SOM Elective Brochure

Electives Type:  Clinical

Elective Title
A/I in Pediatrics- Neonatal Intensive Care Unit in Austin (Dell Childrenís Medical Center)
Course Number
Prerequisites: Successful completion of Year 3 
      Additional Requirements:
Successful completion of Pediatric and Ob/Gyn clerkships. To apply, submit C-Form to Judy Terlik at
Responsible Faculty Director:
Kristy Hermann, MD
Other Faculty:
Neonatologists with Pediatrix Medical Group
Location to Report on First Day
Contact Judy Terlik at or 512-324-7860
Periods Offered
NOT including Period 12 (June), including the holiday vacation Period 13 (Dec)
Maximum Enrollment

 Through participation as an acting intern, the student will develop skills in the assessment, stabilization, diagnosis, and management of critically ill term and premature newborn infants.

 1. The student will be able to obtain appropriate, detailed prenatal, labor and delivery, and transport history. 2. The student will understand the pathophysiology of diseases requiring transport to a tertiary NICU, including outborn delivery and need for surgical, cardiac, and subspecialist evaluation. 3. The student will be able to perform a physical examination on NICU infants and accurately assess gestational age. 4. The student will be familiar with the general care of NICU infants, including temperature support, glucose homeostasis, oxygenation, fluid and electrolyte administration, and nutrition. 5. The student will be aware of common problems of low birth weight, surgical, and cardiac infants, as well as infants requiring subspecialist evaluation, and will be familiar with diagnosis and long-term management.

Description of course activities
 1. The student functions as an intern in the NICU and is supervised by the senior pediatric house officer. He/she takes patients in rotation with the other residents and is responsible for their evaluation, examination, management, and discharge. Along with this goes the responsibility for reading in depth about the patients and their problems, for checking on lab work, and seeing them each day, and for adequate documentation in the medical record. 2. The student is responsible for attending high-risk deliveries along with the pediatric resident. 3. The student participates in attending rounds with the rest of the house staff assigned to the NICU. 4. Night call is not required but available if desired. The student is paired with a neonatologist and/or neonatal nurse practitioner. 5. The student is responsible for talking with the families of babies assigned to him/her and participating in parent education regarding their newborn.

Type of students who would benefit from the course
 Students interested in Family Medicine, Ob-Gyn, Pediatrics, Med-Peds, Surgery, or Anesthesiology. To enroll, UTMB students should submit a C-Form to Judy Terlik at for approval. Visiting students should submit an application through VSAS: Select UTMB at Galveston as the host institution and indicate you wish to take PEDU 4065 on the application.

Weekly Schedule
  Clinical Activities (please insert estimated schedule here)
  Day of Week AM PM
  Monday 7:00AM 5:00PM
  Tuesday 7:00AM 5:00PM
  Wednesday 7:00AM 5:00PM
  Thursday 7:00AM 5:00PM
  Friday 7:00AM 5:00PM
  Average number of patients seen per week: 35  
  Call Schedule:   Night call is not required but available if desired.  

  Research Activities (please insert estimated schedule here)
  Activity Hours per Week
  Faculty contact time

  Self-directed study

  Data collection/analysis


Method of student evaluation
Check all that apply - complete appropriate section(s) only:
1.  Clinical Observation
  A. Where are students observed on this elective?
    Inpatient service   Ambulatory   Surgery   Standardized patients
Patients simulators   Other
  B. Frequency - How often are students observed clinically?
  C. Format - What method(s) are used to document the student's clinical performance?
    Daily oral feedback   End of period oral feedback   Written feedback

2.  Oral Presentation
  A. Audience - To whom does the student present?
    Residents and faculty.
  B. Frequency / duration of presentation(s)?
    Daily on rounds.
  C. Format - What guidelines are set for the student's presentation?
    Review history, physical, problems, and plans for the day.
  D. Assessment - Who assesses the student's presentation performance?
    Self-assessment   Peer assessment   Faculty assessment
  E. Method of content selection
    Current cases  Student-selected topic   Assigned topic

3.  Written Assignment (H&P's, notes, papers, abstracts, etc.)
  A. Frequency of written assignment(s)?
    Daily notes on patients being followed.
  B. Format - What guidelines are set for the student's written work?
    Standard format for written history and physicals and program notes.
  C. Length of written assignment(s)?
    Abstract   Annotated bibliography   1 - 2 page paper   3+ page paper
  D. Are recent references required?   No    If yes, how are they selected?
  E. Method of content selection - e.g. student-selected, relate to cases, etc.?
  F. Audience - Who assesses the studentís written performance?
    Peer Assessment     Faculty Assessment     Other

4.  Examination
    Oral   Written multiple choice   Written essay / short answer   OSCE

5.  Extra Course Activities
  What expectations do you have for the student to demonstrate participation in the elective (e.g. small group activities, seminars, thoughtful questions, providing resources, journal club, resident lecture attendance)?
    Participation in patients care and rounds. Students are strongly encouraged to complete an evaluation of this elective so that we can use the information to improve the experience.

6.  Other Modes of Evaluation
  Please explain below.
    Students are evaluated by the attending faculty and supervisory house officers based on the following criteria: attitude, willingness to work and seek knowledge, responsibility, working relationship with personnel, patients and other physicians, thoroughness, concern for patient welfare, organization, ability to obtain necessary data, state problems clearly, and implement appropriate action.
7.  If this course is an Acting Internship, please complete the following:
  A. Specify how the student will be given formative feedback on their clinical skills.
    Students work directly with attending neonatologists daily and receive feedback on their clinical skills in real time, at the mid-point of their rotation, and at the end of their rotation.
B. List advanced clinical skills that a student will be assured an opportunity to practice.
    Students manage (under direct supervision) neonatal intensive care patients assigned to them, including fluid and electrolyte management, management of advanced respiratory support, and critical care medications. They have first opportunity to perform (under direct supervision) standard NICU procedures on patients that they follow, including endotracheal intubation and umbilical venous/arterial catheter placement.
C. List other advanced clinical skills that a student may be exposed to depending on clinical case availability.
    They may accompany infants to the operating room and observe surgical procedures. They may manage (under direct supervision) cardiac and surgical neonates through all stages of their diagnosis and treatment. They may follow ECMO patients after transfer to the PICU for acute stabilization.
  D. How will the acting intern student have responsibilities similar to a PGY1 resident? How will their responsibilities differ?
    Students start with a team of 2-3 patients and add more based on their comfort and abilities, whereas interns start with at least 6 patients. They add patients in rotation with any interns on service. Both report directly to attending neonatologists.
  E. How will this course help prepare a student enter an internship in this field or a related field?
    Students will begin their intern year with a level of comfort working in the NICU, with exposure to premature infants and neonates with acute surgical and cardiac problems, that other interns will not have. The organizational skills required to work in the NICU setting will be useful in other clinical areas that the intern will experience.
  F. How will midpoint feedback be provided to the student? How will you remediate deficiencies identified at midpoint?
    Students are expected to demonstrate intellectual curiosity, punctuality, attention to detail, efficient time management, and ability to work as part of a team. Deficiencies are discussed directly with the student, and a course of remediation is determined based on the student's needs and job requirements.
  G. Acting Internship students often seek letters of recommendation following their experience. How many different faculty are they likely to encounter during this course? What is the usual number of working days they can expect to encounter the same individual faculty member? Describe the degree of supervision and interaction with faculty vs. residents or other providers.
    Attending neonatologists generally work two weeks at a time. As such, a student can anticipate direct supervision from two or three neonatologists per rotation block (between 5 and 10 working days with each). Students have unrestricted access to attending neonatologists every day, with an average of 3 hours of direct teaching rounds daily.