Eligibility form to be filled and attached with the application for enrolment as Institute to conduct IAP Neonatology Chapter fellowship program
- The institution should have a NICU which provides tertiary level (level 3) care to newborn babies for the last five years.
- The institution should have two DM Neonatology Teachers with five years teaching experience / two MD / DNB Teachers with minimum ten years teaching experience in Neonatology for two Fellowship Candidates (one teacher: :one student)
- All teachers / Neonatologists in the Institute should be Life members of IAP and IAP Neonatology Chapter
- The NICU should fulfill the following criteria:
- NICU in existence since year: ( should be at least 5 years or more )
- Total number of cradles with radiant warmers or equivalent number of incubators ( )
- Central oxygen and suction supply: Yes ( ) No ( )
- Number of ventilators that can provide CPAP and conventional ventilation methods such as SIMV / AC etc to neonates: Number ( )
- Number of single & double surface phototherapy units ( )
- Number of pulse oximeters ( )
- Number of NIBP monitors ( )
- Number of infusion pumps, syringe pumps, drip monitors ( )
- Hemoglucometer: Available or not ( )
- Are the following procedures performed in your NICU:
- lumbar tap ( )
- intercostal drain insertion ( )
- peritoneal dialysis ( )
- exchange transfusion ( )
- Are the following facilities available in your NICU?
- 24- hr service of portable X-rays ( )
- 24-hr service for basic laboratory investigations ( )
- How many average admissions every month in the NICU ( )
- Approximate number of staff nurses in your NICU ( )
- Number of resident doctors who have the minimum MBBS qualification, working in the unit ( )
- Number of fulltime or honorary staff members who have completed M.D. OR D.N.B in Pediatrics and have at least 7 years of post graduate practice as full timers or in private practice ( )
- A teacher qualified in D.M. Neonatology (optional) ( )
- Average number of deliveries conducted in your institute every month ( ) OR
Monthly average deliveries conducted in the referring hospitals ( )
- Does your institution provide the following services to neonates:
- Training mothers to breastfeed especially NICU graduates ( )
- Kangaroo Mother Care ( )
- Follow up outpatient services to these neonates ( )
- Does your institution evaluate the neonates for the following
- Ophthalmologic evaluation of neonates that require it ( )
- Auditory evaluation of neonates that require it ( )
- Physiotherapy evaluation of neonates that require it ( )
- Surgical treatment of emergency surgical situations ( )
- All teachers at the Institute are Life members of IAP, the membership numbers being –
______________; _________________; _________________; ________________; ______________