Neonatal-Perinatal Fellowship Program


The current Neonatal-Perinatal Fellowship Program at the Medical College of Wisconsin began in 1991 as part of Milwaukee County Regional Medical Center/Children's Hospital of Wisconsin.

Host Institution

Children's Hospital of Wisconsin


The Neonatal-Perinatal Fellowship Program is three years in length. During that time fellows will do approximately 12 one-month clinical rotations with the balance of their training to be in research.

Prerequisite Training/Selection Criteria

In order to qualify for our program, physicians generally will have completed a two or three year accredited residency program in the United States. In some cases, a physician who has completed a three-year residency program in pediatrics in a foreign medical school may be considered for fellowship training.

Goals and Objectives for Training

The primary objective is to train a pediatrician in neonatal perinatal medicine so that he/she can function independently as a subspecialist in this field. At the end of the training the (fellow) trainee should have acquired enough training, expertise, and experience to pursue an academic or clinical career. Three basic necessities emphasized for this training program are clinical care, research, and teaching. Each of these components is given equal importance during the three years of training.

 Clinical Components

Fellows will do approximately 12 one-month clinical rotations during their three-year fellowship training with additional in-house night calls throughout the fellowship. All the fellows, including those on service, share the night calls. The call schedule is prepared by the senior fellow and is approved by the program director each month. An effort will be made to distribute the weekend and holiday calls equitably among all the fellows. The call hours for weekdays are generally 4 p.m. to 8 a.m. and weekend/holidays, 8 a.m. to 8 a.m. It is expected that the fellow on clinical service or night call will go on neonatal transports whenever possible.

The fellows' regular work hours are in accordance with the new guidelines of the Specialty & Subspecialty Board Requirements and will be enforced as follows:

The total number of hours spent by each fellow in patient care is limited to 80 hours per week averaged over a four-week period, inclusive of all in–house call activities. In addition, fellows are restricted to 24 hours of continuous patient care and an additional 4 hours of time for the completion of documentation and transfer of patient care responsibilities to other care providers. There will be no new admissions or new transport calls during this 4-hour window that begins from completion of 24 hours of patient care. In addition, fellows will have at least one day off each week. These policies will be strictly enforced.

 Didactic Components

The Division of Neonatology has an academic conference that is held weekly. The topics are divided between basic physiology, patient oriented conferences (joint conferences with other divisions such as Pediatric Surgery), morbidity and mortality conferences, and research topics.

A list of physiology topics to be covered during the three-year fellowship is distributed to each trainee. The fellow is expected to present a minimum of one conference per month selected from this list. The choice of topic is discussed with the fellowship director or an assigned faculty member.

Research conferences are also held throughout the year and are an opportunity for the fellows to hear about ongoing research at MCW to present their own research. The fellow is expected to present a minimum of one research conference per year.

Patient oriented conferences are also held throughout the year. Currently, there is a joint Neonatal-Pediatric Surgery conference held once per month of which the fellow will be expected to present at least three per year. The remainder of the patient oriented conferences is primarily devoted to discussing morbidity and mortality of patients in the NICU. Other disciplines, including pathology and radiology, participate in the conferences as appropriate.

Journal Clubs occur throughout the year. Each fellow is responsible for at least two Journal Clubs each year of the Fellowship. The fellow has a faculty advisor to assist as needed.

Fetal Anomaly Conferences are organized by the departments OB-GYN and Pediatric Surgery and occur once per month. Each fellow should present at least one of these conferences during the three-year fellowship.

Fellows also attend other MCW conferences that are appropriate for their research and general interests and include weekly Clinical Physiology lab meetings, weekly Department of Physiology seminars, weekly NO Journal Clubs and Cardiology Conferences.


The fellow is evaluated after each clinical rotation by the attending faculty. Appropriate areas of weaknesses and strengths are identified. The fellow meets bi-annually with the fellowship director to review his/her performance and to identify areas of improvement. The fellowship director works with each fellow to devise individual means to aid in improving his/her performance when necessary. The fellow will also get an opportunity to evaluate each faculty member as to the effectiveness of his or her teaching, research, and clinical skills. The information will be provided to the department chairman for staff development purposes.

 Patient Care Responsibilities

Since residents and interns rotate in the Children's Hospital NICU, the fellow has the opportunity to teach at the bedside both formally on rounds and informally throughout the day. Daily bedside rounds with discussions of every patient's problems are carried out with the faculty attending, fellows, residents, and sometimes include consultants and other subspecialty attendings. The fellow in the NICU assumes direct patient care responsibility. Fellows will also get an opportunity to teach neonatal resuscitation to pediatric interns and residents when attending high-risk deliveries at Froedtert Hospital. Formal teaching also occurs on an ongoing basis in a series of conferences.

The clinical rotations will be spent in the NICU at Children's Hospital of Wisconsin. The NICU currently has a 43-bed capacity with an average daily census of 36-39 patients. During the clinical rotations, the fellows will attend all high-risk deliveries at Froedtert Hospital. In addition, the fellows will be exposed to a comprehensive variety of neonatal problems and therapies including extremely low birth weight infants and infants requiring high frequency oscillatory ventilation and inhaled nitric oxide. The patient population consists of neonates with a wide range of clinical problems requiring the involvement of various consultants – surgery, cardiology, endocrine, genetics, neurology, neurosurgery, gastroenterology, urology, nephrology, infectious disease, hematology, etc. Fellows will be involved in the care of these neonates with the supervision and assistance of neonatologists and the respective subspecialists. In addition, newborn x-rays are reviewed daily with the pediatric radiologists. The trainee will get adequate experience in performing all procedures commonly employed in neonatology, e.g. endotracheal intubation, chest tube insertion, umbilical vessel catheterization, percutaneous arterial and venous puncture, as well as insertion of percutaneous intravenous catheters, lumbar punctures, etc.

Neonatal Developmental Follow-Up Clinic
All fellows will rotate through the Neonatal Developmental Follow-up Clinic. This will occur during all three years of the fellowship program. The fellows are required to attend the follow-up clinic two days per month when not on service in the NICU.

Clinical Electives
Depending on the individual fellow's needs and desires, elective rotations will be designed throughout the fellowship for additional exposure to areas of particular clinical interest to the fellow (e.g. rotation in PICU for ECMO experience, cardiology rotation with focus on neonatal echocardiography, radiology rotation with emphasis on neonatal ultrasounds and special procedures). Each elective is done for a period of one month and no more than one elective month may be requested for each subspecialty area.

 Procedural Requirements

Competence in performing the following procedures is required to complete the program: chest tube insertion, delivery room resuscitation, intubation, lumbar puncture, needle aspiration of the chest, PICC line insertion, peripheral arterial line insertion, peripheral arterial puncture, umbilical arterial line insertion, and umbilical venous line insertion. The fellows are required to maintain a procedure log, which they submit to the coordinator's office. The program director reviews the log to verify their competence.

 Progression in Responsibilities

First Year

  1. Develop clinical competence (approximately 4 months in the NICU).
  2. Attend the Neonatal Developmental Follow-up Clinic.
  3. Present one basic physiology conference, two journal clubs, and at least three patient oriented conferences.
  4. Attend the Joint Fellowship Curriculum of the Department of Pediatrics
  5. Initiate research: Identify project and mentor. Present one research conference in which a project and its goals are outlined.
  6. Discuss with program director/faculty enrollment in the Master's Program for Clinical Epidemiology or Bioethics.

Second Year

  1. Continue to develop clinical competence (approximately 4 months in NICU) but focus more on teaching skills.
  2. Continue to attend the Neonatal Developmental Follow-up Clinic.
  3. Present one basic physiology conference, two journal clubs, and at least two patient oriented conferences.
  4. Actively pursue identified research project. Present one research conference in which preliminary results of project are outlined. Write a first author abstract that will be submitted by the fall of the third year.
  5. Take statistics course and participate in the Joint Fellowship Curriculum.
  6. Take Research Methods Workshop.

Third Year

  1. Continue to develop clinical competence and polish teaching skills by serving approximately 4 months (including 1 month as a Junior Attending in the NICU at Children's Hospital).
  2. Take a supervisory role in the NICU during clinical rotations.
  3. Continue to attend the Neonatal Developmental Follow-up Clinic.
  4. Present one basic physiology conference, two journal clubs, and at least two patient-oriented conferences.
  5. Present the results of their research project to the Neonatology Division.
  6. Complete research project, present abstract, write manuscript for submission by end of third year.

Other Educational Programs

Sometime during the three years, the fellow must take a Basic Statistics Course. In addition, during the second or third year of fellowship, each fellow must take a Clinical Research Methods Workshop.

Fellows also need to develop skills with computers. The library offers some basic courses that the fellow is encouraged to take.

In order to develop and nurture teaching skills, fellows participate in conjunction with neonatal faculty in weekly perinatal case discussions, weekly discharge planning rounds in the NICU, monthly joint service management meetings for the NICU, and involvement in pediatric grand rounds, resident teaching, nursing in-service, and outreach education to community physicians and nurses.

 Research Component

Approximately 21 to 24 months of training will be devoted to research. Neonatology faculty members are carrying out several research projects. There is excellent collaboration with basic science faculty members in several of these research projects. In addition, there is ample opportunity to devise research projects with other basic science and clinical faculty. Basic science projects that are currently ongoing in the division include studies using an animal model of neonatal pulmonary hypertension to evaluate the pathogenesis of the disorder (the role of various endogenous vasodilators and vasoconstrictors such as nitric oxide, prostaglandins and other arachidonic acid metabolites), studies of vascular endothelium (signal transduction, Ca2+ signaling, free radicals, nitric oxide), and studies of pharmacogenomics, teratogens and their effect on fetal development. Current ongoing clinical projects include the study of institutional ethics, end of life care in the perinatal period, evaluation of neuro-developmental and audiological outcome of healthy term newborns with non-hemolytic hyperbilirubinemia, the effect of body position on breathing patterns and pulmonary mechanics in healthy infants, and studies of inhaled nitric oxide on PPHN.

Fellows receive excellent mentoring at all levels of training. They are required to complete a research project before the end of the third year and to have at least one or more first author publications in a peer reviewed journal. In order for them to complete a successful research project, a faculty mentor along with two additional faculty members, will be assigned to assist and monitor their progress by meeting twice yearly with a Scholarship Oversight Committee. Fellows will also be expected to present their research periodically in formal conferences to the faculty. The senior faculty and others provide guidance in grant writing, paper presentations, and manuscript writing in the Medical College of Wisconsin. Fellows will be expected to take courses in biostatistics and will have the opportunity to take courses in specialized areas of research Interests (e.g. molecular biology).

Fellows are encouraged to submit abstracts to national meetings annually (both basic science and pediatric meetings, such as Pediatric Academic Society Meetings). The Department of Pediatrics pays for the expenses to attend these meetings through the academic development fund assigned to each fellow.


Teaching Staff

Currently there are 20 faculty neonatologists from the Medical College of Wisconsin who staff the Children's Hospital of Wisconsin NICU. Additionally, there are fifteen neonatal nurse practitioners as well as pharmacists, nutritionists, respiratory therapists, and social workers. There is also a full complement of sub specialists in pediatrics based throughout the hospital.


The fellow will spend most of their time at Froedtert Hospital and Children’s Hospital of Wisconsin fulfilling several rotations including the Cardiac Intensive Care Unit, Maternal Fetal Medicine and Anesthesiology. St. Joseph’s Hospital is a community based hospital which the fellow will also rotate through.

Froedtert Hospital is the primary institution where the fellow will spend time for delivery room activities, as well as a two week rotation in the Newborn Nursery (which is actually a Level 2 NICU). There are six faculty perinatologists and an active obstetric residency-training program. Fetal diagnostic procedures including ultrasound, percutaneous umbilical blood sampling, intrauterine fetal transfusions, are carried out as well as routine fetal heart rate and acid base monitoring during labor. High-risk pregnancies constitute nearly 40% of the total patients and more than 30% of newborns delivered here are admitted to the NICU at Children's Hospital. The perinatologists and neonatologists interact closely and have weekly perinatal rounds and monthly morbidity and mortality conferences. An elective rotation is available for the fellow to learn basic fetal monitoring techniques.

Children's Hospital of Wisconsin is physically connected to Froedtert Hospital and was established in 1988. The Neonatal Intensive Care Unit has 43 beds in a state of the art facility that opened in September 2002. ECMO, high frequency oscillation, and inhaled nitric oxide are frequently carried out on appropriate patients. Each year the NICU admits approximately 650 babies with neonatal transport admissions of approximately 300 annually. In addition to the NICU, there is a Neonatal Progressive Care Unit (NPCU) with 16 beds which are used for babies who are no longer critically ill but need intensive care. The NPCU has private patient rooms which allow families to be more involved in their child’s care as discharge approaches. We are in the process of expanding and the construction of a state-of-the-art 71-bed NICU is underway and patients will be occupying this unit in the winter of 2014. In addition to the hospitals, there is a well-organized, active high-risk developmental follow-up clinic. All eligible patients from the NICU are seen in this clinic. Faculty from the Medical College also staffs the follow-up clinic.

 Terms, Conditions and Benefits of Employment

Fellows starting the program prior to July 1, 2015, are employed by the Medical College of Wisconsin (MCW).

Stipend amounts beginning July 1, 2014-2015 Academic Year:

  • PGY4 - $59,255
  • PGY5 - $62,255
  • PGY6 - $64,255
  • PGY7 - $66,255

See MCW Benefits for information regarding vacations, leaves and insurance.

Professional Liability
The MCW Professional Risk Management Department coordinates the professional liability self-insurance program and assures liability coverage with the Wisconsin Injured Patients and Families Compensation Fund in excess of the primary annual limits of $1,000,000 per incident and $3,000,000 in the aggregate. Providers are covered for activities within the scope of duties for the MCW.

Fellows starting the program on or after July 1, 2015 will be employed by Medical College of Wisconsin Affiliated Hospitals (MCWAH).

See MCWAH Benefits, Conditions & Terms of Employment for information regarding vacations, leaves, insurance, stipends and professional liability.

Professional Liability
The MCW Professional Risk Management Department coordinates the professional liability self-insurance program and assures liability coverage with the Wisconsin Injured Patients and Families Compensation Fund in excess of the primary annual limits of $1,000,000 per incident and $3,000,000 in the aggregate. Providers are covered for activities within the scope of duties for the MCW.

Fellowship Program Contact

Pediatrics Neonatology
Department of Pediatrics
Children's Corporate Center, Suite C410
999 N. 92 St.
P.O. Box 1997
Wauwatosa, WI 53226

(414) 266-6820 | Fax: (414) 266-6979

Program Director
Girija Ganesh Konduri, MD |

Associate Director
Una Oliiva Kim, MD |

Fellowship Coordinator
Diane Lawton |

Medical College of Wisconsin
8701 Watertown Plank Road
Milwaukee, WI 53226
(414) 955-8296
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Page Updated 03/04/2015