Neonatal fellowship program

Join us in caring for the most critically ill infants. Using our expertise and pediatric subspecialty collaboration with the most advanced technology in a Level IV NICU, we strive to give our patients the best chance at a healthy, happy life.

The Neonatal-Perinatal Medicine Fellowship at Virginia Commonwealth University School of Medicine is a three-year, ACGME-accredited program that provides exceptional training opportunities and experience in clinical care, research and teaching. Fellows receive training from a world-class group of Faculty in an unmatched level 4 Regional Perinatal Center clinical care environment with unlimited teaching and research opportunities.

As one of 2 fellowship training programs in the State of Virginia, the Neonatal-Perinatal Training Program offers an extensive range of patient conditions for fellow education that prepares future neonatologists for any clinical situation. Upon completion of the program, fellows are ready to excel in the highest level NICUs, caring for the most critically ill infants and their families to optimize future patient care.

The level 4 Neonatal Intensive Care Unit is situated in the Critical Care Wing of the Virginia Commonwealth Health System and a core component of the Children’s Hospital of Richmond at VCUHS.

The Children’s Hospital of Richmond is Virginia’s only comprehensive Children’s Hospital and Academic Medical Center, with complete individual infant single room accommodations for infants and parents in a 40-bed state-of-the-art facility. This comprehensive care includes same level linked labor and delivery suite area, an onsite NICU operating-procedure room, neonatal ECMO facility, neonatal comprehensive Hypothermia Program with continuous EEG monitoring, ground and air transport, as well as a regional Multidisciplinary Neonatal Neurodevelopmental Follow - up Program for the comprehensive follow-up of infants.

The range of research possibilities is almost limitless. Fellows can work with neonatal faculty, with faculty from other pediatric divisions, or other medical school or university faculty. In prior years, fellows have performed research under the mentorship of investigators from the School of Medicine and the Department of Neurosurgery. We can provide support for fellows interested in pursuing an advanced degree in public health or in clinical research. 

At the beginning of the program, fellows attend an introductory course in clinical research design, research ethics, working with subjects protection committees and some introductory biostatistics. Working with the program director and faculty, they identify and meet with a mentor within an area of research that meets the fellow’s interest. By the end of the first year, background reading is done, and a protocol is written and approved by the appropriate regulatory body. 

With about eight months protected time, in the second year fellows perform the needed steps to obtain the data and learn how to analyze the data. They are instructed on abstract presentation and encouraged to submit to (and often present at) regional and national meetings. Many fellows have a manuscript ready by the end of the second year. 

In the third year, there is sufficient time and support to complete data analysis and manuscript preparation and most fellows undertake a second or even third project, either as a natural extension of their primary project or, for example, in clinical research if their primary efforts have been in more basic research. Applying for grants is taught and encouraged. Most fellows have completed at least two projects before graduation. 

Examples of fellow publications 

Fox JR, Thacker LR, Hendricks-Muñoz KD. Early Detection Tool of Intestinal Dysfunction: Impact on Necrotizing Enterocolitis Severity. Am J Perinatology, Mar 23 2015, Epub ahead of print.??http://dx.doi.org/?10.1055/s-0034-1543984. ISSN 0735-1631, 2015. 

Jurdi SR, Jayaram A, Sima A, Hendricks-Muñoz, KD. Evaluation of a Comprehensive Neonatal Resuscitation and Adaptation Score: A pilot study. Global Pediatric Health January - December 2015 2: 2333794X15598293, first published on August 3, 2015 doi:10.1177/2333794X15598293 

Cruz MA, Bremer YA, Porter BO, Gullquist SD, Cole CH, Watterberg KL, Rozycki HJ. Cardiac troponin T and cardiac function in extremely low birthweight infants. Pediatric Cardiology. 2006;27:396-401. 

Bourbia A, Cruz MA, Rozycki J. NF-B in Tracheal Lavage Fluid from Intubated Premature Infants: Association with Inflammation. Oxygen and Outcome. Arch Dis Child. 2006;91:F36-9. 

Powell K, Kerkering KW, Barker G, Rozycki HJ. Dexamethasone Dosing, Mechanical Ventilation and the Risk of Cerebral Palsy. J Maternal-Fetal Neonatal Med. 2006;19:43-8 

Masalunga C, Cruz M, Porter B, Roseff S, Chui B, Mainali E. Increased hemolysis from saline pre-washing RBCs or centrifugal pumps in neonatal ECMO. J Perinatol. 2007;27:380-4. 

Masalunga C, Rozycki HJ, Mainali ES. The impact of hyperoxia on the developing dendritic cell: neonatal versus adult. Pediatr Res. 2007;62:78-82. 

Altirkawi K, Rozycki HJ. Hypocalcemia Is a Common Occurrence in the First 48 Hours of Life in ELBW Infants. J Perinat Med. 2008;36:348-53. 

Lim L, Rozycki HJ. Postnatal SNAP-II Scores in NICU Patients: Relationship to Sepsis, Necrotizing Enterocolitis and Death. J Maternal-Fetal Neonatal Med. 2008;21:415-9. 

Direct clinical experiences are supplemented by didactic and small group conferences. During the first three months, fellows attend a weekly series that introduces the principles and practices of clinical research. There are online modules on literature review, introductory statistics, paper and abstract preparation and adult learning principles.

Once per week, there is a divisional meeting to review new and interesting patients so that even when not on clinical service, fellows can benefit and learn from clinical opportunities. Twice per month previous births and impending high risk deliveries are reviewed with the perinatal service.

There is a bi-monthly morbidity and mortality conference, at which fellows present topics three times per year. Within the division, we hold a monthly journal club, and a monthly evidence-based medicine meeting. Research conferences are convened at least four times per year and usually more frequently. Finally, neonatal physiology and development are reviewed over a two-year cycle as a mini-Board prep. 

Beyond the divisional level, fellows can take advantage of regularly scheduled grand rounds and graduate medical education conferences, departmental research conferences, and the many special meetings and guest speakers from within the medical school community.

Examples of fellow projects presented at local and national meetings 

Karam S, Hendricks-Munoz KD, Xu J, Rozycki H. Multiplex cytokine analysis from trancheal aspirates in ELBW infants: Relationships to ventilation and outcomes.?Society of Pediatrics Research, May 2013 

Russo-Menna I, Carter K, MD2, Hendricks-Muñoz KD, Rezba C.? Transesophageal echocardiography (TEE) as a monitor of intraoperative ventricular volume, function and IV fluid management: impact on intra and postoperative fluid management in the partial separation of conjoined twins.?Society of Anesthesia Research, 2013 

Mohammed T, Munoz JL, Ober J, Lewis S, Xu J, Cone S, Edmond M, Moores R, and Hendricks-Muñoz KD. Methicillin Resistant?Staphylococcus Aureus?(MRSA) and the individual room Neonatal Intensive Care Unit?Society of Pediatrics Research, May 2013 

Jurdi S, Jayaram A , Moores R, Mohammed T, Fox J, Barker G , Hendricks-Munoz KD. Children’s Hospital of Richmond at VCU, Richmond, VA Sustained Quality Improvement initiatives improve neonatal morbidities in premature infants -an institutional experience?Society of Pediatrics Research, May 2013 

Mohammed T, Munoz JL, Ober J, Lewis S, Xu J, Cone S, Edmond M, Moores R, and Hendricks-Muñoz KD. Methicillin Resistant?Staphylococcus Aureus?(MRSA) and the individual room Neonatal Intensive Care Unit?Eastern Society of Pediatrics Research, Philadelphia, Mar 2013 

Fox J, Mohammed T, Moores R,? Jayaram A, Cone S, Barker G, and Hendricks-Muñoz KD. Getting to Zero: Development of a NEC QI initiative to decrease progression in NEC severity.?Eastern Society of?Pediatrics Research, Philadelphia, Mar 2013 

Mohammed T, Munoz JL, Ober J, Lewis S, Xu J, Cone S, Edmond M, Moores R, and Hendricks-Muñoz KD. Methicillin Resistant?Staphylococcus Aureus?(MRSA) and the individual room Neonatal Intensive Care Unit?Society of Pediatrics Research Society of Pediatrics Research May, 2013. 

Fox J, Thacker L, Sheth N and Hendricks-Muñoz KD. Cardio-Respiratory Symptoms: An Early Warning Sign of Intestinal Dysfunction.?Eastern Society of?Pediatrics Research, Philadelphia, Mar 2014 Poster 

Astoria M, Thacker LR, Hendricks-Muñoz KD. Unintended consequences of sedation in the preterm infant.?Washington Mid-Atlantic Neonatal Perinatal?Conference, oral presentation. 10, 2015 

Fox J, Thacker L and Hendricks-Muñoz KD. An Early Warning system to decrease Necrotizing Enterocollitis (NEC) severity.?Infectious Disease Society ID Week?10/2014, Philadelphia PA. Poster 

Astoria M, Thacker LR, Hendricks-Muñoz KD. Unintended consequences of sedation in the preterm infant.?Eastern Society of Pediatric Research ESPR?2015 

Astoria M, Thacker LR, Hendricks-Muñoz KD. Unintended consequences of sedation in the preterm infant.?VCU School of Medicine Resident-Fellow Research Day,?Platform presentation 2015 

Jurdi S, Jayaram A, Hendricks-Muñoz KD. N-RAS Neonatal Resuscitation Adaptation Score .?VCU School of Medicine?Resident-Fellow Research Day,?Platform presentation – Best Clinical Research Award, 2015