UNIVERSITY OF MINNESOTA

GRADUATE MEDICAL EDUCATION

2010-2011FELLOWSHIP POLICY MANUAL

Department of Pediatrics Neonatal-Perinatal MedicineFellowship Program

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Introduction/Explanation of Manual

On behalf of the faculty and staff, welcome to the Department of Pediatrics at the University of Minnesota. We hope that the time you spend in the Neonatal-Perinatal Medicine Fellowship Program will be both educational and enjoyable.

This Fellowship Addendum outlines policies and procedures specific to your training program. Policies in this addendum have been developed in accordance with standards set by the American Board of Pediatrics (ABP) and the Accreditation Council for Graduate Medical Education (ACGME), and are subject to periodic review and change by the faculty, program director, and department chair.

Refer to the Institution Manual and the Pediatric Program Policy Manual for further policies and procedures.

The Institution Manual can be found on the GME website at: http://www.gme.umn.edu/residents/instpolicyman/home.html

The Pediatric Program Policy Manual can be found on the Pediatric Residency website at: http://www.pedsres.umn.edu/current/programmanual/home.html

Mission Statement of the University of Minnesota Department of Pediatrics’ Fellowships

The Department of Pediatrics at the University of Minnesota promotes excellence in academic subspecialty training with an emphasis on producing academic leaders who generate the new knowledge required to provide the best care for infants, children, and adolescents.  

We will accomplish this through: Recruiting fellows with outstanding academic potential and commitment. Providing state-of-the-art clinical training. Providing exceptional training and mentorship in basic, translational, clinical, and epidemiologic

research, medical education, academic leadership, and advocacy for pediatric health. Ensuring a scholarly work product during fellowship which serves to facilitate fellows’

professional transition into academic faculty positions.Mission Statement of the University of Minnesota Neonatal-Perinatal Medicine Fellowship

The mission of the NPM fellowship, in accord with the mandate put forth by the American Board of Pediatrics, is to train neonatal-perinatal medicine subspecialists as 1) physician-investigators responsible for generating new knowledge through basic science or clinical research of neonatal physiology and disease states, 2) the highest quality clinicians responsible for providing complex, technically expert, comprehensive and compassionate care to neonates with severe, complex or life-threatening health problems in the setting of the NICU or SCN, and 3) educators responsible for imparting this new knowledge and clinical application to medical students, residents, generalists, obstetricians and nonphysician providers who will be caring for neonates.

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Table of Contents

Introduction/Explanation of Manual............................................................................................................2Mission Statement of the University of Minnesota Department of Pediatrics’ Fellowships......................2Table of Contents.........................................................................................................................................3SECTION 1 - STUDENT SERVICES........................................................................................................6

MEDICAL SCHOOL REGISTRATION................................................................................................6TUITION AND FEES.............................................................................................................................6LATE FEES.............................................................................................................................................6ADDITIONAL COURSES.....................................................................................................................6CAMPUS MAIL......................................................................................................................................6CAREER SEARCH RESOURCES.........................................................................................................6E-MAIL...................................................................................................................................................6HIPAA TRAINING.................................................................................................................................6PAGERS..................................................................................................................................................7RESIDENT ASSISTANCE PROGRAM (RAP).....................................................................................7

SECTION 2 - BENEFITS...........................................................................................................................7EDUCATIONAL EXPENSE ALLOWANCE........................................................................................7INSURANCE..........................................................................................................................................8

Health and Dental Insurance Coverage...............................................................................................8Professional Liability Insurance..........................................................................................................8Life Insurance......................................................................................................................................8Voluntary Life Insurance.....................................................................................................................8Long-Term Disability Insurance..........................................................................................................8Short-Term Disability Insurance.........................................................................................................8Insurance Coverage Changes (refer also to the Pediatric Program Manual).......................................8

LAUNDRY SERVICES..........................................................................................................................8LEAVE POLICIES..................................................................................................................................8

POLICY ON EFFECT OF LEAVE FOR SATISFYING COMPLETION OF PROGRAM..............8Vacation...............................................................................................................................................9Holidays...............................................................................................................................................9Interviewing Time...............................................................................................................................9Professional/Academic Leave.............................................................................................................9Parental: Maternal/Paternal/Partner Leave..........................................................................................9Sick Leave...........................................................................................................................................9Medical Leave...................................................................................................................................10Personal Leave of Absence................................................................................................................10

MEAL ALLOTMENT...........................................................................................................................10PARKING..............................................................................................................................................10PHOTOCOPYING PRIVILEGES........................................................................................................10SCRUB SUITS, LABCOATS, AND ID BADGES..............................................................................11STIPENDS.............................................................................................................................................11PAYCHECKS/DIRECT DEPOSIT.......................................................................................................11TAX INFORMATION..........................................................................................................................11WORKER’S COMPENSATION POLICY AND PROCEDURES......................................................11

SECTION 3 - Institution Responsibilities.................................................................................................11

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SECTION 4 - DISCIPLINARY AND GRIEVANCE PROCEDURES....................................................12GRIEVANCE PROCEDURES AND DUE PROCESS........................................................................12HOUSE STAFF SUBSTANCE USE/ABUSE POLICY......................................................................13

SECTION 5 - GENERAL POLICIES AND PROCEDURES..................................................................14SUBSPECIALTY TRAINING REQUIREMENTS FOR FELLOWS..................................................15

Academic Expectations for Pediatric Fellows...................................................................................15Core Curriculum................................................................................................................................15Scholarly Activities...........................................................................................................................16Work Product of Scholarly Activity..................................................................................................16Scholarship Oversight Committee (SOC).........................................................................................16External Oversight.............................................................................................................................17Responsibilities of the Training Program Director............................................................................18

CURRICULUM.....................................................................................................................................18NEONATAL-PERINATAL FELLOWSHIP CURRICULUM............................................................18

Clinical Curriculum...........................................................................................................................18Scholarly Activity..............................................................................................................................19Collaborative Research......................................................................................................................19Potential Mentors within the Division of Neonatology.....................................................................20Conferences.......................................................................................................................................22Conferences.......................................................................................................................................22Teaching Responsibilities..................................................................................................................22Educational Programming.................................................................................................................22

PROGRAM GOALS AND OBJECTIVES...........................................................................................23ACGME CORE COMPETENCIES......................................................................................................23DUTY HOURS......................................................................................................................................24ON-CALL..............................................................................................................................................25

General On-Call Requirements..........................................................................................................25Transport Call....................................................................................................................................25

SCHEDULING......................................................................................................................................25First-Year Scheduling........................................................................................................................25Second-/Third-Year Scheduling........................................................................................................25NICU Follow-up Clinic.....................................................................................................................25Allocation of Clinical/Scholarly Activity Time................................................................................25Schedule Changes..............................................................................................................................26

ABSENCE COVERAGE......................................................................................................................26BACK-UP POLICY..............................................................................................................................26MONITORING OF FELLOW WELL-BEING.....................................................................................26SUPERVISION OF FELLOWS............................................................................................................27

Overall Supervision...........................................................................................................................27Lines of supervisory responsibility—Clinical...................................................................................27Lines of supervisory responsibility—Research / SCHOLARLY ACTIVITY..................................27

EVALUATION.....................................................................................................................................28Steps in the Evaluation Process.........................................................................................................28Possible Outcomes of Review by the Resident Review Committee (RRC)......................................28Types of Evaluations.........................................................................................................................29Evaluation Confidentiality.................................................................................................................29

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Types of Assessments........................................................................................................................29Annual Program Review....................................................................................................................31Subspecialty In-Training Examination (SITE)..................................................................................31Residency Management Suite (RMS)...............................................................................................31

TRAINING/GRADUATION REQUIREMENTS................................................................................31TEACHING MEDICAL STUDENTS..................................................................................................31

ACLS/BLS/PALS RECERTIFICATION.........................................................................................31AMA POLICY FOR ACCEPTING GIFTS......................................................................................31MEDICAL RECORD/DICTATION COMPLETION......................................................................32CONTINUITY OF CARE.................................................................................................................32DEMONSTRATION OF ENGLISH LANGUAGE PROFICIENCY BY NON-NATIVE SPEAKERS OF ENGLISH...............................................................................................................32GUIDELINES FOR PROFESSIONAL DRESS...............................................................................32PROFESSIONAL INTRODUCTION GUIDELINES......................................................................32MEDICAL LICENSURE..................................................................................................................32MOONLIGHTING POLICY:...........................................................................................................32ON CALL ROOMS, SUPPORT SERVICES, LABORATORY/PATHOLOGY/RADIOLOGY SERVICES........................................................................................................................................33MEDICAL RECORDS......................................................................................................................33SECURITY/SAFETY........................................................................................................................33UNAUTHORIZED LEAVE..............................................................................................................33

SECTION 6 – ADMINSTRATION..........................................................................................................34DEPARTMENT OF PEDIATRICS: ADMINISTRATION.................................................................34

Head of the Department of Pediatrics................................................................................................34DEPARTMENT OF PEDIATRICS: DIVISION OF NEONATOLOGY.............................................34DEPARTMENT OF PEDIATRICS: PAYROLL..................................................................................35RESOURCES........................................................................................................................................35

Web Sites...........................................................................................................................................35Governing Boards..............................................................................................................................35Career-Related...................................................................................................................................35

Debt Management..................................................................................................................................35Confirmation of Receipt of your Fellowship Addendum for Academic Year 2010-2011........................36

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SECTION 1 - STUDENT SERVICES(Please refer to Institution Policy Manual at http://www.med.umn.edu/gme/residents/instpolicyman/home.html for Medical School Policies on the following: Academic Health Center (AHC) Portal Access; Child Care; Computer Discount/University Bookstore; Credit Union; Disability Accommodations; Expression Connection; Legal Services; Library Services; Medical School Campus Maps; Resident Assistance Program; Tuition Reciprocity; University Card (UCard); University Events Box Office; University Recreation Sports Center(s))

MEDICAL SCHOOL REGISTRATIONRefer to Pediatric Program Manual at: http://www.pedsres.umn.edu/current/programmanual/services/registration/home.html

TUITION AND FEESRefer to Pediatric Program Manual at: http://www.pedsres.umn.edu/current/programmanual/services/tuition/home.html

LATE FEESRefer to Pediatric Program Manual at: http://www.pedsres.umn.edu/current/programmanual/services/fees/home.html

ADDITIONAL COURSES Individuals wishing to take additional courses for credit should contact their Fellowship Coordinator AT LEAST TWO (2) MONTHS prior to the beginning of the academic semester. Permission in writing from the Fellowship Program Director is required to register for additional courses. There may be an additional cost to the fellow for registering for additional courses for regular day school and certain day/night courses. The department does not cover the cost for these courses.

CAMPUS MAILAny personal or professional mail, journals, etc. must be forwarded to your home address. University-related mail addressed to fellows is available in each fellow's postal box located in Room D-136 Mayo.

CAREER SEARCH RESOURCESTo assist fellows with their post-fellowship career search, resources regarding available academic and clinical positions in neonatology are available in the University Neonatology office, D-136 Mayo. Postings are in a binder located in the fellows’ cubicle.

E-MAIL Refer to Pediatric Program Manual at: http://www.med.umn.edu/peds/pedsres/current/programmanual/services/email/home.html

HIPAA TRAININGRefer to Pediatric Program Manual at:

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http://www.med.umn.edu/peds/pedsres/current/programmanual/services/hipaa/home.html

PAGERSUniversity alphanumeric pagers are required at all times (the only exceptions are during a leave of absence or vacation). You will be assigned one pager number to be used throughout your fellowship. Pagers are available through your Fellowship Program Coordinator. Should you lose your pager, a temporary or permanent replacement can be obtained at the University of Minnesota Medical Center (UMMC/UMACH) Information Desk. Notify your Fellowship Coordinator immediately of the loss. Please note: Once you locate your lost pager, please return the replacement to Communications and notify the Coordinator, or you may be billed by the department.  Pagers are the property of Fairview and must be returned no later than 30 days after leaving/completing the program. If you lose your pager, do not return your pager or if your pager becomes damaged beyond repair, you may be charged the replacement pager fee. 

For those residents entering a UMN fellowship, your residency pager number can be transferred into fellowship by having your Fellowship Program Coordinator contact the Education Manager at elgray@umn.edu.

RESIDENT ASSISTANCE PROGRAM (RAP)Refer to Pediatric Program Manual at: http://www.med.umn.edu/peds/pedsres/current/programmanual/services/rap/home.html

SECTION 2 - BENEFITS(Please refer to Institution Policy Manual at http://www.med.umn.edu/gme/residents/instpolicyman/home.html for Medical School Policies on the following: Boynton Health Services; Employee Health Services; Exercise Room at UMACH-F; FICA; Dental Insurance; Health Insurance; Life Insurance; Voluntary Life Insurance; Long-Term Disability; Short-Term Disability; Insurance Coverage Changes; Bereavement Leave; Family Medical Leave Act (FMLA); Holidays; Medical Leave; Military Leave; Parental Leave; Personal Leave; Professional Leave; Vacation/Sick Leave; Witness/Jury Duty; Effect of Leave for Satisfying Completion of Program; Loan Deferment; Minnesota Medical Association Membership; Minnesota Medical Foundation Emergency Loan Program; Pre-Tax Flexible Spending Accounts; Professional Liability Insurance; Stipends; Veterans Certification for Education Benefits; Workers’ Compensation Benefits).

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EDUCATIONAL EXPENSE ALLOWANCEEach NPM fellow is allotted $500 per academic year. This allowance must be used for professional or educational expenses, such as those associated with attending professional meetings, payment of journal subscriptions, reimbursement for payment of board examination fees, medical licensure outside the state of Minnesota, or purchase of medical books or medical equipment. Since payments and reimbursements under this allowance must be made in accordance with University business practices, fellows should contact the NPM program director or coordinator in advance of making the purchase, to assure that the expense is eligible for reimbursement and to complete the necessary paperwork. The paperwork will be processed by the NPM program coordinator.

Reimbursement for expenses including Minnesota medical license, DEA certification, AAP membership with Perinatal Section membership and UMACH, credentialing are automatically covered by the program for all fellows and are not deducted from the allotted $500 per year.

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INSURANCE Contact Deb Slavin at 612-626-6910/ slavi002@umn.edu if your question involves any payroll implications or contact Office of Student Benefits at 612-624-0627 or umshbo@umn.edu if you have strictly a benefit question. When in doubt, contact Deb.

Refer to Pediatric Program Manual for insurance information at: http://www.med.umn.edu/peds/pedsres/current/programmanual/benefits/insurance/home.html

Health and Dental Insurance Coverage

Professional Liability Insurance

Life Insurance

Voluntary Life Insurance

Long-Term Disability Insurance

Short-Term Disability Insurance

Insurance Coverage Changes (refer also to the Pediatric Program Manual)

LAUNDRY SERVICESAll scrubs obtained on either NICU must be returned to the dispensing machine for laundering. Lab coats will be laundered per the procedure for each lab – review with your individual mentor. Additional laundry is the responsibility of the individual fellow.

LEAVE POLICIES

POLICY ON EFFECT OF LEAVE FOR SATISFYING COMPLETION OF PROGRAM All fellows should first review the University of Minnesota Medical School’s Institution Policy Manual for the sections discussing LOAs and leaves. This manual is at: http://www.med.umn.edu/gme/residents/instpolicyman/home.html.

As required by the American Board of Pediatrics, all fellows must complete three years (36 months) of pediatric training. Of these, 33 months must be spent in completing training requirements. This leaves one month for each year of training to be applied to vacation, sick time, parental leave, and other absences. When accumulated absences from training exceed this three month allotment, training may be extended to satisfy ABP requirements.

If you have questions regarding training time requirements, please review these with your Fellowship Program Director.

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VacationStandard paid vacation time is three weeks plus an additional week of paid leave per year for each fellow to be arranged at least 90 days in advance with the Fellowship Director. Vacation time cannot be carried over from training level year-to-year.

HolidaysFellowship programs follow the Pediatric Residency Program holiday schedule and policy located at: http://www.med.umn.edu/peds/pedsres/current/programmanual/benefits/leave/holidays/home.html. University of Minnesota, University of Minnesota Physicians, or other organizations’ official holidays are not program holidays.

Interviewing TimeA fellow may take up to three calendar days of non-vacation time to interview for a job. These dates must be scheduled with the program in advance and minimize program interruption.

Professional/Academic LeaveA fellow may take up to four calendar days of non-vacation time to attend professional meetings in each year of fellowship. The fellow must submit a request indicating (a) the conference objectives and essentials and the ways in which the meeting fits into the fellow's overall training goals, and (b) plans for appropriate coverage of patient care responsibilities. The travel request must be approved by the Fellowship Director at least 60 days in advance of the conference.

Parental: Maternal/Paternal/Partner LeaveThe typical date/pay configuration in Pediatrics for parental leave is as follows:

Maternity Leave (LOA Form MUST be completed and given to Fellowship Coordinator, Education Manager (elgray@umn.edu), and Payroll (slavi002@umn.edu) prior to leave):

o Typical birth-Two (2) weeks of paid time that does not extend training and four (4) weeks of short-term disability that extends training. Any time on LOA after these dates is unpaid and extends training.

o Cesarean-section- Two (2) weeks of paid time that does not extend training and six (6) weeks of short-term disability that extends training. Any time on LOA after these dates is unpaid and extends training.

Paternal Leave: Two (2) weeks of paid time that does not extend training. Any time on LOA after these dates is unpaid and extends training.

Partner Leave: Two (2) weeks of paid time that does not extend training. Any time on LOA after these dates is unpaid and extends training.

Sick LeaveAn illness resulting in an absence from a rotation must be communicated to the Fellowship Program Director to assure adequate coverage. Any illness resulting in an absence in excess of forty-eight (48) hours requires a physician’s letter describing the medical condition, reason for absence, and anticipated length of the illness. This policy applies only to personal illness. These absences must be documented with a physician's letter. This time can extend training.

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Medical LeaveFor a continuous absence due to personal illness or disability while under the care of a physician, see the disability policies outlined in Institution Policy Manual at http://www.med.umn.edu/gme/residents/instpolicyman/home.html. Written confirmation by the fellow's physician of the need for absence from the training program is required.

When it appears that a major illness will result in a continuous absence from service, it is essential that the trainee communicate with their Fellowship Director, Fellowship Coordinator, the Department of Pediatrics’ Payroll Office, and the Office of Student Benefits.

Personal Leave of Absence Only under UNUSUAL circumstances, such as a personal or family emergency, will a Personal LOA be considered. Such an LOA will be subject to the general conditions noted above. All personal time taken must be made up.

Requests for a personal LOA should be considered carefully as they create scheduling stress in the program and may extend your training. When time away due to LOA is made up at the end of residency training, the additional rotation(s) will conform to the requirements of the American Board of Pediatrics and to program requirements. These rotations and sites may not be the same rotations or sites that were changed to accommodate the LOA. Added rotations are assigned to meet individual training needs and program requirements. Individual preferences may be accommodated when possible.

All LOAs must be discussed with your Fellowship Director and approved in writing at least three (3) months in advance of the start of the LOA. Exceptions may be made if the request falls within the definition of the Family Medical Leave Act (FMLA).

The insurance benefits noted previously in the Institution Manual may be continued at your own expense during a personal LOA. Please consult with the payroll office to arrange extended coverage: Deb Slavin (612) 626-6910.

MEAL ALLOTMENTThe policy for meals at UMACH is outlined at: http://www.med.umn.edu/peds/pedsres/current/programmanual/benefits/meals/home.html. If you qualify for a meal allotment under this policy, contact your coordinator if you do not receive a meal card.

PARKINGThere is no contract or University-paid parking for Pediatric fellows, except those grandfathered in under previous divisional policies. Parking may be acquired and paid for by the fellow.

PHOTOCOPYING PRIVILEGESFellows have photocopying privileges in the Neonatology office on both the University campus and at CHCM–SP. There is a sign-on code specifically for fellows' use for the photocopy machine. Please ask for assistance when first using the copier, or if you experience difficulties while using it. There will be no limit placed on this privilege as long as it is not abused.

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Fellows may also photocopy articles using the photocopy machine in the biomedical library in Diehl Hall. Please contact the Fellowship Coordinator for the budget number to use for this.

SCRUB SUITS, LABCOATS, AND ID BADGESA UMN AHC ID badge is provided in addition to any hospital badges you will receive. Badges must be worn for clear identification. If your AHC badge breaks or is lost, the department will provide a replace-ment. Other lost/broken badges are replaced by the institution (i.e. contact UMMC/UMACH security desk for Fairview badges). Fellows should contact their fellowship coordinator to arrange for their badges.

Professional attire is expected for clinical care and is the responsibility of the fellow. Labcoats are not required for routine clinical care. Scrubsuits are provided on-site and are not to be worn expect for certain procedures. For fellows pursuing basic research, the laboratory in which the research is performed will be responsible for providing appropriate safety wear, including a labcoat.

STIPENDS Stipend rates and policies are at: http://www.med.umn.edu/gme/residents/stipendinfo/home.html

PAYCHECKS/DIRECT DEPOSITRefer to Pediatric Program Manual at: http://www.med.umn.edu/peds/pedsres/current/programmanual/benefits/pay/home.html

TAX INFORMATIONOther than providing the standard W-4 deduction claim forms, the Department of Pediatrics does not provide information or advice on tax matters.

WORKER’S COMPENSATION POLICY AND PROCEDURESRefer to Institution Policy Manual at:http://www.med.umn.edu/gme/residents/instpolicyman/beneworkerscomp/home.html

SECTION 3 - Institution Responsibilities (Please refer to Institution Policy Manual at http://www.med.umn.edu/gme/residents/instpolicyman/home.html for Medical School Policies on the following: ACGME Resident Survey Requirements; ACGME Site Visit Preparation Services; Master Affiliation Agreements or Institution Affiliation Agreements; Program Letters of Agreement; Confirmation of Receipt of Program Policy Manuals; Designated Institution Official Designee Policy; Duty Hour Monitoring at the Institution Level Policy and Procedure; Experimentation and Innovation Policy; Funding; GME Competency Teaching Resources and Core Curriculum; Graduate Medical Education Committee (GMEC) Responsibilities; Graduate Medical Education Committee Resident Leadership Council Responsibilities; Institution and Program Requirements; Internal Review Process; International Medical Graduates Policy; New Program Process; Orientation; Visa Sponsorship Policy). 

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SECTION 4 - DISCIPLINARY AND GRIEVANCE PROCEDURES(Please refer to Institution Policy Manual at http://www.med.umn.edu/gme/residents/instpolicyman/home.html  for Medical School Policies on the following:  Discipline/Dismissal/Nonrenewal; Conflict Resolution Process for Student Academic Complaints; Academic Incivility Policy and Procedure; University Senate on Sexual Harassment Policy; Sexual Harassment and Discrimination Reporting; Sexual Assault Victim’s Rights Policy; Dispute Resolution Policy)

GRIEVANCE PROCEDURES AND DUE PROCESSThe following is an outline of the general procedures and process for the resolution of grievances which may arise within the fellowship program. Detail and clarification must be added as the various elements of these proposals are accepted or rejected or replaced with alternatives. These guidelines or policies are confined to the process within the Department of Pediatrics with the assumption that appeal of the final action or decision coming from the intradepartmental process will remain a viable option once the departmental grievance process has been completed.

A. Principles1. Definition of the legitimate areas of disagreement to be covered by these procedures.2. Provision of ascending levels of recourse with potential for final resolution of the conflict

at each of these levels without prejudice to any rights of the involved individuals.3. Adherence to the principles of due process, academic freedom and fairness.4. Procedures to be readily available and expeditiously executed.5. Inclusion of a system of advocacy.6. Process to be fully documented.

B. Grievance Committee for the Pediatric Education Programs1. The Department of Pediatrics Residency Review Committee (RRC) will fulfill this role.2. All actions of this committee are considered advisory to the Fellowship Program Director

and the Head of the Department of Pediatrics.3. All recommendations of this committee are by a simple majority vote with a quorum

present. A quorum consists of one-half of all the named members of the committee, plus one.

C. Areas of Potential Grievance Covered by these GuidelinesThe areas of possible grievance to be resolved by the following procedures will include, but not be limited to, the following:1. Evaluation of fellow performance by the faculty.2. Assignment or definition of fellow duties.3. Interpretation and implementation of other policies and guidelines, such as those included

in this document.4. Fellow-fellow conflicts.5. Fellow-chief resident conflicts.6. Fellow-resident conflicts.7. Fellow-faculty conflicts.

D. Potential Parties to the Process

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1. Principals in the complaint.2. Mentors, as advisors and advocates.3. Grievance committee.4. Department Head and/or a designee.

E. Grievance Resolution ProcessAs defined here, resolution will be considered an outcome deemed acceptable to the principals to the complaint. When resolution is reached, no further steps in the process will be taken and the matter will be considered closed. This policy assumes that any single principal to the grievance retains the right to carry the process forward by denial of resolution, and to appeal the intradepartmental decisions to extra-departmental grievance procedures.

Steps in the Process:

1. Review of complaint with mentor or other ad hoc advisor. Outcome: resolved OR taken to step 2

2. Informal discussion with other persons deemed appropriate by parties to the complaint. Outcome: resolved OR taken to step 3

3. Formulation of a formal written complaint.4. Forwarding of complaint to the grievance committee, with copies to principals to the

complaint and to the Head of the Department.5. Committee review of the complaint with consultation and written minutes, but without

tape recording. Outcome: resolved with report to the Head of the Department OR taken to step 6

6. Department Head reviews the grievance committee actions and recommendations and then advises the parties to the complaint of his decision as to the dispensation of the complaint action. Outcome:  resolved OR taken to step 7

7.  Appeal to the Medical School and the appropriate extra-departmental grievance process

HOUSE STAFF SUBSTANCE USE/ABUSE POLICYIt is the policy of the University of Minnesota that personnel will be free of controlled substances. Chemical abuse affects the health, safety and well-being of all members of the University community and restricts the ability of the University to carry out its mission. Similarly, the Department of Pediatrics recognizes that chemical/substance abuse or dependency may adversely affect the physician-in-training’s ability to perform efficiently, effectively and in a professional manner. The department believes that early detection and intervention in these cases constitutes the best means for dealing with this social problem and creates the best environment for providing improved patient care. Accordingly, the following policy has been adopted.

A. No fellow shall report for assigned duties under the influence of alcohol, marijuana, controlled substances, or other drugs including those prescribed by a physician which affect his/her alertness, coordination, reaction, response, judgment, decision-making abilities, or adversely impact his/her ability to properly care for patients.

B. Engaging in the use, sale, possession, distribution, dispensation, transfer or manufacture of illegal drugs or controlled substances may have a negative impact on fellow’s ability to perform his/her duties; therefore, no fellow shall use, sell, possess, distribute, dispense,

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transfer or manufacture any illegal drug, including marijuana, nor any prescription drug (except as medically prescribed and directed) during working hours, while on rotation at any hospital or institution participating in the training program.

C. Any violation of this policy may subject the fellow to discipline, including, but not limited to, suspension and/or termination.

D. When there is reasonable cause to believe that a fellow may be using, selling, possessing, distributing, dispensing, transferring, or manufacturing any illegal drug, controlled substance, or alcohol, the fellow may be required to undergo medical evaluation and assessment. The fellow’s ability to continue participation in the program will be determined by their Fellowship Program Director in consultation with attending faculty, Department of Pediatrics Residency Review Committee, and/or the Department Head. Actions may include, but are not limited to, recommendation for treatment and return to duty, suspension from duty with pay, suspension from duty without pay, and/or termination.

E. Depending upon the circumstances, the department may notify appropriate law enforcement agencies and/or medical licensing boards of any violation of this policy.

F. Fellows who are convicted of a criminal drug statute violation (including DWI, boating tickets, etc.) are required to inform their Fellowship Program Director, Department of Pediatrics Residency Review Committee, and/or the Department Head of the conviction (in writing) within five (5) calendar days thereof.

G. Other fellows who have reasonable cause to believe that a colleague is using a substance which adversely impacts on the fellow’s performance in the training program must report the factual basis for their concerns to their Fellowship Program Director.

H. If a fellow is taking a medically authorized substance which may impair his or her job performance, the fellow must notify his or her supervising attending faculty or the Fellowship Program Director of his or her temporary inability to perform assigned duties.

I. The policy of the American Board of Pediatrics maintains that physicians who have a history of chemical dependency, as reported to the American Board of Pediatrics, and who submit documentation acceptable to the American Board of Pediatrics that their disease is known to be under control, can apply for and take the certifying examination. Candidates who have a current problem of chemical dependency, as reported to the American Board of Pediatrics, will not be issued a certificate upon completion of all requirements for certification unless they submit documentation that their disease is known to be under control for five (5) years from the time of the most recent occurrence of the disease.

J. Fellows are encouraged to seek assistance in addressing any problems they might have related to alcohol or substance abuse.

K. Fellows must be aware that there are significant criminal penalties, under state and federal law, for the unlawful possession or distribution of alcohol and illicit drugs. Penalties include prison terms, property forfeiture, and fines.

SECTION 5 - GENERAL POLICIES AND PROCEDURES(Please refer to Institution Policy Manual at http://www.med.umn.edu/gme/residents/instpolicyman/home.html for Medical School Policies on the following: Academic Health Center (AHC) Student Background Study Policy; Background Study Policy and Procedure; Applicant Privacy Policy; Appointment Letter Policy and Procedure; Blood Borne

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Pathogen Diseases Policy; Certificate of Completion Policy; Classification and Appointment Policy; Compact for Teaching and Learning; Disability Policy; Disaster Planning Policy and Procedure; Documentation Requirements Policy; Documentation Retention Requirements for FICA Purposes Policy; Dress Code Policy; Duty Hours/On-Call Schedules; Duty Hours Policy; Duty Hours/Prioritization of On-Call Room Assignments; ECFMG/J1 Visa Holders: Documentation Required for FMLA; Effective Date for Stipends and Benefits Policy; Eligibility and Selection Policy; Essential Capacities for Matriculation, Promotion and Graduation for U of M GME Programs; Evaluation Policy; Health Insurance Portability and Accountability Act; Immunizations and Vaccinations; Immunizations: Hepatitis B Declination Form; Impaired Resident/Fellow Policy and Procedure; Licensure Policy: Life Support Certification Policy; Moonlighting Policy; National Provider Identification (NPI) Policy and Procedure; Nepotism Policy; NRMP Fees Policy; Observer Policy; Post Call Cab Voucher Policy (UMACH-F; HCMC); Registered Same Sex Domestic Partner Policy; Release of Contact Information Policy; Residency and Fellowship Agreement Policy; Residency Management Suite (RMS): Updating and Approving Assignments and Hours in the Duty Hours Module of RMS; Restrictive Covenants; RMS Information Maintenance for Participating Hospitals; Standing and Promotion Policy; Stipend Level Policy; Stipend Funding from External Organizations Policy; Supervision Policy; Training Program and/or Institution Closure or Reduction Policy; Transitional Year Policy; USMLE Step 3 Policy; Vendor Policy; Verification of Training and Summary for Credentialing Policy; Voluntary Life Insurance Procedure; Without Salary Appointment Policy ).

SUBSPECIALTY TRAINING REQUIREMENTS FOR FELLOWS

Academic Expectations for Pediatric FellowsThe Department has identified a core list of academic expectations for all pediatric fellows in order to support our mission. This list includes, but is not limited to, completion of ABP requirements, development of an individualized learning plan (ILP), Scholarship Oversight Committee meeting frequency, identification of an academic mentor, completion of Core Curriculum series, attendance at Pediatric Research, Education, and Scholarship Symposium (PRESS), and presentation of scholarly work. The current list of Academic Expectations for Fellows is located at: http://www.med.umn.edu/peds/education/fellowships/current/home.html.

Core CurriculumAll fellowship programs participate in a core curriculum in scholarly activities.  This curriculum provides experiences that lead to an in-depth understanding of biostatistics, clinical and laboratory research methodology, study design, preparation of applications for funding and/or approval of clinical or research protocols, critical literature review, principles of evidence-based medicine, ethical principles involving clinical research, and the achievement of proficiency in teaching.  Participation in the core curriculum should lead to an understanding of the principles of adult learning and provide skills to participate effectively in curriculum development, delivery of information, provision of feedback to learners, and assessment of educational outcomes.  We anticipate graduates will be effective in teaching both individual and group learners in clinical settings, classrooms, lectures and seminars, and also by electronic and print modalities. 

The Department Education Office offers an annual department-wide core curriculum series for pediatric subspecialty programs. The core curriculum is managed at the Department level to optimize training, while minimizing duplication of effort across the various subspecialty programs participating.  Current

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attendance requirements and schedule are located at: http://www.med.umn.edu/peds/education/fellowships/current/corecurriculum/home.html.

Scholarly ActivitiesIn addition to participating in a core curriculum in scholarly activities, all fellows will be expected to engage in projects in which they develop hypotheses or in projects of substantive scholarly exploration and analysis that require critical thinking. Areas in which scholarly activity may be pursued include, but are not limited to: basic, clinical, or translational biomedicine; health services; quality improvement; bioethics; education; and public policy. In addition to biomedical research, examples of acceptable activities might include a critical meta-analysis of the literature, a systematic review of clinical practice, a critical analysis of public policy, or a curriculum development project with an assessment component.

Work Product of Scholarly Activity Involvement in scholarly activities must result in the generation of a specific

written "work product" as outlined by the ABP (www.abp.org). Examples of include, but are not limited to:

A peer-reviewed publication in which a fellow played a substantial role An in-depth manuscript describing a completed project A thesis or dissertation written in connection with the pursuit of an advanced degree An extramural grant application that has either been accepted or favorably reviewed A progress report for projects of exceptional complexity, such as a multi-year clinical trial

The fellow’s Scholarship Oversight Committee (SOC) is instrumental in guiding the fellow’s activity towards an acceptable product. The SOC will be arranged by each fellow in collaboration with the program director. In addition to the work of the SOC, the department will provide all subspecialty fellows with the opportunity to participate in a departmental research, education, and scholarship forum to present their work product and receive feedback from department faculty.

Scholarship Oversight Committee (SOC)The SOC, in conjunction with the trainee, the mentor, and the program director will determine whether a specific activity is appropriate to meet the ABP guidelines for scholarly activities (www.abp.org). These activities require active participation by the fellow and must be mentored. The mentor(s) will be responsible for providing the continuous ongoing feedback essential to the trainee’s development.

Review of scholarly activity and the written work product will occur at the local level with each fellow having a SOC responsible for overseeing and assessing the progress of each fellow and verifying for the ABP that the requirement has been met. The SOC must consist of three or more individuals, at least one of whom is based outside the subspecialty discipline; the fellowship program director may serve as a trainee’s mentor and participate in the activities of the oversight committee, but should not be a standing (i.e. voting) member. Particular emphasis will be placed on encouraging identification of committee members whose professional and research responsibilities encompass elements of the trainee’s scholarly interest, but who do not necessarily have a primary appointment in the Department of Pediatrics. Examples of such individuals include faculty in clinical departments in the University of Minnesota Academic Health Center (AHC), faculty in basic science departments, or faculty in the Schools of Public Health or Education.

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This committee will:1. Determine whether a specific activity is appropriate to meet the ABP guidelines for

scholarly activity.2. Provide guidance in charting a course of preparation beyond the core fellowship

curriculum to ensure successful completion of the project.3. Evaluate the fellow's progress as related to scholarly activity.4. Meet with the fellow early in the training period (within 6 months of initiation of

fellowship training) and regularly thereafter.5. Require the fellow to present/defend the project related to his/her scholarly activity.6. Advise the program director on the fellow's progress and assess whether the fellow has

satisfactorily met the guidelines associated with the requirement for active participation in scholarly activities.

The fellow, in conjunction with the fellowship director or designee and research mentor, should identify the direction for the scholarly activity.  At the first SOC meeting, the purpose will be to hear the general path the fellow has chosen, to help further outline the path, and determine the specific steps for the fellow to meet the outlined path. The SOC should meet again within 4-6 months of the first meeting and at least semi-annually thereafter to further update and guide the fellow on developing their scholarly path. 

A written report by the chair of each trainee's SOC should be completed twice a year and forwarded to the fellowship program director. The Department Education Office will provide the subspecialty training programs with standard forms for documenting each SOC meeting. The fellowship director and the head of the fellow's SOC are expected to monitor whether additional SOC meetings are necessary for fellows who need more help or may be changing their scholarly activity. 

The final responsibility of the SOC is to review and approve the final scholarly “work product” of the applicant prior to submission to the ABP.

A list of potential SOC members and their research interests are available under “Fellowship Administration Intranet” at: http://www.med.umn.edu/peds/education/fellowships/home.html. You will need to log in to the Intranet with your x500 and password. Fellows are encouraged to recruit their own SOC members with guidance from their program director.

External OversightA program’s ability to provide a satisfactory scholarly experience for all trainees will be evaluated periodically, as described below.

The Pediatric Residency Review Committee (RRC) of the ACGME reviews the training program’s structure as it relates to the ACGME clinical, administrative, and scholarly activity requirements.

Periodic peer review of the quality of the training environment related to scholarly activity, in addition to that undertaken by the RRC, occurs. Currently, the Department of Pediatrics’ Fellowship Oversight Committee (FOC) serves in this peer review role.

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Responsibilities of the Training Program DirectorIn addition to meeting the requirements of the ACGME related to the six general competencies, the responsibilities of the training program director shall include the creation of a core curriculum in scholarly activities, the identification of a mentor, the creation of the Scholarship Oversight Committee responsible for overseeing and assessing the progress of each trainee, and providing verification to the ABP of the successful completion of training. Additional duties are as assigned by the Department of Pediatrics’ Department Head and the University of Minnesota Medical School.

It is the responsibility of the training director to review the SOC documentation and clarify the responsibilities and outcomes for each fellow. The SOC and the Fellowship Program Director are both accountable for scholarly progress of individual fellows and will share their recommendations with the Department Chair.

Verification of Scholarly ActivityUpon completion of training, the ABP will require:

Verification from the training program director that the clinical and scholarly skills requirements have been met

A comprehensive document (i.e. personal statement), written by the fellow, describing the scholarly activity that includes a description of his/her role in each aspect of the activity and how the scholarly activity relates to the trainee’s own career development plan

The actual “work product” of the scholarly activity as described above Signature of the fellow, program director, and members of the Scholarship Oversight

Committee on both the personal statement and work product of the fellow as described above

The fellow will need to produce the work product and personal statement, as well as obtain approval from the SOC to be eligible to sit for the Subspecialty Board Examination.  The decision about the adequacy of the work product is the responsibility of the SOC and the program director. 

Fellowship Program Directors are evaluated on these responsibilities annually as part of their annual faculty performance review.

CURRICULUM

NEONATAL-PERINATAL FELLOWSHIP CURRICULUMThe NPM fellowship program consists of the following components as outlined by the Program Requirements for Education developed by the American Board of Pediatrics (ABP) and ACGME Resident Review Committee (RRC) for Neonatal-Perinatal Medicine. Please see www.acgme.org/acWebsite/RRC_320/320_prIndex.asp. Fellows are assigned to these components in an educationally appropriate sequence over the usual 36 months of training.

Clinical CurriculumThe clinical curriculum is based on providing PL-4 fellows (1st year) with a high degree of direct patient contact and responsibility on the NICU, and providing PL-4/5/6 fellows graded supervisory

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responsibility for the PL-1/2/3 residents, medical students and their patients. The first year consists of predominately clinical activities and the second two years are primarily for scholarly activity. The fellowship requires 12-15 months of clinical rotations consisting of a minimum of 12 months assigned to the NICU, one month on cardiology and additional elective time as desired. Six to nine months of the first year are spent rotating between the two NICUs as a clinical fellow who functions as a junior staff person in the supervision of the hour-to-hour care of critically ill newborn infants. In addition, fellows generally have three to six months of clinical experience during the second and third years. During the third year of clinical service, the fellow is expected to function fully as a junior attending neonatologist. Formal training in NRP, transport of the critically ill newborn infant and ECMO will be provided. Participation in the NICU Follow-up Clinic is required during all three years of the fellowship. Elective rotations include a Maternal-Fetal Medicine and Pediatric Surgery rotation.

Scholarly ActivityThe remainder of the Neonatal-Perinatal Medicine Fellowship consists of 18-21 months of scholarly activity. As per the ABP, “all fellows will be expected to engage in projects in which they develop hypotheses or in projects of substantive scholarly exploration and analysis that require critical thinking. Areas in which scholarly activity may be pursued include, but are not limited to: basic, clinical or translational biomedicine; health services; quality improvement; bioethics; education; and public policy.” Traditional clinical basic research or other scholarly activities, within neonatology, perinatology and developmental biology are facilitated by the mentors in neonatology or other related subspecialties. Neonatologists and subspecialists in other pediatric divisions supervise these studies and are instrumental in developing individual projects with appropriate specific curriculum (e.g., laboratory meetings, journal clubs, course work).

Fellows will work with the program director and their specific mentor, once an area of interest is identified, to develop an individualized learning plan (ILP) along one of two tracks: either a research scholar track or a clinical scholar track. The goals and objectives will then be individualized to address the specific area of scholarly investigation.

Collaborative ResearchThe University of Minnesota and Children’s Hospitals and Clinics–St. Paul have been involved in many national collaborative trials over the past twenty-five years including trials of surfactant, inhaled nitric oxide and the STOP-ROP consortium. Additional collaborative research is ongoing between division members and members of the Divisions of Gastroenterology (Sarah Jane Schwarzenberg, M.D., and Glenn Gourley, M.D.), Cardiology (Jamie Lohr, M.D.) in the Department of Pediatrics; the Department of Laboratory Medicine and Pathology (Carol L. Wells, Ph.D.); the Institute of Child Development (Kathleen Thomas, M.D., and Megan Gunnar, Ph.D.); and the Department of Veterinary Pathobiology (Mathur Kannan, Ph.D., and David R. Brown, Ph.D.). Several fellows have been supported on the Infectious Disease Training Grant as part of a combined neonatal-infectious disease fellowship.

Fellows also have the opportunity to participate in graduate-level coursework offered by the University and to obtain a Masters of Clinical Research, Masters of Public Health or Masters in Health Informatics. The specific curricula for these programs are listed at their respective websites.

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Potential Mentors within the Division of NeonatologyCatherine M. Bendel, M.D.~ Dr. Bendel’s research is on the pathogenesis of infections due to Candida albicans and other Candida species in neonates. Her work is specifically oriented toward assessing yeast factors that account for adhesion and virulence and the host microbe interaction. Dr. Bendel has developed tissue culture models to assess yeast adhesion, as well as animal models to evaluate gastrointestinal tract colonization and the pathogenesis of invasive yeast infections. Her work is supported by grants from the March of Dimes, Birth Defects Foundation, and the NIH.

Mark Bergeron, M.D. ~ Dr. Bergeron is on faculty at Children’s Hospitals and Clinics–St. Paul, and has a Master’s in Public Health in the area of Maternal and Child Health. Dr. Bergeron has a strong interest in clinical research and has been actively involved in the Vermont Oxford Network.

J. Michael Coleman, M.D.~ Dr. Coleman is director of the Apnea Diagnostic Center and the Infant Apnea Program at Children’s Hospitals and Clinics–St. Paul. The center serves as a comprehensive apnea diagnostic center for a five-state area, with the capability of monitoring pCO2 responsiveness, EEG, airflow impedance and gastroesophageal reflux during sleep. Dr. Coleman’s specific research interest is in mechanisms of control of ventilation in neonates and its relationship to SIDS. He is funded by the Research and Education Fund of Children’s Hospitals and Clinics–St. Paul.

Cheryl A. Gale, M.D.~ Dr. Gale is an established investigator in the molecular pathogenesis of Candida albicans infections. She has a joint appointment in the Department of Genetics, Cell Biology and Development, and is a faculty member of the University of Minnesota’s Molecular, Cellular, Developmental Biology, and Genetics Graduate Program. Dr. Gale’s research focus is in molecular mechanisms of C. albicans morphogenesis and how fungal morphogenesis proteins are involved in tissue invasion and destruction. Her research is funded by the NIH (NIAID).

Thomas George, M.D.~ Dr. George is Clinical Director of the UMACH NICU and Associate Program Director for the Pediatric Residency Program. He is involved in clinical research projects on the NICU, participates in our Vermont-Oxford Network team, administrative/program development, outreach, and neonatal CME activities.

Michael K. Georgieff, M.D.~ Dr. Georgieff is an established investigator in neonatal nutrition and metabolism and neurodevelopment. He has a joint appointment in Pediatrics and the Institute of Child Development and is a member of the Neuroscience Graduate Faculty. Dr. Georgieff is the chief of Neonatology and Co-Director of the Center for Neurobehavioral Development (CNBD) at the University of Minnesota. He also directs the Neonatal Nutrition Support Service and the NICU Follow-up Clinic at the University site. His research is on the impact of early nutrition on developmental outcome of infants, specifically studying the cellular and molecular mechanisms of placental iron transport and the neurologic sequelae of perinatal iron deficiency. He is supported by grants from the NIH (NICHD and NINDS).

Sixto F. Guiang, III, M.D.~ Dr. Guiang’s research focuses on the effect of iron deficiency on fetal and neonatal myocardial energetics and contractility. His interest lies in the regulation of myocardial hemoprotein expression (myoglobin, cytochrome c) during conditions of limited iron availability and hypoxia. He is also involved in multiple clinical research projects.

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Dana E. Johnson, M.D., Ph.D.~ Dr. Johnson investigates the short- and long-term medical and developmental effects of early childhood institutionalization and the outcome of children adopted internationally. Of particular interest is the relationship between stress and somatic/brain growth. His work is supported by the Minnesota Medical Foundation, the Viking Children’s Fund, the NIH, and Genentec. He is also a member of the CNBD.

Mathur Kannan, Ph.D.~ Dr. Kannan is a member of the Department of Veterinary Pathobiology in the School of Veterinary Medicine. His research focus is in the areas of signal transduction mechanisms in smooth muscle cells of airway and pulmonary vasculature, and macrophages. Specifically, he is studying the role of cyclic ADP-ribose in intracellular calcium regulation in smooth muscle cells. These studies include nitric oxide and cyclic nucleotide regulation of calcium and force in smooth muscle. Dr. Kannan is investigating the role of calcium and NF-kB activation in cytokine gene expression including macrophages and their response to bacterial toxins. He is funded in part by the NIH.

Andrea Lampland, M.D.~ Dr. Lampland’s research interests lie in minimally invasive modes of ventilation. Dr. Lampland collaborates with Dr. Mammal in the Infant Pulmonary Research Center at CHCM-SP.

Mark C. Mammel, M.D.~ Dr. Mammel is an established investigator in the field of pulmonary medicine and is the director of the Infant Pulmonary Research Center at Children’s Hospitals and Clinics–St. Paul. His research focus is on mechanical ventilation of the newborn infant. He is currently funded by the Children’s Health Care Foundation.

Raghavendra Rao, M.D.~ Dr. Rao is a core faculty member with the Center for Neurobehavioral Development and is a member of the Graduate Program in Neuroscience. His research focus is regional brain development under typical and adverse perinatal conditions. He is specifically interested in understanding the effects of acute hypoglycemia, iron deficiency, chronic hypoxia, acute hypoxia-ischemia on the developing hippocampus. He utilizes high-field NMR spectroscopy and immunohistochemistry in his research, which is funded by the NICHD, Viking Children’s Fund, the Graduate School and the Minnesota Medical Foundation

Kari Roberts, M.D.~ Dr. Roberts participates in clinical research projects and the Vermont Oxford Network QI/QA projects. Her particular area of interest is neonatal resuscitation and education in the clinical setting of the NICU. She is a member of the SimPORTAL team and has developed neonatal simulation labs for residents and fellows.

Jill M. Therien, M.D.~ Dr. Therien’s research interest is in the area of memory and early language development. She uses electrophysiologic techniques to study these processes in both healthy and high-risk infants. She collaborates with Drs. Nelson and Georgieff, as well as Dr. Raye-Ann deRegnier at Northwestern University, Chicago, IL. She is currently funded by the Viking Children’s Fund and the NIH.

Theodore R. Thompson, M.D.~ Dr. Thompson’s research interests include neonatal transport, pulmonary hypertension and ethical issues in the NICU setting. He is a professor of pediatrics and Chief of Staff at the University of Minnesota Medical Center, Fairview, heavily involved in the clinical education programs for the Year 3 and 4 medical students. He also serves as Associate Head for

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Community Affairs for the Department of Pediatrics, as well as Medical Director for the NICU at Fairview Southdale and Ridges Hospitals. Dr. Thompson was the 2006 recipient of the University President’s Outstanding Service Award, and is a recipient of the Leonard Tow Faculty Humanism Award from the Minnesota Medical Foundation.

ConferencesThe table below provides a listing of the major conferences offered and the frequency at which they occur.

ConferencesThe table below provides a listing of the major conferences offered and the frequency at which they occur

Conference FrequencyNeonatal-Perinatal Fellows’ Conference 1/weekClinical Standards Conference (Morbidity and Mortality/Pathology; UMACH)

1/ 2 months

Morbidity and Mortality Conference (Pathology; CHCM-St. Paul) 1/monthNICU Resident Conference 1/weekMaternal-Fetal Medicine/Neonatal Conference 1/ 3 monthsPediatric Grand Rounds 1/weekPediatric Department 3M Conference 1/week (Neo presents 1per year)Pediatric Core Curriculum for the Subspecialty Resident 8/yearCenter for Neurobehavioral Development Colloquia 2/monthECMO Training Course 1-week course/12-18 monthsNRP Certification 1/ 2 yearsVermont Oxford Outcomes Network 1/monthNICU Collaborative Practice Council (UMACH) 1/monthNICU Health Team Rounds (UMACH) 1/weekSocial Service Rounds (CHCM-SP) 1/weekPediatric Research, Education and Scholarship Symposium (P.R.E.S.S.)

1/year

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Teaching Responsibilities

Educational ProgrammingOngoing clinical and scholarly educational programs include the weekly Fellows’ Conference, composed of our Neonatal Research Conference, the Neonatal Physiology Course (based on Neonatal-Perinatal Medicine: Diseases of the Newborn Infant, 8th edition; editors: Fanaroff & Martin), Journal Club and other didactic lectures. The Pediatric Core Curriculum for Subspecialty Residents is a seminar series for all fellows in the Department of Pediatrics. Other conferences and lecture series specific to individual areas of interest are also available, such as the Developmental Biology Center bi-monthly seminar series. Each NICU has specific neonatal conferences for the education of pediatric and family practice residents, as well as perinatal and pathology conferences. The table above provides a listing of the major conferences offered and the frequency at which they occur. Education information and lectures are also available online at the Neonatal-Perinatal Medicine Fellowship web site:https://intranet.ahc.umn.edu/peds/neonat/education/fellowship/shared/home.html

PROGRAM GOALS AND OBJECTIVESRefer to the independent program document, Goals and Objectives, for this information. This document is located at: http://www.med.umn.edu/peds/education/fellowships/administration/goals/home.html.

ACGME CORE COMPETENCIESAll University of Minnesota Medical School Fellowship training programs define the specific knowledge, skills, attitudes, and educational experiences required by the RRC to ensure its residents/fellows demonstrate the following:

Patient Care - Fellows must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health.

Medical Knowledge - Fellows must demonstrate knowledge of established and evolving biomedical, clinical, epidemiological and social-behavioral sciences, as well as the application of this knowledge to patient care.

Practice-based Learning and Improvement – Fellows must demonstrate the ability to investigate and evaluate their care of patients, to appraise and assimilate scientific evidence, and to continuously improve patient care based on constant self-evaluation and life-long learning. Fellows are expected to develop skills and habits to be able to meet the following goals:

identify strengths, deficiencies, and limits in one’s knowledge and expertise; set learning and improvement goals; identify and perform appropriate learning activities; systematically analyze practice using quality improvement methods, and implement changes

with the goal of practice improvement; incorporate formative evaluation feedback into daily practice; locate, appraise, and assimilate evidence from scientific studies related to their patients’ health

problems; use information technology to optimize learning; and,

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participate in the education of patients, families, students, residents and other health professionals.

Interpersonal and Communication Skills - Fellows must demonstrate interpersonal and communication skills that result in the effective exchange of information and collaboration with patients, their families, and health professionals. Fellows are expected to:

communicate effectively with patients, families, and the public, as appropriate, across a broad range of socioeconomic and cultural backgrounds;

communicate effectively with physicians, other health professionals, and health related agencies; work effectively as a member or leader of a health care team or other professional group; act in a consultative role to other physicians and health professionals; and, maintain comprehensive, timely, and legible medical records, if applicable.

Professionalism - Fellows must demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles. Fellows are expected to demonstrate:

compassion, integrity, and respect for others; responsiveness to patient needs that supersedes self-interest; respect for patient privacy and autonomy; accountability to patients, society and the profession; and, sensitivity and responsiveness to a diverse patient population, including but not limited to

diversity in gender, age, culture, race, religion, disabilities, and sexual orientation.

Systems-based Practice - Fellows must demonstrate an awareness of and responsiveness to the larger context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care. Fellows are expected to:

work effectively in various health care delivery settings and systems relevant to their clinical specialty;

coordinate patient care within the health care system relevant to their clinical specialty; incorporate considerations of cost awareness and risk-benefit analysis in patient and/or

population-based care as appropriate; advocate for quality patient care and optimal patient care systems; work in inter-professional teams to enhance patient safety and improve patient care quality; and participate in identifying system errors and implementing potential systems solutions.

DUTY HOURS Duty Hours are defined as all clinical and academic activities related to the training program, i.e.,

patient care (both inpatient and outpatient), administrative duties related to patient care, the provision for transfer of patient care, time spent in-house during call activities, and scheduled academic activities such as conferences. Duty hours DO NOT include reading and preparation time spent away from the duty site.

Duty hours are limited to 80 hours per week, averaged over a four-week period, inclusive of all in-house call activities.

Fellows are provided with 1 day in 7 free from all educational and clinical responsibilities, averaged over a 4-week period, inclusive of call.

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The training program provides adequate time for rest and personal activities, which consists of a 10-hour time period provided between all daily duty periods and after in-house call.

All fellows are required to track their duty hours in New Innovations’ Residency Management Suite (RMS).

Programs review this duty hour information on a quarterly basis to address violations. More information about duty hours is available in the Pediatric Program Manual.

ON-CALLIn-house call is defined as those duty hours beyond the normal work day when fellows are required to be immediately available in the assigned institution. In-house call must occur no more frequently than every third night averaged over a four week period. Continuous on-site duty, including in-house call, must not exceed 24 consecutive hours. Fellows may remain on duty for up to 6 additional hours to participate in didactic activities, transfer care of patients, conduct outpatient clinics and maintain continuity of medical and surgical care

General On-Call RequirementsOn-call requirements vary throughout the fellowship but will always be in compliance with ACGME guidelines (www.acgme.org/acWebsite/irc/irc_IRCpr703.asp). Fellows covering the clinical service are on-call more frequently than when assigned to research. Specific schedules are determined for each site. On-call coverage is provided by pager-availability home call at UMACH, and is generally nine nights per month for the clinical fellow and four nights per month for the research fellows assigned to UMACH. In-house on-call coverage is required at CHCM–St. Paul and consists of six nights per month for clinical fellows and three to four nights per month for research fellows assigned to that site.

Transport CallAll fellows must participate in providing coverage for transports, as part of their on-call responsibilities at UMACH. Additional opportunities to provide transport call by moonlighting are available.

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SCHEDULING

Fellows will meet with the Fellowship Program Director in the spring of each year to discuss scheduling options based on educational considerations.

First-Year SchedulingThe first year rotations will be scheduled by the NPM program director based on educational considerations. Six to nine months of clinical time and six to three months of research time will be scheduled based on each fellow’s individual educational/research goals. Fellows may elect also to spend one month working with the perinatal specialists or pediatric surgeons during either the first or second year. These elective rotations are independently arranged by the fellow with the appropriate University maternal-fetal medicine or surgery attending physician. Elective rotations are arranged for a 2-4-week time period, usually in conjunction with a scholarly activity rotation.

Second-/Third-Year SchedulingThe majority of the second and third years will be spent in scholarly training/endeavors. Fellows will spend two to three months per year in required clinical rotations or electives.

NICU Follow-up ClinicFellows will participate in NICU Follow-up Clinic during each year of training. Attendance is required.

Allocation of Clinical/Scholarly Activity TimeIn accordance with the ABP and ACGME, the fellow will be scheduled for a minimum of 12 non-consecutive months of required clinical service on the NICU and one additional month of cardiology. This NICU clinical time will be divided evenly between both hospital sites. An additional three to six months may be scheduled based on individual fellows’ and the program’s needs.

Schedule ChangesOnce the rotation schedule is finalized and distributed at the beginning of the year, changes will not be permitted except when fellows arrange mutually acceptable trades with other fellows. These trades must be approved by the NPM program director. Occasionally, changes in the schedule may become necessary because of sickness or family emergency. Such changes will be made without compromising the established curriculum of the NPM fellowship program.

ABSENCE COVERAGEThere may be a number of situations in which fellow may be unable to fulfill scheduled responsibilities. These situations include sickness, disability, pregnancy, personal reasons and educational reasons. Coverage of anticipated absences should be arranged among the fellows by trading assignments, or using the “backup call” schedule. This schedule is determined by the fellows on a monthly basis and covers all clinical responsibilities, including NICU Follow-up Clinic. (See Back-Up Policy)

BACK-UP POLICYResident and fellow well-being will be closely monitored by the training program and supervising faculty. Faculty and fellows are educated to recognize the signs of fatigue and will adopt and apply policies to

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prevent and counteract the potential negative effects. Instruction on accessing Fatigue curriculum is available at: http://www.med.umn.edu/gme/residents/orientation/home.html#GMEMoodle. If a trainee feels they cannot provide safe patient care, they should immediately contact the supervising faculty, who will excuse the trainee from patient care responsibilities until the trainee is rested and able to provide safe patient care again. Once the trainee is excused, their patient care duties will become the responsibility of the supervising physician, utilizing any additional identified back-up systems as needed. Any other faculty member, fellow or member of the health care team who identifies a fellow as being fatigued should also contact the supervising faculty to suggest removal of the fellow until safe patient care can once again be provided.

MONITORING OF FELLOW WELL-BEINGThe program director is responsible for monitoring resident stress, including mental or emotional conditions inhibiting performance or learning, and drug-related or alcohol-related dysfunction. Both the program director and faculty should be sensitive to the need for timely provision of confidential counseling and psychological support services to residents. Situations that demand excessive service or that consistently produce undesirable stress on residents must be evaluated and modified. Refer to the Back-Up Policy for instruction on what to do if a fellow is fatigued or stressed, especially if unable to provide safe patient care.

SUPERVISION OF FELLOWS

Overall SupervisionAll patient care must be supervised by qualified faculty. The program director will ensure, direct, and document adequate supervision of residents and fellows at all times. Fellows will be provided with rapid, reliable systems for communication with supervising faculty. Fellows must be supervised by teaching staff in such a way that they assume progressively increasing responsibility according to their level of education, ability, and experience. On-call schedules for teaching staff must be structured to ensure that supervision is readily available to fellows on duty. The teaching staff must determine the level of responsibility given to each fellow.

Lines of supervisory responsibility—ClinicalFor all patients, the core pediatric/family practice resident or NNP will be supervised by the NPM fellow, who will report directly to the attending neonatologist. The attending neonatologist is responsible for providing appropriate supervision to the NPM fellow. Good communication and feedback is important to optimize both patient care and fellow education. If the fellow feels that he/she is not receiving adequate guidance/supervision, he/she must communicate this directly to the attending physician. If the attending neonatologist is not immediately available, the NPM fellow is responsible for reporting to the NPM program director or the co-director at CHCM-St.Paul, or other available faculty on call. A fellow may request the physical presence of an attending at any time and will never be refused. Any significant change in a patient’s condition must be reported immediately to the attending physician. All patients scheduled for discharge must be discussed with the attending prior to the discharge.

Lines of supervisory responsibility—Research / SCHOLARLY ACTIVITYNPM fellows are responsible for planning and executing their own scholarly activity projects, as well as generating a written work product for submission to the American Board of Pediatrics (ABP). Supervision of this work is provided by the primary research mentor. The mentor may designate other

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members of his/her research team (Ph.D.s, technicians, etc.) to assist with supervision of portions of the work as indicated.

However, the mentorship for the overall project must come from the research mentor. Periodic formal reviews by the SOC are required. The NPM program director is responsible for supervising the individual faculty research mentors to ensure that each fellow is working toward achieving their scholarly goals. Concerns on the part of the NPM fellow should be directed first to the research mentor and then, if unresolved, to the NPM program director and SOC.

All patient care must be supervised by qualified faculty. The program director will ensure, direct, and document adequate supervision of residents and fellows at all times. Residents/Fellows will be provided with rapid, reliable systems for communication with supervising faculty. Residents must be supervised by teaching staff in such a way that the residents assume progressively increasing responsibility according to their level of education, ability, and experience. On-call schedules for teaching staff must be structured to ensure that supervision is readily available to residents on duty. The teaching staff must determine the level of responsibility given to each resident/fellow. Faculty and Residents/Fellows are educated to recognize the signs of fatigue and will adopt and apply policies to prevent and counteract the potential negative effects.

EVALUATIONEvaluation is an essential component of the educational process and should contribute to the professional growth of each fellow. Problems with expected performance or progress on the part of a fellow should be identified and reported early. The evaluations of all fellows should be subject to regular and frequent review. Mentors should be central to the review process. Evaluation shall extend to the fellow notice of all information which is pertinent to the evaluation and an opportunity for concerns to be communicated and heard.

Steps in the Evaluation ProcessAppropriate faculty evaluator and evaluation setting are identified. The evaluation format and instrument is defined. The evaluator determines and reviews sources of information pertinent to the evaluation. Written evaluations are completed by the evaluator, using either the standard evaluation form found in our online tool or, in exceptional circumstances, an ad hoc evaluation. Evaluations are to be discussed with the fellow by the evaluator. The Fellowship Program Director can involve the Resident Review Committee (RRC) for guidance on potential remediation situations. In accord with the fellow contract, if at any time the Evaluator, the Fellowship Program Director and/or the Chairperson of the RRC determines that patient care or safety is jeopardized they may bring that information immediately to an emergency meeting of the RRC and/or to the head of the Department of Pediatrics who may suspend the fellow from patient care responsibilities.Copies of the written evaluations are readily available to the fellow and his or her mentor via our online tool, or sent upon request.

Fellows meet twice a year with the Program Director for evaluation, and the Program Director provides a final evaluation for each fellow completing the program. Records of the evaluations on each resident and fellow are accessible to them.

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Possible Outcomes of Review by the Resident Review Committee (RRC)The RRC may recommend one or more of the following as courses of action for the Fellowship Program Director to pursue:

1. Normal advancement with commendation2. Normal advancement within the training program.3. Medical and/or psychiatric appraisal as to suitability for continuation of fellowship training.4. Probation with continuation of normal rotations, but with more detailed and frequent evaluation.

The fellow and his/her mentor are invited to appear before the RRC before an individual is placed on probation.

5. Probation with loss of credit for a specified rotation or rotations deemed unsatisfactory by the RRC. The RRC may recommend that such non-credited rotations be satisfactorily repeated or that the fellow be assigned to a comparable remedial service or rotation.

6. Immediate suspension with pay. The fellow is relieved of all duties relative to the fellowship training program. This action is temporary until one of the following is implemented.

7. Probation with certain rotations or services to be repeated.8. Modification of the fellow's assigned program to provide remedial training in a special setting

with a special assigned tutor(s).9. Dismissal from the program. 10. Final written summary review on completion, of or departure from the program, to be entered

into the fellow's permanent file.Actions 5, 6, or 7 above will automatically require extension of the minimum training time necessary to become eligible for the examinations of the American Board of Pediatrics.

Types of EvaluationsIn accordance with ACGME requirements, all UMN pediatric fellowship programs are required to collect multiple types of evaluations. The evaluations required to be collected via RMS include:

Program Director Eval of Fellow (2X per year at minimum) -completed semiannually before progression meeting with Program Director

Fellow Self-Eval (2X per year at minimum)-completed semiannually before progression meeting with Program Director

Fellow Eval of Program (2X per year at minimum)-completed before semiannual progression meeting with Program Director

Faculty Eval of Fellow (2X per year at minimum)-completed quarterly during clinical year (CHMS-SP) or end of monthly rotation

Faculty Eval of Program (1X per year at minimum) Fellow Eval of Rotation (2X per year at minimum) Fellow Eval of Core Curriculum (after each attended session) Fellow Eval of Faculty (1X per year at minimum) For patient/family evaluation and nurse evaluation, standard department forms are available from

Fellowship Coordinator. At least 2x/year (or more if the PD prefers), the coordinator will give the fellow 5-10 of each of these evaluations to distribute. After distribution, the coordinator will collate the responses for the fellow file.

Evaluation ConfidentialityEvaluation confidentiality is of high importance in the department. A grid outlining evaluation confidentiality is available at: http://www.med.umn.edu/peds/education/fellowships/current/home.html.

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In order to maintain a confidential feedback system, there are several mechanisms in place: Only the program coordinator and Department Education Office have access to view the fellow

identity for evaluations the fellow has completed on faculty. Evaluation of faculty teaching performance is included in all annual faculty performance

evaluations. These evaluations are completed either by the Department Chair or Division Chair. In cases where there are few evaluators and evaluation results are inaccessible to the subject,

summary results can be obtained from the coordinator or the Department Education Office. Coordinators receive annual guidance on how to collate evaluations to promote confidentiality.

Types of AssessmentsDemonstration of basic clinical competency in NICU at each site, as well as in Follow-up Clinic should be achieved during the first year. Written evaluation scores should be in the satisfactory range. During the second year, refinements should occur such that by the third year, fellows should be able to demonstrate competency at the level of a new junior attending, and written evaluation scores should be above satisfactory. The following methods are used by the program director to assess the fellows’ achievement of the clinical goals, objective and competencies:

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1. Written evaluations of competency in all areas of clinical care are competed by the faculty, through RMS. These evaluations/assessments are completed quarterly during the first year and semi-annually during the second and third years. The NPM subspecialty resident’s technical abilities are also assessed.

2. 360º evaluations of the fellows are completed by the neonatal nurse practitioners, respiratory therapists, social workers, discharge planners and NICU nursing staff. The program director also meets semi-annually with the chief NNP to review the performance of each fellow, with particular attention paid to an assessment of procedural skills.

3. Each fellow must keep a procedural log. Any procedural complications are reviewed at the respective M&M conference equivalents.

4. Parent evaluations of each fellow are completed – minimum 3/year/ NICU.

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5. ABP Subspecialty In-Service Examination (SITE) 6. NRP certification 7. Participation in health team/social service rounds 8. Participation in M&M conferences and evaluation

of care provided

9. Participation in NPM fellow’s conference 10. NeoReviews self-assessment scores. The Division

provides each NPM subspecialty resident with a subscription to NeoReviews, offering another opportunity for learning, self-assessment and the establishment of habits which will lead to life-long learning and regular CME.

11. Participation in family conferences with written evaluations

12. Participation in Collaborative Practice Counsel 13. Fellow portfolio

Annual Program ReviewThe program is evaluated in detail at least once per year. Minutes of the program review are to include five key areas of performance. These five areas are:

Current fellow performance (scholarly activity, # of procedures, SITE results) Faculty development (development opportunities including new clinical skills, admin skills, and

teaching, scholarly activity, statement that performance has been reviewed) Graduate performance (board results) Overall program evaluation (discussion of fellow and faculty evals) Action plan (any follow-up, address deficiencies)

Subspecialty In-Training Examination (SITE)Fellows are required to take the American Board of Pediatrics Sub-specialty In-training Examination (SITE) each year when offered by the ABP. The full cost of this examination is covered by the Division of Neonatology. The results assist the fellow and the NPM program director in identifying individual strengths and weaknesses and in assessing year-to-year progress. Exam results are helpful in planning lectures, in designing a reading program and in preparing for the board examination. A strong correlation between previous SITE results and an individual’s ability to pass the NPM Sub-specialty Exam exists. The exam is a timed, computer-based test that must be completed during a specific interval determined annually by the ABP. Details will be provided by the NPM program director when available.

Residency Management Suite (RMS)Refer to Pediatric Program Manual at: http://www.med.umn.edu/peds/pedsres/current/programmanual/general/rms/home.html

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TRAINING/GRADUATION REQUIREMENTSUpon successful completion of all program requirements, the Fellowship Director will provide a final summative evaluation for each fellow who completes the program. The program requirements are in accordance with the requirements outlined by the ABP and ACGME. This evaluation will include a review of the fellow’s performance during the final period of training and will include verification that the fellow has demonstrated sufficient professional ability to practice competently and independently. This final evaluation will be part of the fellow’s permanent record.

TEACHING MEDICAL STUDENTSRefer to Pediatric Program Manual at: http://www.med.umn.edu/peds/pedsres/current/programmanual/general/teaching/home.html

ACLS/BLS/PALS RECERTIFICATIONIndividual hospitals will provide training for required certifications. Contact Fairview Organizational Learning at 612-273-6195 to determine your required training.

AMA POLICY FOR ACCEPTING GIFTSRefer to Pediatric Program Manual at: http://www.pedsres.umn.edu/current/programmanual/general/otherpolicies/giftpolicy/home.html

MEDICAL RECORD/DICTATION COMPLETIONRefer to Pediatric Program Manual at: http://www.pedsres.umn.edu/current/programmanual/general/otherpolicies/records/home.html

CONTINUITY OF CARERefer to Pediatric Program Manual at: http://www.pedsres.umn.edu/current/programmanual/general/otherpolicies/continuity/home.html

DEMONSTRATION OF ENGLISH LANGUAGE PROFICIENCY BY NON-NATIVE SPEAKERS OF ENGLISHRefer to Pediatric Program Manual at: http://www.pedsres.umn.edu/current/programmanual/general/otherpolicies/proficiency/home.html

GUIDELINES FOR PROFESSIONAL DRESSRefer to Pediatric Program Manual at: http://www.pedsres.umn.edu/current/programmanual/general/otherpolicies/dress/home.html

PROFESSIONAL INTRODUCTION GUIDELINESRefer to Pediatric Program Manual at: http://www.pedsres.umn.edu/current/programmanual/general/otherpolicies/introduction/home.html

MEDICAL LICENSUREYou are not required to have a state license to participate in UMN Pediatric Fellowship Programs although state law mandates that each fellow have a training permit (aka residency permit). The

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Department of Pediatrics will issue a permit application form to you for completion. This must be done BEFORE starting any rotations. This is a one-time application and is valid throughout your fellowship.

You are responsible for COMPLETION, AND COORDINATION of all licensing activities! Send a copy of your Minnesota license to the Department Education Office for your file. If you wish to obtain a license (remember, this is an option NOT a requirement) or you have questions regarding licensing, you may contact the state board directly at:

Minnesota Board of Medical PracticeUniversity Park Plaza2829 University Avenue SE, Suite 500Minneapolis, Minnesota 55414-3246(612) 617-2130 (612) 617-2166 (fax)

You can also find information about the process of obtaining a medical license on the pediatric website.

MOONLIGHTING POLICY: All moonlighting must be approved prospectively by your program director. The prospective moonlighting request/approval form is at: http://www.med.umn.edu/peds/education/fellowships/current/home.html.

Full moonlighting policy and procedure are at: http://www.med.umn.edu/peds/pedsres/current/programmanual/general/otherpolicies/moonlighting/home.html.

ON CALL ROOMS, SUPPORT SERVICES, LABORATORY/PATHOLOGY/RADIOLOGY SERVICES Refer to Pediatric Program Manual at: http://www.pedsres.umn.edu/current/programmanual/general/otherpolicies/services/home.html

MEDICAL RECORDSRefer to Pediatric Program Manual at: http://www.pedsres.umn.edu/current/programmanual/general/otherpolicies/records/home.html

SECURITY/SAFETYRefer to Pediatric Program Manual at: http://www.pedsres.umn.edu/current/programmanual/general/otherpolicies/safety/home.html

UNAUTHORIZED LEAVEA fellow taking unauthorized leave will be subject to disciplinary procedures, including probation and/or termination.

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SECTION 6 – ADMINSTRATION(Please refer to Institution Policy Manual at http://www.med.umn.edu/gme/residents/instpolicyman/home.html for Medical School Policies on the following:  University of Minnesota Physicians, GME Administration Contact List, GME Administration by Job Duty; GME Organization Chart.)

DEPARTMENT OF PEDIATRICS: ADMINISTRATION

Head of the Department of PediatricsAaron Friedman, M.D., HeadPWB 13-118Telephone: (612) 624-3113

Pediatric Education Office PWB 13-168Telephone: (612) 624-4477, #1FAX: (612) 626-7042Internet: http://www.med.umn.edu/peds/education/fellowships/home.html

Education Manager/Department Fellowship Administrator: Emily Gray612-624-0410/ elgray@umn.edu

Associate Fellowship Administrator: Valerie Cole612-624-8788/ cole0430@umn.edu

DEPARTMENT OF PEDIATRICS: DIVISION OF NEONATOLOGYChief, Division of NeonatologyMichael Georgieff, M.D., georg001@umn.edu, 612-626-2971

Director, Neonatal-Perinatal Medicine Fellowship ProgramCatherine M. Bendel, M.D., bende001@umn.edu, 612-626-3250

Co-Director, Neonatal-Perinatal Medicine Fellowship ProgramMark Mammel, M.D., mamme001@umn.edu, 651-220-6261

Coordinator, Neonatal-Perinatal Medicine FellowshipEllen Sullivan, sull0380@umn.edu, 612-626-2958

Other Administrative Support, Division of NeonatologyKristin Koppen, koppe037@umn.edu, 612-625-7738

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DEPARTMENT OF PEDIATRICS: PAYROLLPayroll Specialist: Deb Slavin612-626-6910/ slavi002@umn.eduPediatrics, Ob/Gyn and Women's HealthRoom 353-37717 Delaware Street SEMinneapolis, MN 55414

RESOURCES

Web SitesNeonatology Divisionhttp://www.peds.umn.edu/divisions/neonatology

Please refer to the Pediatric Program Policy Manual for additional Web Sites information.

Governing BoardsPlease refer to the Pediatric Program Policy Manual for Governing Board information.Link: http://www.med.umn.edu/peds/pedsres/current/home.html

Career-RelatedPlease refer to the Pediatric Program Policy Manual for Career-Related information.Link: http://www.med.umn.edu/peds/pedsres/current/home.html

Debt ManagementPlease refer to the Pediatric Program Policy Manual for Debt Management information.Link: http://www.med.umn.edu/peds/pedsres/current/home.html Medical SocietiesFellows may choose to join medical societies including the American Academy of Pediatrics, the American Medical Association, and others at their own expense.

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Confirmation of Receipt of your Fellowship Addendum for Academic Year 2010-2011

By signing this document you are confirming that you have received and reviewed your Fellowship Addendum for this academic year. This policy manual contains policies and procedures pertinent to your training program. This receipt will be kept in your personnel file.

Fellow Name (Please print) _______________________________________________

Fellow Signature ________________________________________________________

Date __________________

Coordinator Initials ________________

Date __________________

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