In some of the largest hospitals in the United States, there are 6000 to 7000 babies born each year. Ten percent of these deliveries may have a difficulty that requires admission into the hospital neonatal intensive care unit, called the NICU. There, families and babies will find that they are cared for by doctors who have studied the special development, illnesses and other factors that affect newborns. These doctors are called neonatologists.
What is a Neonatologist?
A neonatologist focuses on newborn medical care. A newborn has a very specific set of needs and developmental considerations that can affect the development of the child well into their future. The neonatologist may care for newborn babies, sick babies or premature babies in a regular hospital setting or in an specialized area like the NICU or Neonatal Intensive Care Unit which is designed for critical care scenarios.
Due to the specific developmental needs of newborns, a neonatologist will need to be well educated on the various systems and organs that are still in development when the child is born. Here are a few examples of what a neonatologist may attend to from the article “A Career in Neonatology: Information for Students and Teachers”:
For premature babies, some examples include:
For full-term babies, some medical situations include:
Educational Requirements for Becoming a Neonatologist
The minimum educational requirement for being a neonatologist is a doctoral degree with special training in pediatrics and neonatology.
Step-by-Step Educational Path to Becoming a Neonatologist
Bachelor’s Degree
The first step in becoming any type of physician is to complete a bachelor’s degree. Undergraduate study sets the individual up for success as they learn the foundational scientific and psychological theories that will be studied more in depth throughout their training.
While some aspiring doctors write-off this portion of education as less-important, the most successful doctors know that what they put into their years as an undergraduate can serve them well as they pursue their career goals. Undergraduate extra-curricular activities can give the individual experience in a patient care setting, which will lead to more confidence and success during the clinical years of medical training.
The time and effort put into studying the sciences at this level will provide a solid foundation for testing and learning more advanced principles and the discipline that is developed will help when it comes to the strenuous schedules and expectations of residency, internships and fellowships. In some cases, the contacts made during undergraduate work will be the ones that provide open doors to medical school acceptance, competitive fellowships and more.
Specifically, students will need to show their academic standing and dedication to education in order to be accepted into medical school. Most medical schools require a cumulative GPA of 3.0 or higher with the more competitive schools requiring a 3.5 or better for consideration. Grades in the sciences will show that the student is ready for the advanced science coursework required in medical school as well as prepare them for taking the Medical College Admissions Test (see below).
Medical College Admissions Test (MCAT)
The Medical College Admissions Test is required by all medical schools, the scores on which will either make the student a candidate for acceptance, or place them behind others who are seeking acceptance into the same school. The test is designed to show that the student grasps the basic scientific concepts, critical thinking skills and problem solving techniques that will be required to be a successful student and future physician.
The worldwide average MCAT score is a 25.2. Depending on the medical school that the student is applying to, a competitive score on the MCAT is a 30 or higher with a perfect score being a 45. It is wise for the student to know prior to taking the test what a competitive score is for the school of their choice. This will help them determine if they need to increase their study and preparation time for the test.
While the biological science and physical science courses that are taken during undergraduate study will prepare the student somewhat for the MCAT, it is widely recommended that students take advantage of the many resources that are available to help them prepare for the test. Pre-tests and practice-tests, study sessions, online and in person tutoring, and other resources are valuable for those who are seeking a high score.
Medical School Admissions
Medical school admissions are extremely competitive. The students that prepare for the application process by using their time as an undergraduate student wisely will do the best when it comes to consideration and competing against other applicants.
An application for medical school will include the students cumulative GPA, and grades in the science courses that are required for entry. It will also include any extra-curricular activities, leadership experience and multiple letters or recommendation – most schools require three.
Throughout the application process the student should seek to show their dedication to the medical field, work ethic, educational foundation for continued study and any other qualities that set them apart from other students. The student’s MCAT score is also included in the packet and plays an important role in consideration.
Most medical schools have published minimum requirements for their incoming students which include specific coursework and grades, test scores and more. The student should work to not only meet these minimums but exceed them and set themselves apart from other applicants with their complete submission packet.
Medical School
The pressure of being accepted into medical school can be a lot, but students should be aware that the work and focus that is required to be a candidate for medical training does not end once they have been accepted into medical school. The four years that will be dedicated to learning about the science and principles of practicing medicine will be tough.
The first two years of medical school are dedicated to scientific coursework that expands the student’s knowledge of how the human body works and interacts with our environment. The scientific foundation that is lain will be what the student builds their practical medical practice off of and should be taken very seriously.
Throughout medical school tests and evaluations will show if the student has fully grasped and can apply the concepts taught. One of these tests, the United States Medical Licensing Exam (USMLE) Step 1, happens about two years into medical school, prior to the student entering the clinical portion of their early training. This first of three steps is designed to evaluate the student’s scientific and conceptual knowledge of medical practice.
According to the USMLE, step 1 “assesses whether you understand and can apply important concepts of the sciences basic to the practice of medicine, with special emphasis on principles and mechanisms underlying health, disease, and modes of therapy.” This test asks questions that both ensure the student understands and can apply scientific principles and ensure that they will be able to continue learning throughout their career as a physician.
After passing the USMLE Step 1, the student will enter into two years of clinical experience under direct supervision from a training doctor. The two years are called Rotations and are designed to give the student experience in a variety of medical specialties and patient care settings. This experience will either validate or contribute to their decision of specialization.
Some students enter into Rotations with an idea of the direction they want to take their medical career and will find out if their skillset matches what is needed to succeed within their desired specialty. Other students find their skills are brought forth and they are able to decide which specialty most interests them during rotations. Either way, it is important for the student to work closely with their trainers to ensure they are choosing a medical specialty that will be fulfilling and a good match for them.
After rotations, students take the United States Medical Licensing Exam, Part 2, which “assesses whether you can apply medical knowledge, skills, and understanding of clinical science essential for the provision of patient care under supervision and includes emphasis on health promotion and disease prevention.” From here the student moves on to active patient care as a Resident Physician
Residency
A Neonatologist will complete a residency focused on pediatrics. This residency and internship period will last around three years as the doctor learns more and gets more experience in patient care for children. During this time, the physician will gain full-time experience in a clinic, inpatient, emergency or other environment where they are closely supervised and trained by a teaching staff. This phase of education also includes lectures, conferences, and other opportunities to gain a deep understanding of pediatrics.
I addition to basic pediatric care, the resident will also be exposed to the pediatric intensive care sub-specialty and neonatal intensive care subspecialty which will help further crystalize the direction of their training and career path.
The first year of pediatric residency, the United States Medical Licensing Exam, Step 3, is taken, which is one of the final tests required to be licensed to practice medicine as a doctor. The year after pediatric residency, the pediatric board examination is taken which will certify the doctor as a pediatric specialist.
Fellowship
After three years of pediatric training under supervision the physician will start a neonatology fellowship. Many neonatology fellowships are split between active patient care and research. By the completion of this portion of training, the physician will have first hand experience with a variety of neonatal needs as well as have completed and published research work pertaining to neonatal health and newborn care.
After fellowship, a final set of exams will certify the physician as a subspecialist in neonatal-perinatal medicine.
Licensing
The licensing structure for a neonatal specialist starts in medical school, before specialization, as the student takes exams to show their knowledge of the needed sciences as well as their clinical understanding and grasp of the art of the medical practice. This first set of tests comes in the three steps of the USMLE which are mentioned above.
After medical school the doctor enters an internship or residency program where the final step of the USMLE is administered. Upon graduation of the internship and/or residency program, the doctor completes the exams focused on pediatric medicine.
Moving on education, the doctor enters fellowship. Post-fellowship exams and licensure identify the doctor as a licensed neonatal specialist.
Understanding the Career Path
Work Environments
There are many places that employ neonatologists throughout the medical field. Medical school hospitals, group practices, community hospitals, solo practices are just a few. The majority of neonatologists are in an urban setting, though not necessarily inner city. Very few practice in a rural setting as smaller hospitals or offices will often send mothers and babies that have or are expected to have complications to larger hospitals.
The career outlook for neonatologists is based on the number of new births each year. The number of births and birth rate in the United States fell dramatically in 2010 and continued to be lower than previous years, hitting an all time low in the most recent years. However, with the increase in economic strength in the country some predict that more people will feel better prepared and more stable, which could lead to more families choosing to have children in the near future.
Salary
Neonatologists are not among the top paid physicians, but they do earn more, on average, than general pediatricians. Neonatologists have experienced a large increase in pay recently, up 11.9% according to a recent physician’s survey. The average reported salary was around $200,000, but some doctors reported making closer to $320,000 and up to $480,000.
The range is based largely on the type of practice that one is part of, bonuses and other compensations that are included in salary reports. For aspiring neonatologists, most reports have clusters of earning between $225,000 to $250,000 and $290,000 to $310,000 with higher and lower earning marks considered outliers.
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