How to Become a Neonatologist in Australia

Core training: 30 months; At least, in core neonatal and perinatal positions
Perinatal setting: 18 months; At least, with exposure to fetal medicine and developmental follow-up
Neonatal surgical setting: 6 months; At least, or the equivalent
Neonatal retrieval: 6 months; In a retrieval service, or enough retrieval experience through core training to gain competence
Non-core training: 6 months; At most, in a related specialty
In Australia or Aotearoa New Zealand: 24 months; At least, at accredited settings

Rules and conditions

Three phases of at least 12 months full time each: specialty foundation, to orient you, specialty consolidation, toward the learning goals, and transition to Fellowship, to confirm you meet the standards for practice without supervision
No more than 6 months of core time in a junior position, such as registrar or senior neonatal medical officer. The rest in senior positions, such as senior registrar or fellow
At least 2 accredited settings, and ideally no more than 18 months in any one
Non-core options: developmental medicine, community paediatrics, general paediatrics, infant mental health, paediatric intensive care, palliative care or research
Developmental and psychosocial training, if not done in Basic Training: in Australia, 6 months by the end of Advanced Training in developmental, community, disability or rehabilitation paediatrics, child and adolescent psychiatry, child protection or palliative medicine
In Aotearoa New Zealand: a 3-month rotation, or a logbook of 12 cases

Accredited settingsCore training counts only at an accredited setting. Each sets its most total, core perinatal, retrieval and neonatal surgical time, and the retrievals and follow-up its months likely give, in the accredited sites list
Aotearoa New ZealandAuckland City, Christchurch Women's, Waikato and Wellington hospitals, each up to 24 months with 18 of core perinatal time, and Middlemore Hospital, up to 18 with 12, accredited with conditions
OverseasBritish Columbia Children's and Women's Hospital and Mount Sinai Hospital in Canada, and Evelina London Children's, St George's, St Michael's and University College hospitals in the United Kingdom, each up to 18 months
In the territoryCanberra Hospital, up to 24 months with 18 of core perinatal time. 12 months there count as 3 of neonatal surgical training

What every accredited neonatal and perinatal setting must give you

Births in the region: 8,000; Each year at least, in the region a perinatal centre takes referrals from
Births on site: 2,500; Each year at least, at a perinatal centre's level 3 facility
Airway support: 100; Infants needing it each year at a perinatal centre, at least
Orientation: First week; An induction to training at the setting

Rules and conditions

An intensive care nursery, in a perinatal centre tied closely to its obstetric program, or in a children's hospital, which cares mainly for newborns with surgical conditions and gives no perinatal experience
In a children's hospital, care before and after surgery for most of: gut and chest conditions, diaphragmatic hernia, abdominal wall defects, neurosurgical problems, a patent ductus needing ligation, and retinopathy needing laser
Short-term and long-term neurodevelopmental follow-up and discharge planning, in both kinds of unit
Regular planned consultant-level work in most of: leading ward rounds, discharge planning and antenatal counselling, planning retrievals, difficult talks with parents, committee work, guidelines, assessing juniors and rosters
Quality assurance and audit, writing and updating clinical guidelines, protected research time, and teaching of junior trainees, medical students, neonatal nurses and a neonatal resuscitation program
Most of: perinatal and neonatal mortality and morbidity meetings, case conferences, journal reviews, X-ray meetings, tutorials and neonatal grand rounds, with study leave for external education
Support from specialists in maternal fetal medicine, paediatric cardiology, neurology, surgery and radiology, genetics, obstetric and neonatal anaesthesia, perinatal pathology, developmental paediatrics and ophthalmology
Laboratories and imaging around the clock, and neonatal nurses, at least half of them qualified in neonatal intensive care

Supervisors: 2; Each rotation. One a Fellow in neonatal and perinatal medicine for core training, or an RACP Fellow for non-core
Research project supervisor: 1; Nominated before specialty consolidation, recommended
Supervisor meetings: Every 3 months; At least
Trainees per neonatologist: 1; Full-time equivalent at most

Rules and conditions

You nominate your rotation supervisors in each rotation plan, from the eligible supervisors listed on MyRACP
Supervisors hold FRACP or the equivalent and work as neonatologists at least half time, with protected time, part of which goes to supervising trainees
Enough supervision to complete a research project in 12 months

Divisional examinations: 2; Written and Clinical, passed in Basic Training before Advanced Training

Rules and conditions

Divisional Written Examination: sat once the foundation phase of Basic Training is complete, and run by the RACP
Divisional Clinical Examination: sat once the written examination is passed and the consolidation phase of Basic Training is complete, and run by the RACP

Learning captures: 12; Each phase, at least one a month
Observation captures: 12; Each phase, at least one a month
Progress reports: 4; Each phase, at least one every 3 months
Rotation plans: 1; For each rotation, at or before its start
Research project: 1; Before the end of training, submitted by the end of specialty consolidation, recommended

Rules and conditions

Rotation plans are due by 28 February for rotations in the first half or whole of the year, and by 31 August for the second half
A Progress Review Panel decides at the end of each phase, and can set conditions
Research project submission dates are 31 March, 15 June and 15 September in Australia, and 15 December in place of September in Aotearoa New Zealand. It is marked pass, fail or resubmit
Suggested: presenting research at grand rounds, a conference or journal club

Neonatal retrievals: 25; Recommended, most led by you, at least half needing ventilatory support, with term, preterm, cardiac and neurological cases
Endotracheal intubations: 20; Recommended, nasal or oral

Airway and ventilation, recommended

20Bag and mask or T-piece ventilation
10Conventional ventilator set up and used
10High frequency oscillatory ventilator set up and used
10Inhaled nitric oxide set up and used
10Surfactant given, by endotracheal tube and minimally invasive methods
5Supraglottic airway placements
5Each of continuous positive airway pressure, low flow and high flow therapy set up and managed

Vascular access and blood collection, recommended

20Peripheral intravenous cannula insertions
20Venesections and blood culture collections
10Umbilical arterial catheter insertions
10Umbilical venous catheter insertions
10Peripherally inserted central catheter insertions
5Each of peripheral arterial catheter insertion, peripheral arterial puncture and capillary blood sampling

Other procedures, recommended

20Times leading, such as ward rounds, resuscitation or acute deterioration
10Lumbar punctures
5Each of naso- or orogastric tube insertion, bladder catheterisation, bladder ultrasound, chest compressions, histogram interpretation and oxygen weaning, chest drain insertion and thoracocentesis

Rules and conditions

One combined procedures and neonatal retrievals logbook, kept across training and reflected on case by case
The numbers are recommended minimums to record, not proof of competence. Competence is assessed by observation captures
Desired where exposure allows: abdominal paracentesis, cranial ultrasound, emergency pericardiocentesis, exchange transfusion, intraosseous needle insertion, nasopharyngeal tube insertion and ventricular drainage

Supervisor workshops: 3; Free, by the end of training

Rules and conditions

RACP Supervisor Professional Development Program: practical supervision skills, teaching and learning in healthcare settings, and work-based learning and assessment, as virtual or face-to-face workshops or online courses
Suggested: a biostatistics or quality improvement course
Recommended: the RACP Communication Skills, Ethics, Introduction to Leadership, Management and Teamwork, and Research Projects resources

Part-time training: 0.2; Full-time equivalent, at least
Interruption: 12 months; Continuous, with no extra training required
Time limit: 8 years; To complete the program

Rules and conditions

Each application to train part-time or to interrupt training covers up to 12 months, and is made again to extend it
More than 12 continuous months away can bring a return to training plan for the first 6 months back, and more than 24 months requires one and may add training
Approved full-time parental and medical leave does not count toward the time limit
Advanced Training starts within 5 years of completing Basic Training

Neonatal and Perinatal Medicine

How to become a neonatologist in Australia

Prerequisites

Applications

Timeline

When to apply

Competition

Program structure

Basic Training in Paediatrics and Child Health

Examinations

Specialty foundation

Training time

Competencies

Courses

Assessments

Specialty consolidation

Competencies

Courses

Assessments

Projects

Transition to Fellowship

Competencies

Assessments

Selection criteria

Application process

Entry tips

What the college has changed

Training posts

Available Neonatal and Perinatal Medicine training positions

Official resources

Official links

Prerequisites

Applications

Timeline

When to apply

Competition

Program structure

Examinations

Training time

Competencies

Courses

Assessments

Competencies

Courses

Assessments

Projects

Competencies

Assessments

Selection criteria

Application process

Entry tips

What the college has changed

Training posts

Available Neonatal and Perinatal Medicine training positions

Official resources

Official links

Related specialties