. A minimum of four (4) months of level III clinical neonatal experience in a neonatal intensive care unit with surgical and outborn patients and with the breadth of pediatric subspecialty services available on site
1.1.3. A maximum of one (1) month in a pediatric intensive care unit
1.1.4. A minimum of one (1) month and a maximum of two (2) months in a level II neonatal intensive care unit
1.2. A minimum of six (6) months of research experience or other scholarly activity related to Neonatal-Perinatal Medicine
1.3. A minimum of one (1) month (or longitudinal equivalent) in a high risk antenatal clinic or consultation service. Where a high risk antenatal clinic or an antenatal consultation service does not exist, one (1) month in a maternal-fetal medicine unit, where a large component of the clinical experience includes antenatal consultation, is acceptable.
1.4. A minimum of one (1) month in high-risk newborn followup (or longitudinal equivalent). Where a high-risk newborn followup program does not exist, one (1) month in child development, where graduates from the neonatal intensive care unit are a large component of the patient population, can be substituted.
1.5. A minimum of one (1) month (or longitudinal equivalent) in neonatal transport
1.6. A minimum of two (2) months of electives, individualized to the experience and goals of the resident
1. In section 1.1.4., where a neonatal unit is a combined level III and level II, this may be considered level II experience.
2. Subspecialty residents in Neonatal-Perinatal Medicine must be provided with increasing individual professional responsibility while under appropriate supervision.
3. For the two (2) years of training, the subspecialty resident must attend scheduled neonatal academic and teaching activities as mandated by the subspecialty training program.
4. During the residency program, the majority of calls must be in neonatology.
5. Candidates interested in joint subspecialties are required to submit for assessment by the respective subspecialty committees prior to the start of subspecialty training.
Examples of elective rotations include:
- Maternal Fetal Medicine
- Neonatal Follow-up Clinic
- Pediatric Intensive care
The Neonatal-Perinatal Medicine Residency Program trainees spend the majority of their Neonatal Intensive Care Unit rotation at the Montreal Children’s Hospital and several rotations at the Jewish General Hospital.
Trainees spend the majority of their NICU rotations at the Montreal Children's Hospital during the two-year period.
Residents will participate and eventually direct rounds as they gain seniority. They will go to resuscitations as part of a resuscitation team where they will gain invaluable experience in neonatal resuscitation.
Due to the high acuity and active turnover of patients, attendings and residents work together to be effective both in patient care and guiding residents to become confident in their development of differential diagnosis and management of patients as well as the flow of patients on the unit.
In addition, the presence of all the Pediatric Subspecialists allows the residents to care for patients with all types of pathology. Furthermore, residents will give presentations to the Neonatology group and teach residents and students.
Trainees spend several rotations at the JGH NICU during a two-year period. Initially, they will co-direct rounds and go to resuscitations with the attending. Once a certain comfort level is reached and the attending assesses appropriate skill level, trainees can enjoy autonomy and independence of practice. They must continue to report several times a day to the attending that will guide them so they become confident in their development of differential diagnosis and management of patients and of the unit.
The code “lavender” which means that our experienced obstetrics colleagues are delivering a sick neonate is activated 2-7 times in a 24-hour period. The experience gained from a very active delivery room, allows for graduating residents to become Neonatal Resusitation Program (NRP) instructors and feel very confident in resuscitating our most fragile 23-week neonates. As a result, trainees receive excellent experience with all related procedural skills in neonatology. Finally, trainees enjoy teaching residents and students.
The Transport, Procedures and Consultation (TCP) Rotation was established in 2016 by the residents and has now been incorporated into the program. It has the unique aspect of being created by residents for residents to meet the requirements they wanted.
During the TCP Rotation the residents participate in morning rounds as the Bed Manager. The Bed Manager manages movement of patients in and out of the unit throughout the day and is in constant contact with each Neonatologist on service and the Nurse in Charge. The resident answers all transport calls and if the patient requires an MD, they are dispatched with the team to go stabilize and transport the infant. Furthermore, residents review and do complex antenatal consults and consults for extreme prematurity. The neonatologist is present for assistance and feedback. Also, a resident on this rotation has priority for procedures.
This is an opportunity to help establish independent thought for the resident and to give them a clear understanding of what the transport team does and what the limitations in the community are. Currently, the TCP Rotation is a two-week rotation in the second year of training but will soon be established as a junior rotation as well. Residents enjoy and learn a lot about how to manage patients more independently.
Residents will have several blocks of research during the two-year period to complete a scholarly activity. Initially they must decide on a topic that interests them and locate a research mentor with whom they wish to work. Upon completion of training, an resident is expected to create, disseminate, apply and translate medical knowledge through scholarly activities.
Scholarly activities can be and are not limited to Basic Science Research, Clinical Research, Epidemiology, Education, and Quality Improvement, Public Health or Leadership projects.
The Maternal Fetal Medicine (MFM) rotation is an elective one block rotation that residents enjoy in their second year of training. The rotation is tailored to the resident’s interests so that they may participate in fetal surgery, MFM clinic, ultrasound clinic, the management of MFM patients on the wards, observe procedures (examples: amniocentesis, percutaneous umbilical blood sampling) and/or fertility clinic.
Follow-up Clinic is an elective one block rotation that residents enjoy during their two-year residency training. The clinic is very active with graduate patients from the Montreal Children's Hospital who are seen on a specific routine. Residents do assessments of development and general pediatrics and write the clinic note, which is a global assessment of the patient’s visit and plans for treatments and follow up. This rotation also offers a one year fellowship in Follow-Up for graduating residents and Pediatric Residents who are interested.