The Infant Complex Care Fellowship is an ICGME certified fellowship designed for the general pediatrician and consists of one-year curriculum for post-residency training. It focuses on the unique medical and developmental needs of prematurely born and other high-risk infants and toddlers after discharge and during the first two to three years of life. Fellows who complete this training will then be able to bring their specialized knowledge and expertise into careers in pediatric academic positions (hospitalist, NICU follow-up, Level 2 nursery, neonatology) and general pediatric practices across the country.
The fellow is an important member of our Transitional Medical Home program in which we partner with well-childcare physicians and APPs to coordinate care for our most medically fragile NICU graduates. He/she/they will be trained in best practice for providing convalescent care, discharge planning, and comprehensive post-discharge care for premature and critically ill term or near-term infants. The fellow will become proficient in the tenants of complex care coordination, manage and troubleshoot medical equipment, assess need for care escalation inpatient and outpatient, and support the mental health of patients and their caregivers. Fellows will become experienced in dealing with ongoing neonatal morbidities such as chronic lung disease, gastroesophageal reflux, brain injury, growth, nutrition and feeding difficulties, early motor and other developmental problems, and psychosocial problems common in parents of high-risk infants. The fellow will also become familiar with expected outcomes of various neonatal conditions, the early precursors of cerebral palsy and other developmental disorder, differentiate between the transient neurologic abnormalities commonly seen in premature and other sick newborn infants and the red flags that predict later neurologic and developmental problems. This knowledge and these skills should prove to be extremely valuable to the fellow in future practice.
Fellowship Curriculum:
The curriculum of the Infant Complex Care Fellowship will include:
- Participation in the outpatient multi-disciplinary Special Infant Care Clinic (SICC), Duke University’s medical and neurodevelopmental follow-up clinic for high-risk infants. The clinics are currently held 3 days a week – two full in-person days and one half-day tele visit.
- Inpatient clinical service (~4-12 weeks) in a transitional care nursery setting with particular emphasis on nutrition, convalescent care, and discharge planning of high-risk infants especially those with technology dependence. Depending on fellow’s long-term goals, aim for fellow to serve as acting attending in our Transitional nursery (TCN) during the second half of year.
- Participation in the multi-disciplinary Duke Pediatric Cardiac Neurodevelopmental Clinic (PCNC), Duke University’s medical and neurodevelopmental follow-up clinic for high-risk children with complex congenital heart disease.
- Participation in weekly Convalescent/Chronic Care rounds for the Intensive Care Nursery/Transitional Care Nursery during which developmental and psychosocial issues are discussed and discharge plans are made for medically fragile.
- Consultation on the pediatric floor for premature or high-risk infants transferred from NICU or readmitted after discharge for exacerbation of neonatal problems.
- Elective weeks (~ 4-8 weeks), including but not limited, the following areas:
- Feeding/Speech Disorders
- Physical/Occupational Therapy
- Neuroimaging
- Neonatal Neurology
- Rehabilitation/Cerebral Palsy clinic
- Palliative Care
- Participation in ongoing neurodevelopmental follow-up studies and/or pursuing scholarly activities based on his/her/their long-term goals/interests.
- Fellow will be on pager call during the day on alternate weeks, one night per week, and one weekend a month to answer calls for our Transitional Medical Home Program patients. The fellow will also round in the TCN one weekend per month to become familiar with future medical home patients.
See our website for more information: https://pediatrics.duke.edu/education/fellowship-programs/infant-complex-care
Eligibility Criteria:
To be eligible for the Infant Complex Care Fellowship, applicants must:
- have completed a pediatric residency program approved by the Accreditation Council for Graduate Medical Education and
- be board-eligible or board-certified in general pediatrics.
Ideal candidates will:
- be planning a career focused on caring for infants and/or children with medical complexity.
CONTACT INFORMATION:
Program Coordinator:
Marissa Ivester
marissa.ivester@duke.edu
Program Director:
William F. Malcolm, MD
Professor of Pediatrics
Division of Neonatal-Perinatal Medicine
Duke University Medical Center
