Fellowship Program Overview

Program Overview

We have a staff of six attending neonatologists, four perinatologists, four neonatal nurse practictioners and six neonatal-perinatal fellows. Our neonatal attendings (without assistance from fellows) also service three other community hospital special care nurseries.

We admit 350-400 patients per year to Loyola Medicine's neonatal intensive care unit (NICU), with an average daily census of 27-30. About 15% of our admissions are <28 weeks gestation, and about 40% are term giving the fellows a wide range of clinical exposure. About 15% of admissions are outborn transfers.

Our program is supported by the following pediatric subspecialists:

We also consult with pediatric surgery and the surgical subspecialists including cardiovascular surgery, hand surgery, otolaryngology, orthopedics, neurosurgery, plastics and urology.

Our program has a strong working relationship with the Maternal-Fetal Medicine Fellowship program and the Department of Obstetrics and Gynecology. A doctor of pharmacy and neonatal nutritionists help manage our patients.

Loyola Medicine's occupational therapy, physical therapy, speech therapy, audiology, social work and spiritual care teams are also actively involved in educational program as well as in the daily care of our patients.

As part of our active quality improvement activities, we are part of the Vermont-Oxford Network. We also review quarterly neonatal and maternal morbidity and mortality issues for our Regional Perinatal Network as well as help initiate and implement both the regional and state of Illinois ongoing quality projects.

Loyola University Chicago's Neiswanger Institute of Ethics, located on Loyola University Medical Center's campus, is another resource with a full range of ethics offerings in academics, lectures, consultation and research.

Follow-Up Clinic

We have an excellent high-risk newborn follow-up clinic which meets one half days a week. Fellows participate approximately one to two times per month in these clinics. The clinic is supported by a neonatal nurse practitioner and OT/PT trained in early intervention.

On-Call Schedule

On-call responsibilities are consistent through all three years, averaging six in house calls per month. Attending coverage is provided concurrently; attendings and fellows share weekend NICU team rounds. Fellows are responsible for primary critical decision-making and provide ongoing reports to the attending.

Fellowship Training

Fellowship training at Loyola includes:

• 12 months of clinical neonatology
• One-month rotations in cardiology
• Two to four months of electives such as infectious diseases, neo pharmacology and radiology
• 16-18 months of research
• Three months of vacation/meeting

Other electives may be accommodated.

Our 40 bed NICU is divided into two clinical teams each consisting of one attending neonatologist, one fellow, pediatric and meds-peds residents, nurse practitioners and fourth year medical students. Fellows act as team leaders with support from attendings.

Medical rounds are in the morning and fellows huddle twice a day with OB staff to keep apprised of labor and delivery, ante-partum and post-partum.

Fellows are trained in procedures such as endotracheal intubation, umbilical catherization, peripheral arterial lines, PICC placement, chest tubes, paracentesis and exchange transfusion.

Program Research/Scholarly Activity

The fellowship requires research/scholarly activity following the guidelines outlined by the American Board of Pediatrics’ scholarly activity requirement. An individualized scholarly oversight committee for each fellow is formed and will mentor each fellow through his/her scholarly activity.

Research conferences presented by fellows and attendings are designed to present results of current projects, discuss new protocols and critique proposed research design. Fellows are expected to present their research at a regional and national research meeting such as the Society for Pediatric Research meeting or an appropriate subspecialty society research meeting.

A manuscript submitted to a peer-reviewed journal is expected for completion of the scholarly activity. The design, implementation and completion of a fellow CQI project is expected prior to program completion.

The fellow with the guidance of an attending neonatologist, will also design and implement a quality improvement project, usually through several cycles. These are often presented at regional and national quality congresses, such as VON Annual Conference and Illinois Perinatal Quality Collaborative Conference.

Scholarly Activity (snapshot)

Maclean J, Katebian R, Suh E, Mirza K, Amin S. Neonatal Hemophagocytopathic Lymphohistiocytosis. Neoreviews Vol 20, No 6 June 2019 e316.

Srinivasan N, Schwartz A, John E, Price R, Amin SC. Acute Kidney Injury Impairs Postnatal Renal Adaptation and Increases Morbidity and Mortality in Very Low-Birth-Weight Infants. American Journal of Perinatol. Aug 2017.

Amin SC. Rapid feed advancement appears protective in very low birth weight infants. J Pediatr. 2016 Mar;170:341-4. doi: 10.1016/j.jpeds.2015.12.055

Remon JC, Amin SC et al. Resected Intestinal Tissue Predicts Mortality in Surgical Necrotizing Enterocolitis. J Perinatol. 2015 Sep; 35(9):755-62.

Amin SC, Pappas C, Iyengar H, Maheshwari A. Short Bowel Syndrome in the Neonatal Intensive Care Unit. Clin Perinatol. 2013; 40:53-68

Amin SC, Remon JI, Subbarao GC, Maheshwari A. Association between Red Cell Transfusions and Necrotizing Enterocolitis. J Matern Fetal Neonatal Med 2012; 25(Suppl 5):85-9

Astrug, L and Claud, E(2020). Necrotizing Enterocolitis. In R Polin and M Yoder (Ed.) Workbook in Practical Neonatology (6th edition, pp. 330), Philadelphia, PA.

Astrug L, Claud E (2018). 'Necrotizing Enterocolitis: Neonatology Questions and Controversies' in Neu J, Poindexter B, Polin R (editor). Neonatology Questions and Controversies. Philadelphia, PA: Elsevier, pp 87-98.

Astrug L, Lu L, Lu J, Yu Y, Claud E (2017). 'Prenatal Probiotics Enhance Neonatal Gut Immunity.' Pediatric Academic Societies Conference. San Francisco, California.

Astrug L, Christine L, Ochieng J, Hornig J, Jaleel M (2015). Decreasing Blood Culture Contamination with Coagulase-Negative Staphylococcus (CoNS) in the NICU: A Quality Improvement Project. Pediatric Academic Societies Conference. San Diego, Ca.

Astrug L (2014). "Neonatal Aortic Thrombosis Case Report." Southern Regional Conference: American Federation of Medical Research. New Orleans, LA.

Astrug L, Thinman D, Baldovsky M (2014). 'Constipation and Abdominal Pain in a 2 year old girl.' Consultant for Pediatrics. V13:I9.

Feltman DM, Weiss MG, Nicoski P, Sinacore J. Rocuronium for non-emergent intubation of term and preterm infants. Journal of Perinatology 2011; 31: 38-43. PMID: 20539274

Katebian R, Festle L, Herring B, Nickoski P, Bennett LN. Obtaining Admission Blood Work from the Umbilical Cord and Improving Average time to First Dose of /Antibiotic and Intravenous (IV) Dextrose.

Ngan M, Durazo-Arvizu R, Weiss MG, Kramer H. Nutrient-Enriched Infant Formula Is Associated With Higher Weight Gain for Low Birth Weight Infants. J Pediatr Gastroenterol Nutr. 2017 Jun;64(6):975-978. PMID: 28541261

Poster Presentations

Vermont Oxford Network (VON) Improvement Science Expo, Chicago, IL October 2-6, 2019.

St. Albert's Day LUMC Research Conference, Maywood, IL October 24, 2019.

Program Conferences

Our weekly and monthly conferences provide an ample and varied educational experience including: