About the Program

You will benefit from Iowa’s tradition of collaboration.

The University of Iowa is well suited to be part of this unique approach to managing the heart and circulatory system of the tiniest babies. 

We are leaders in neonatology care, known worldwide for documenting our protocols and sharing them with the world.

Our culture of academic medicine is one of collaboration, where it’s natural for specialists in cardiology to work closely with neonatologists to better understand complex physiology and develop appropriate care based on groundbreaking diagnostic tools.

In partnership with the pediatric echo lab, trainees will be exposed not only to neonatal echocardiography but will also get an opportunity to observe cardiac MRI and fetal echocardiography as part of their training.

You will be among the nation’s first fellowship-trained specialists.

Iowa accepts one or two fellows each year for this first-of-its-kind program. Our first fellow entered the program in the summer of 2019.

If accepted, you would be among only a handful of practicing neonatologist in the United States with fellowship-based training in this groundbreaking approach to the hemodynamic management of premature infants.

You will work in unrivaled facilities designed for specialty care.

We provide care in the University of Iowa Stead Family Children’s Hospital. Our intensive care facilities were designed by our care teams and came on line in the past few years. They offer the most sophisticated technology and incorporate best practices for patient care. In our center, echocardiography may be used in combination with near infrared spectroscopy and non-invasive cardiac output monitoring to develop a comprehensive understadning of neonatal physiology in real time.

University of Iowa Hospitals & Clinics is a designated Magnet hospital, and has been so longer than most in the country. Our nurses and support teams work at the highest levels of responsibility, adding to the quality of care we are able to deliver for our patients and their families.

You will use state-of-the-art simulators and imaging modalities.

Iowa is one of the few places in the country to make full use of the EchoCOM echocardiology simulator. The device allows for 3D reconstructions and can provide simulations of conditions with anatomically normal and abnormal heart structures.

The Iowa echocardiography team uses state-of-the-art imaging that allows for precise assessments of individual patients as well as instant access to database images for background and comparison.

The Year in Detail

The University of Iowa (UI) program is fully funded one-year fellowship training based on the 2011 American Society of Echocardiography guidelines/standards.

Aside from one month of NICU fellow service designed to familiarize non-UI trainees with the operations, population, and protocols unique to the UI program, the year is protected for Neonatal Hemodynamics training.  NICU service may be completed concurrently with phase I.

The duration of each phase will vary by trainee based on acquisition of competencies and individual progress.  Longitudinal exposure to primarily hemodynamics cases and primarily cardiology teaching/cases is encouraged and will be facilitated collaboratively independent of training phase.

Phase I – Image Acquisition  

Ultrasound physics tutorial utilizing online resources with a log-book of modules and a quiz will be completed concurrently with familiarization with normal and abnormal anatomy using a dedicated echocardiography simulator (EchoCOM, Leipzig Germany) and the TnECHO website/app. After successful demonstration of these skills, hands-on training will be undertaken in the Pediatric Echocardiography lab under the co-supervision of Neonatal and Cardiology departments.

Phase II – Neonatal Hemodynamics Integration

Hands-on training in the NICU with graduated supervision of Hemodynamics consults including imaging, measurement, interpretation and therapeutic decision making with regular case reviews. Training at UI will provide a wide range of clinical exposure including asphyxia, ECMO referrals, congenital diaphragmatic hernia, and a high volume of periviable neonates (e.g. 22+0– 23+6 weeks). Training in limited head ultrasound screening and point of care ultrasound will be provided.

Longitudinal Academic Progress

Academic supervision on a minimum of one research project suitable for presentation at a scientific meeting and publication as a first author in a peer reviewed journal. An academic oversight committee will be formed for each trainee.

On call

Limited on call commitments will continue throughout the year in order to maintain competency in intensive care skills and procedures [1-2/month].  Pay, duty hour restrictions, and vacation policy will be standardized in accordance with University of Iowa policy.

Evaluation 

Comprehensive evaluation will be performed on the basis of the achievement of competencies. Throughout training, fellows are expected to keep a log book of scans completed including the indication, their role in the consultation (clinical data collection, image acquisition and which plane(s), duration, reporting).  Learners will be expected to complete a practical test of image acquisition covering recognition of red flags for common cardiovascular problems and congenital heart diseases utilizing simulator cases to complete phase I. Thereafter imaging skills will be evaluated using objective scoring tools using Direct Observation of Practical Skills (DOPS) assessments throughout the training.  By the end of training, fellows should be able to adequately capture 90-110 images in ≤30 minutes. Fellows will provide assessment, impression and plan for every scan and will be critiqued on their problem formulation, interpretation and physiological knowledge.  The intent is to document progress in sophistication of analysis and concordance with expert opinion. Upon completion of training, the candidate is expected to function as a competent and independent specialist in neonatal hemodynamics. A successful candidate must acquire a working knowledge of the theoretical and practical aspects of the discipline including its foundations in science and research.