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An Exploration of Neonatology

by Kylie Bachmann (’24)

As a Medical Sciences student, when I ask classmates and peers what their future plans are, the responses are not very diverse. The most common answers that I’ve heard include pediatrics, ER medicine, surgery, cardiology, and family medicine now and then. Although there are thousands of subspecialities and health-related careers, why are only a few discussed among undergraduates? Are these fields really that popular, or are they simply more familiar to the public? One of the many lesser known careers is neonatology. I interviewed Dr. Stephen E. Hunter, a neonatologist at Dayton Children’s Hospital, and asked him about what it’s like to be a neonatologist and what advice he’d give to students who may be interested in pursuing this career.

Q: What is neonatology?

A: Neonatology is the subspecialty or study that cares for premature infants and sick newborns. We care for infants from birth till discharge from the hospital and will usually readmit babies if they are within a month of their due date (~44 weeks gestation).

Q: Why did you choose this career path?

A: I always knew I wanted to work with kids. I remember interviewing a neighbor who was a pediatric ED physician at St. Louis Children’s Hospital and also shadowed a family friend who was a general pediatrician. My daughter Miriam and son Matthew were both born about 11 weeks early and I think that had a strong influence in my decision. During pediatric residency I enjoyed taking care of very sick patients, enjoyed procedures, and preferred the inpatient setting vs outpatient setting. My ultimate decision was between Pediatric Critical Care and Neonatology and ultimately decided on neonatology.

Q: What is your favorite aspect of neonatology?

A: I enjoy the variety of the patients that we care for in neonatology. We care for a good amount of normal newborn infants in nurseries in the community for local pediatricians and get to help new parents as they are learning to care for their infants. When I am working in the level 4 NICU at Dayton Children’s I enjoy taking care of the sick infants and collaborating with the multiple subspecialists that care for the patients there such as surgery and cardiology

Q: If you had to convince someone to become a neonatologist, what would you tell them?

A: You get a decent variety of patients to care for, are able to help new parents learn to care for their infants, and also have a good number of procedures that you can become proficient in. There is a large rush of adrenaline when there is a sick newborn or delivery that requires resuscitation, but one of the biggest reasons is that the vast majority of our infants get better and you get to see babies go from being really sick to being able to be discharged home healthy.

Q: What is your LEAST favorite aspect about neonatology?

A: The night call that we have to do — especially when we have to take in-house night call.

Q: What does a typical day in neonatology look like for you?

A: We have 5 neonatologists in our group and have 4 rotations that you could possibly be on. There are 2 physicians that round at Dayton Children’s Hospital NICU (usually from 8am-5pm), 1 physician that cares for the infants at Springfield Regional Medical Center that also has a level 2 Special Care nursery (8am-5pm), and then the other physician that rounds at Southview Medical Center, Soin Medical Center, and Kettering Medical Center seeing normal newborns for a variety of local pediatricians (usually 8am-3pm). At night there is one physician on call for Dayton Children’s and the local hospitals that we care for the normal newborns (about 6 or 7 calls per month). Occasionally there are in house calls at Springfield, usually about 1 a month.

Q: What kind of schooling did you have and how many years did it take to become a neonatologist?

A: After getting your bachelors from college, you go to medical school (4 years) and then do a 3-year pediatric residency, followed by a 3-year neonatology fellowship.

Q: What is your schedule like? Are you on call? Is it flexible?

A: Noted the calls above. We do about six or seven at-home calls that may require us to go in to see sick infants or new admissions. There is always a neonatal nurse practitioner or 2nd or 3rd year pediatric resident in house that usually are the first ones to get called. We also do about one night a month in house call at Springfield Regional Medical Center for the nursery and special care nursery.

Q: What type of skills does this career require? (e.g. attention to detail, critical thinking, working well under pressure, steady hand)

A: All of those above skills are required to be successful in the career of neonatology. Our patients are not able to tell us their symptoms and we have to utilize our attention to detail and critical thinking skills to care for these patients. Also when dealing with very small premature infant there are a lot of precise calculations with regards to fluid management and so attention to detail is very important. For those that work in areas where they are responsible for attending deliveries working under pressure as well as working well with a team to care for sick newborn is very important.

Q: What would you tell a medical student considering neonatology?

A: I would tell them to try and shadow a day in the NICU and working closely with the nurse practitioner will allow for a very good look into the life in the NICU.

Q: Would you consider neonatology a lesser-known career? If so, why do you think this is?

A: I think outside of the medical field, neonatology could be considered a lesser-known career. Fortunately for most parents who have normal healthy children, they likely will never need the services of a neonatologist. Many parents take for granted that most infants are healthy and go home when the mother is discharged. Also, many of the NICU’s are within adult hospitals and we are usually the only physicians that care for pediatric patients, so our sphere of influence does not reach much beyond the NICU.

Q: Is there anything else you would like to add?

A: Being a neonatologist has been a very fulfilling career and with most areas of medicine, the joy of caring for infants and providing that support for worried parents can be very rewarding. Equally rewarding is the relationships that you form with the other staff members and co-workers who you stand shoulder to shoulder with when there is a critically ill infant you are caring for. It truly is a team approach and like in any critical care situation maintaining a calm approach in the face of stress is paramount.

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