Neonatology residency not fellowship

[juniordoc84]

:confused:

Our medical schools here at Egypt offers Neonatology residency programs beside pediatric ones,we spend 2 years at NICU,8 months at pediatric wards,4 months at PICU

On the other hand i found that at USA or UK neonatology 's a subspeciality that one should finish pediatric residency first in order to be eligible to 've neonatology fellowship

i just wanna know if our system considered weak or what ?

[Stefan Johansson]

I think it is good to have neonatology as a subspecialty of pediatrics, considering the need for policlinical follow-up visits after neonatal intensive care (with a lot of general pediatric councelling!)

In Sweden, every neonatologist completes pediatric residency (about 5 years), which includes about 6-12 months of neonatal medicine. The following neonatal specialty takes another 3 years. I personally think the Swedish system is a too rigid though. During the pediatric residency, we should be able to individualize the programme to a greater extent than we can today.

[juniordoc84]

8 years in order to be a neonatologist....impressive.

the pediateric residency here is 3 years only :)

[Stefan Johansson]

8 years in order to be a neonatologist....impressive.

And the internship after graduation from medical school, adds another 18 months. And since research training is not counted in, writing a PhD comes on top too. So, even if you're getting through the whole system asasp, you will be middle-aged before you're a fully qualified neonatologist!

My bottomline... I think our education is a bit too long. Less is more!

[Agnieszka Domanska]

Since 2004 we have a possibility to spacialise in neonatology in two ways - one is same as in Sweden - after 5 year residency in pediatrics and takes 3 years. Another path is more " direct" it starts after one year general internship post graduation medical school. That is the way I do my specialty in neonatology. We have about three years of training in pediatrics ( general pediatrics of small children, infecious diseases, surgery, cardiology, clinical genetics and prenatal medicine ) and two years of intensive care of the newborn and healthy newborns. So it takes 5 years now to become a neonatologist. The advantage of this system is that when you are going to concentrate only on intensive care it takes not so long time to gain a specialty and you can learn more accurate what you really are interested in. The disadvantage is lack of experience in treatment and monitoring development of children after discharge from neonatal ward. In my opinion - this "two ways system" gives opportunity to divide neonatologists into two groups. One is - pediatricians who work in neonatal 1 grade units. They deal mostly with healthy newborns , they are able to resuscitate and stabilise vital functions of babies born in poor condition in time they need to transport them to secondary or tertiary level hospital. They also work as pediatricians. They do 5 year pediatrics and then 3 years of neonatology. The second way is very comfortable for those who are going to work only in third level NICU. That is 5 year training only in neonatology. I am about finishing it this year and I find this way of training very good. The training in pediatrics was useful, but to be honest, I didn't like any day I had to spend in Children' s Hospital instead of our NICU. What do you think about it?

[Stefan Johansson]

Agnieszka,
the Polish system seems more flexible than ours.
I personally think a "fast-track" to neonatology would be good also for Sweden.
One example; a colleague is a specialist in anestesiology, and she wants to become a neonatologist. Despite the fact that she is trained in intensive care/anestesiology - she will have to go through 5 years of pediatric training before she can formally enter a neonatology fellowship.
I think that's a waste (of time... of expertise... of common sense...)

[Agnieszka Domanska]

As far as I know they are about to change it and return to the former system - like in Sweden. The reason for that decision is that when we apply for job in other countries our training would be considered as not completed.

[aymaniham]

Hi all,
Here in Saudi Arabia, you have to finish 4 years training in pediatrics then 2-3 years in neonatology.
In Canada, they have to go through 4 years training in pediatrics, but they can include the last year in neonatology training in addition to 1-2 more years to be qualified neonatologist.

[hehady]

In Egyptian Universities the situation is different, we have to spend 3 years general pediatircs residency and pass MsC exam and then at least 3 more years in neonatology, including thesis in a research related to neonatology, then you can be a lecturer in Pediatrics/neonatology after finnishinfg MD exam in Pediatrics. Currently we planning MD degree in neonatology after finishing 3 years residency in general pediatrics.

[somashekhar]

In India the situation is just about OK. at 17 years you complete high school and enter graduate medical school (college as it is known here). By 22.5 years you have completed graduate medicine including a one year internship. Then you do pediatrics for 3 years which includes neonatal rotations for about 6-9 months. So by 25.5 years you are a pediatrician. Then you take up a subspeciality/superspeciality like Neonatology which you do for three years. So by 28.5 years you can be a specialist in Neonatology. Is that middle aged? It would be difficult to study medicine faster than that. And as medicine explodes this time will also be insufficient. PhD is not a chosen topic.
THE CATCH --> There are about a maximum of 4-6 Neonatal positions in a country of 1 billion people. Additional 10-14 positions have sprung up in the last year or so but these specialists will not be able to teach in most MCI accredidated medical colleges.
AN EARLIER CATCH --> Getting into Pediatric residency is a tough job almost about 30,000 candidates vie for about 300 positions year after year and some students may take a period of 1-3 year before they can enroll into a residency program.
This is one of the main reasons for flight of human capital to other countries for education. For the past few years many of them are returning back and offering services at corporate hospitals across the country. Unfortunately educational and public institutes have not benefitted.