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Vocational Training
Neonatal/Perinatal
Medicine - Australia
Supervising Committee
Specialist Advisory Committee (SAC) in Neonatal/Perinatal
Medicine. The SAC in Australia will supervise trainees
in both Australia and New Zealand.
Definition
of Specialty
The College recognised that the practice of modern neonatal/perinatal
medicine is different from the standard practice of paediatrics and developed
a specialised training program. The practice encompasses the care of the foetus,
the preterm infant and the ill new born. Once, a satisfactory training program
has been completed the title of neonatologist is formally recognised.
General Principles
- Advanced
training in neonatal/perinatal medicine is supervised by the SAC in Neonatal/Perinatal
Medicine (SAC NPM) which reports to the CPPT.
- Advanced training in neonatal/perinatal
Medicine is for three years following satisfactory completion of basic paediatric
training and the FRACP Examination in paediatrics.
- Advanced training in
neonatal/perinatal medicine consists of two core years preferably undertaken consecutively
and one non core year.
- During core advanced training trainees are employed
in SAC accredited or approved sites.
- Supervised training in both neonatal
and foetal medicine in accredited teaching units throughout this training time
is required. This program should be closely associated with a comprehensive
training
program in obstetrics.
- A minimum of 18 months tertiary clinical perinatal
training is essential.
- Adequate experience with the care of surgical neonates
is essential (eg. the equivalent of 6 months in a children's hospital).
- No
more than 18 months of neonatal training in a children's hospital(s) will be accepted
towards the required 3 years of neonatal/perinatal training.
- Trainees
must participate in care and management of the foetus and newborn in collaboration
with maternal fetal medicine specialists and paediatric subspecialists.
- Trainees
need to participate in multidisciplinary teams which include nursing and allied
health staff in the care of newborns and their families.
- No more than
2 years can be spent training in any one centre. Neonatal units are accredited
for training of varying lengths of time up to 2 years.
- Trainees may complete
some advanced training outside Australia or New Zealand. Applications to train
in overseas hospitals are reviewed on an individual basis. Commencing in
2008, the SAC requires at least one year of core advanced training must be
spent
in Australia or New Zealand.
- All subspecialty
paediatric trainees must complete the community and child health requirements
for paediatric training.
Note that the guidelines differ between Australia
and New Zealand.
Components of Training
Core Training- Core training is of 2 years duration preferably undertaken
consecutively.
- A minimum of 18 months tertiary clinical perinatal training
is essential.
- Trainees must have experience in the transport of the sick
newborn and have a full understanding of the principles and practice of regionalisation
of perinatal care including transfer of high risk pregnancies to appropriate centres.
A minimum of 25 neonatal retrievals representing a broad range of complexities
is required.
- Trainees must develop an understanding of all aspects of
post discharge care of high risk infants, including:
- involvement in discharge
planning, particularly multidisciplinary counselling and liaison meetings;
- follow
up of post intensive care medical problems in an outpatient setting;
- participation
in a long term developmental follow up program, to become familiar with assessment
techniques and long term developmental sequelae.
Contact with community services
and site visits to early intervention centres are desirable. It is expected that
the equivalent of 1 session per week for 2 years would be spent in follow up activities
including exposure to all aspects mentioned. Trainees whose community paediatric
term has included a large developmental component may receive credit.
- The
training program in neonatal/perinatal medicine must provide opportunities for
clinical and investigative experience in understanding both normal and abnormal
aspects of foetal and neonatal growth and development. There must be provision
for the trainee to participate in the diagnosis and management of these problems
as seen in the foetus, during labour, in the neonatal period, and in the follow-up
of possible sequelae.
- Trainees must be competent in the management of
neonatal disorders affecting cardiorespiratory, neurological, haematological,
metabolic, endocrine, renal and gastrointestinal systems.
- Trainees must
be competent in the management of the critically ill newborn infant, including
techniques of resuscitation, airway support, electronic vital signs monitoring,
temperature control and nutritional support.
- Trainees should be involved
in the teaching of resident medical and nursing staff, and medical students, on
various aspects of well and sick newborn infants.
- Trainees must have experience
in collecting and evaluating information on fetal and neonatal morbidity and mortality.
The trainee should be able to conduct quality assurance/audit evaluations of clinical
management of common conditions such as respiratory distress syndrome, asphyxia
or neonatal sepsis. These evaluations should extend to include the various methods
of treatment used in these disorders.
- Trainees should learn about research
techniques, participate in laboratory and/or clinical research, and make critical
analyses of research results. The research must be supervised by a teacher with
demonstrated skills and experience in clinical and/or laboratory research. At
least one advanced training project should be in clinical or laboratory research.
- Trainees
must demonstrate the ability to use available literature including web-based and
other electronic databases to answer clinical questions. Trainees needs to be
able to critically appraise the medical literature, be familiar with systematic
reviews and promote evidence based practice.
- The training program should
include experience in acute crisis counselling and in the psychological and ethical
aspects of perinatal care.
- The program must include attendance at regular
learning sessions such as reviews of morbidity/mortality, case presentations,
current literature discussion groups, and research meetings. A trainee will be
encouraged to establish regular contact with other Level 3 Units through attendance
at rounds and other teaching sessions at the respective units.
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