Information about Toronto’s TNE training program can be found Here
For question regarding the fellowship positions or to discuss your suitability, please contact
Information about Vancouver’s TNE training program can be found Here
For further information, trainees who are interested in our training program can contact
The trainees enrolled in Targeted Neonatal Echocardiography Program undergo hands on training at the Pediatric Echocardiography laboratory at Alberta Children’s Hospital prior to doing TNE in the NICU. Trainees are involved in scanning, reporting and discussing management of hemodynamic problems in the NICU. In addition to TNE, we have expanded our program to point of care ultrasound education program called Sonography Clinical Assessment of Newborn (SCAN), which conducts training program all over the world.
TNE Fellowship aims to provide a comprehensive understanding and skillsets required for an integrated hemodynamics practice for a neonatal clinician. The training program is competency based and usually requires 18 to 24 months to complete.Eligibility criteria is completion of Royal College Equivalent training in Neonatal-Perinatal Medicine with demonstrable interest and knowledge in the neonatal hemodynamics sub section. Application process includes submission of CV and Letter of Intent to the program, and upon short listing will be called for interview by a multi-disciplinary panel. Deadline for Application is December 15 every year. Please contact Melissa Meaver for further information
London offers a 2 year subspecialty training program in Neonatal Perinatal Medicine, with an average intake of 3- 4 national/international trainees every year. We plan to launc a 1-2 year TNE training program in July 2021/2022. In the meantime, the TNE program offers elective rotations where trainees get the opportunity to understand the clinical utility of TNE, learn hemodynamic physiology, current treatment modalities and basics of echocardiograms. The TNE program is also currently offering a special interest third year fellowship training for NPM trainees who have completed their 2 year NPM training program. This custom designed third year allows trainees to learn more about Neonatal Hemodynamics and pursue scholarly work in this field and prepare themselves for formal TNECHO training.
Our Fellowship in Targeted Neonatal Echocardiography is a 1-year program commencing with intense training in the echo lab supervised by senior echocardiography technicians for 5 months, followed by a consolidation period in the NICU with graduated supervision of hemodynamics consults. Trainees are given timely and real-time feedback on imaging, measurement, interpretation, and therapeutic decision making as part of regular case reviews. On call commitments in both NICUs is part of the Fellowship in order to maintain competency in intensive care skills and procedures. Undertaking a hemodynamics-related research project is mandatory. An elective period of 4-6 weeks in another neonatal hemodynamics training centre is provided as an option. We seek individuals who are passionate about neonatal hemodynamics and who will have completed their core Neonatal-Perinatal Fellowship training. Preference will be given to individuals who have demonstrated a high level of competence and an ability to work well in a team environment during their previous training. The most appropriate candidates are selected for interview based on their letter of intent, reference letters, and academic and scholarly achievements listed in their CV. In addition, all candidates must meet the Ontario criteria for eligibility. Interested candidate should contact Ms. Tanya Forward, Program Administrator, Division of Neonatology
The Clinical Research Neonatal Hemodynamics program consists of 1 or 2 years of additional training in hemodynamics/ echocardiography research targeted to the neonatal population with research methods, under the supervision of a primary faculty supervisor. The duration of the fellowship will depend on the predicted time frame of the research project and funding (note: supervisor and duration of fellowship to be confirmed by all parties prior to fellowship start). A 1-year fellowship may be extended to a 2nd year if all parties agree (including McGill University postgraduate office and the sponsor, where applicable). Patient care responsibilities are designed to maintain clinical competence in Neonatology and to enhance knowledge and experience in neonatal diseases targeted by the fellow’s research. The fellow will be involved both in the NICU and in the research in neonatal follow-up. The fellow will be trained on the Philips echocardiographyEpiq 7 machine, on TomTEC, strain (2D and 3D) and on Syngo and VVI. Reference links for application process: https://www.neocardiolab.com/fellowship-program-programme-de-moniteur https://www.mcgill.ca/pgme/admissions/prospective-fellows https://www.mcgill.ca/peds/education-training/pgme/programs/neonatology/fellowship https://www.mcgill.ca/pgme/programs/fellowship-programs Any questions please contact:
Currently there is no TNE fellowship program at the CHU Sainte-Justine. However, there is a neonatal hemodynamic elective rotation built for neonatal fellows (4 weeks duration). This elective is open for fellows in training in a neonatal and perinatal medicine program from any centers, with an interest in TNE. This elective aims to allow clinical exposition to neonatal hemodynamics using functional ultrasound for assessment, diagnosis and response to treatment in different pathologies of the neonate. Prerequisite: Mastery of basic echocardiographic views and knowledge of normal cardiovascular anatomy in newborns Under the supervision neonatal hemodynamic consultants, the fellow will be invited to be involved in Hemodynamic assessment of newborns: Perform functional cardiac ultrasounds requested from the neonatal unit Formulate an interpretation of clinical and ultrasound data Present a treatment and follow-up plan to the medical teams Carry out an assignment (presentation, review of a protocol) on a subject of neonatal hemodynamics Of note, CHU Sainte-Justine is a Montreal French academic environment. For more information, please contact us to:
Contact name and email for potential applicants:
Contact name and email for potential applicants:
Information about Iowa City’s TNE training program can be found Here
For further information, trainees who are interested in our training program can contact
For training opportunities and discussing eligibility, please contact
Neonatal cardiac intensive care is a newly emerging subspecialty within neonatology whose primary goal is to enhance the cardiovascular care of newborns with structural heart disease and/or hemodynamic instability. This 4th year fellowship is designed to systematically, and academically, train the next generation of neonatal-cardiac intensivists. For patients with structural heart disease, the neonatal-cardiac ICU fellow will provide care that arcs throughout the patients’ hospital stay including (1) participation in prenatal counseling of expecting mothers; (2) leading the delivery room care and transition to ex-utero life; (3) leading the pre-operative management and ensuring preparedness for cardiac surgery; and (4) active involvement and consultation during the post-operative period in the cardiac intensive care unit. For neonates with significant hemodynamic disease, the neonatal-cardiac fellow will again provide care that arcs throughout the patients’ hospital stay. This includes performing and interpreting targeted hemodynamic echocardiography to objectively guide a therapeutic plan for patients with hemodynamic instability. When medical management fails, the 4th year fellow must help to decide when ECLS support is needed and lead the management which ensues. We are accepting 1 trainee per year for this fully funded, UC Irvine GME approved training program. If interested, please directly email the program director, Dr. Amir H Ashrafi (firstname.lastname@example.org), with the following: (1) One-page letter of intent describing your reason(s) for applying to the program and how it impacts your career goals (2) Curriculum Vitae (3) Two letters of recommendation (one from fellowship program director) This is a 12-month clinical program running from July 1 to June 30 every year. Application process will close once a fellow has been selected. Applicants must have completed a NICU fellowship and be board eligible/certified. Graduates of the program will receive a diploma for completion of their 4th year fellowship AND a certificate of competency targeted neonatal echocardiography in accordance with the American Society of Echocardiography. Currently, there is no board certification for neonatal-cardiac intensive care.
As part of the NYPH – Columbia University Neonatal-Perinatal Medicine Training Program all fellows can learn at least introductory levels of Targeted Neonatal Echocardiography (TNE) and neonatal cardiac intensive care. The curriculum is individualized to each trainee’s needs and career goals. Those who dedicate their scholarly work to projects including TNE can develop advanced TNE skills and competence. Applications to this program are done through the Electronic Residency Application Service (ERAS) system. For additional information, please contact Dr. Tina Leone The unique clinical experiences and broad expertise of the team in the NICU at NYPH – Columbia University provides an ideal environment for learning neonatal cardiovascular care. Trainees who have completed Neonatal-Perinatal Medicine training and are interested in obtaining advanced training in Neonatal Cardiac Intensive Care and Neonatal Hemodynamics will be considered for an individualized program that combines hemodynamics and cardiac intensive care training. Individuals interested in advanced training should contact Dr. Tina Leone at
Information about Dublin’s TNE training program can be found Here
For training opportunities and discussing eligibility, please contact
1) NPE (neonatologist performed echocardiography) and hemodynamic management: Fellowship information Department of Neonatology. La Paz University Hospital Faculty lead: María Carmen Bravo Eligibility criteria: Experience in Neonatology, newborn neuroimaging and NPE. Motivation, critical thinking and problem-solving oriented skills. Good interpersonal skills, including team working. Good communication skills, willingness to engage in public presentations and ability to transmit complex concepts in a clear way. Good time and workload management skills, including both initiative and flexibility. Application process: For questions regarding the fellowship position or to discuss your suitability, please contact Dr. María Carmen Bravo (email@example.com) 2) PhD Position Offer Form Project Title/Job Position title: Personalised monitoring of brain and heart blood circulation in neonates Troubles in blood circulation in the immediate days after birth constitute a critical risk in newborns, leading to death lasting handicaps. The application of personalised medicine (PM) could lead to significant improvements such as fewer complications, earlier hospital discharge, and better long-term neurological outcome. Non-invasive haemodynamic monitoring in neonatal critical care is thus essential and it is becoming progressively more sophisticated. Reliance on mean blood pressure values as an isolated biomarker to determine circulatory well-being in newborn infants is an overly simplistic approach to a much more complex problem. It is essential to optimize signal integration and data analysis to guide the decision making progress. Many studies support the use of Neonatologist performed echocardiography (NPE) as an essential tool to define a real situation of haemodynamic compromise and to characterise which is the main determinant that is failing in the newborn infant with circulatory insufficiency. However, the technique offers intermittent information, describing the moment “when” the study has been performed. For that reason, continuous monitoring (such as near infrared spectroscopy [NIRS] and cerebral blood flow autoregulation [CBF-AR], continuous cardiac output monitoring or the perfusion index) able to detect periods of haemodynamic vulnerability are essential to indicate when further assessment is needed to guide the cardiovascular treatment. IdiPAZ’s Neonatology researchgroup has extensively contributed to this field of research for many years. We pursue an individualised approach for earlier detection of circulatory impairment by the integration of non-invasive, continuous, cot-side routine and non-routine monitoring tools of physiological parameters. We hypothesisedthis multichannel approach will allow a personalised, pathophysiologically-oriented manner to guide cardiovascular treatment that will improve the long-term outcome of this vulnerable population. Role: The candidate will be trained in the performance and interpretation of the non-invasive intermittent techniques, as NPE basic and advanced (tissue Doppler and Strain), or continuous monitoring systems as NIRS and CBF-AR, cardiac output or perfusion index. Application process: For questions regarding the PhD position or to discuss your suitability, please contact
Q-NiCHE training program: The Q-NiCHE program is aimed at training neonatologists in Doha, Qatar, at Sidra Medicine in collaboration with the Paediatric Cardiology department at Sidra Medicine. Candidates are offered the opportunity to progress through 3 levels of Q-NiCHE training. Levels 1 and 2 constitute basic training, and Level 3 constitutes advanced training. A certificate of completion of basic training will be awarded upon successful completion of Level 2. Trainees may, after that, opt to undertake the advanced training (level 3). Every trainee will have a designated Q-Niche Trainer, and it is recommended that trainee-trainer ''appraisal'' meetings should occur as regularly as needed to support the trainee's needs (suggested time interval – once every three months). The program curriculum is based on Neonatologist performed echocardiography (NPE) and incorporates maintenance of log book of echo done, attendance at echo lab, Direct observation of procedural skills (DOPS), Case based discussion (CBD) and regular assessment by Echo review competency panel (ERCP). The progression is based on 6 monthly evaluation and final sign off after in-depth interview assessing theoretical knowledge and practical application of acquired skills conducted jointly by Q-NiCHE trainers and Pediatric Cardiology team. Contact: Professor Samir Gupta Division Chief of Neonatology & Q-NiCHE TPD:
Teaching according to ASUM standards. Only teach those in clinical positions at JHCH. Have run a training program in Newcastle since 2008.
Teaching according to ASUM standards but with greater emphasis on delineation of normal anatomy. Only teach those in clinical positions at KEMH. Active program teaching Lung Ultrasound, now an integral part of management.
Teaching according to ASUM standards. Only teach those in clinical positions at MCH in collaboration with Department of Diagnostic Imaging.
Teaching according to ASUM standards Regular bedside ultrasound teaching provided to advanced trainees Annual formal 10-week training program (accredited as ASUM basic training course)
Teaching those in clinical positions at RPA according to ASUM standards. Training program initially developed by Prof Nicholas Evans, who continues to provide onsite TNE training.
Neonatal trainees employed by GCNIC will have the opportunity to receive both hands-on and theoretical TNE training according to the Basic (Introduction to Neonatal Ultrasound) and Advanced Neonatal Ultrasound courses accredited as part of the Certificate in Clinician Performed Ultrasound (CCPU) through the Australasian Society for Ultrasound in Medicine (ASUM). There is the opportunity to attend combined congenital cardiac disease education together with the Cardiology and Cardiothoracic Surgery departments as well as gaining expertise in the clinical care of neonates with complex congenital cardiac disease. Joint cardiac ultrasound teaching sessions are also run with Paediatric Intensive Care Unit clinicians with the support of the Cardiology department, and there is the opportunity to attend combined teaching with Westmead Hospital (perinatal NICU).
Below are the guidelines developed by various hemodynamic experts for their individual sites. They are shared purely for education purposes.
Clinical Physiological Considerations (3rd ed)
Cardiovascular Physiology Concepts (2nd ed)
Lippincott Williams & Wilkins.
An approach to cardiovascular support based on disease pathophysiology
Semin Perinatol. (2016) 40:174–88. doi:10.1053/ j.semperi.2015.12.005.
Giesinger RE, McNamara PJ.
Clin Perinatol. (2017) Jun;44(2):377-393
EL Khuffash AF, McNamara, PJ
Pediatr Res. (2017);82:901-14.
Giesinger RE, More K, Odame J, Jain A, Jankov RP, McNamara PJ.
J Pediatr. (2017); 188:24-34
Krishnan U, Feinstein JA, Adatia I, Austin ED, Mullen MP, Hopper RK, et al.
Advances in diagnosis and treatment. In Seminars in Fetal and Neonatal Medicine
(Vol. 20, No. 4, pp. 262-271). WB Saunders.
Jain, A., & McNamara, P. J. (2015, August).
expert consensus statement issued by the cardiovascular dynamics section of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC).
Crit Care 24, 620 (2020). https://doi.org/10.1186/s13054-020-03326-2
Singh, Y., Villaescusa, J.U., da Cruz, E.M. et al.
Front Pediatr. 2017 Sep 15;5:201. doi: 10.3389/fped.2017.00201. PMID: 28966921; PMCID: PMC5605552.
collection of reference articles. https://www.nature.com/collections/pjlqbgkmwk
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NPA: Dr. Amish Jain
Funding: Heart & Stroke Ontario Clinician Scientist (Phase II) Award
The focus of the IMPRINT research program is to improve the clinical care and reduce the burden of pulmonary heart disease in preterm neonates suffering from pulmonary hypertension. The program’s current studies are:
Prospective observational study to develop robust echocardiographic criteria for early identification of preterm infants at risk of developing chronic pulmonary hypertension PMID: 33789855 | DOI: 10.1136/bmjopen-2020-044924
Funding: Canadian Institutes of Health Research (IHDCYH)–SickKids Foundation Participating sites: 6 NHRC sites across Canada, the United States & Europe
A detailed registry of preterm neonates treated with inhaled nitric oxide Funding: Mallinckrodt Investigator Initiated Research Grant Participating sites: 12 Canadian NHRC sites
NPA: Dr. Dany Weisz
PA: Dr. Amish Jain, Dr. Luc Mertens, Dr. Prakesh Shah
The main objective of this study is to develop an outcome-based definition of ‘significant’ PDA among extremely low gestational age neonates at different postnatal ages. Funding: Canadian Institutes of Health Research Project Grant Participating sites: 17 Canadian NHRC sites
NPA: Dr. Souvik Mitra
PA: Dr. Amish Jain, Dr. Prakesh Shah
The main objective of this registry-based comparative effectiveness research study is to compare the different pharmacotherapeutic practices aimed at closure of patent ductus arteriosus and to evaluate their impact on clinical outcomes in extremely preterm infants (<29 weeks GA) . Funding: Canadian Institutes of Health Research Project Grant Participating sites: 22 Canadian sites
NPA: Dr. Joseph Ting
Participating sites: BC Women’s Hospital and Health Centre & University of Iowa Stead Family Children’s Hospital
NPA: Audrey Hebert
Participating sites: CHU de Québec-Université Laval & University of Iowa Stead Family Children’s Hospital
The Neonatal Hemodynamics Research Center wishes to acknowledge the uniquely brilliant career of Dr Regan Giesinger. Regan completed her training in neonatal-perinatal medicine and neonatal hemodynamics at the University of Toronto. She was appointed as Assistant Professor of Pediatrics and Staff Neonatologist at SickKids hospital, Toronto in 2015. Thereafter, she was appointed Director of one of the world’s leading neonatal hemodynamics programs and Associate Professor of Pediatrics at the University of Iowa in 2018. Although quiet and humble in every encounter, Regan’s intelligence and quick thinking intimidated many. She recognized that if we are to provide the “best” care, there was an urgent need to re-engage with physiology and in providing the “right” therapy, clinicians needed to recognize the importance of diagnostic precision and delineation of the specific phenotype. Regan’s dedication to patients and their families was second to none.
Regan was an exceptional young clinician scientist, who at a very early stage of her career, achieved an international reputation in her chosen field of neonatal hemodynamics and the application of targeted neonatal echocardiography (TNE) as a critical bedside tool to enhance clinical care and research through the provision of enhanced diagnostic and mechanistic insights. Although her career was cut short, she made substantial scientific contributions including 65 original articles, 11 book chapters, and numerous abstracts. She also served as a co-investigator on several National Institute of Health (NIH) grants. Her primary research work, which characterized the relationship between right ventricular dysfunction and neurodevelopmental outcomes in term neonates with hypoxic ischemic encephalopathy, was precedent setting and has laid the foundation for further investigations aimed at improving the outcomes for this vulnerable population of neonates. She also published several original contributions related to novel therapies in pulmonary hypertension, and the use of nitric oxide in preterm infants. In addition, she delivered more than 100 invited talks across the world, including the United States, Canada, Sweden, Romania, Italy, India, and the UK. She was honored with delivering the 2020 Neonatal Hemodynamics club lecture at PAS. Regan showed outstanding strength, integrity and leadership in education, training and administrative roles, and represented the very best of academic medicine. She was a member of the Neonatal Hemodynamics Advisory at PAS and was an executive member of the Neonatal Hemodynamics and TNE specialty interest group at the American Society of Echocardiography. In 2021, Regan was appointed as fellow of the American Society of Echocardiography (FASE), making her one of the few neonatologists to receive this accolade.
I would say her greatest achievement has been re-shaping the minds of so many young trainees and building the culture of the hemodynamics movement in Neonatology. Regan was a deep thinker, and time spent reflecting on complex patients, gaps in scientific knowledge or debating optimal hemodynamic care was when she flourished. Her landmark publication in the Blue Journal on the beneficial impact of hemodynamic screening on outcomes in extremely preterm babies is transformative. Sadly, Regan passed away from us after an extensive battle with cancer on May 16th, 2023. She has left behind a powerful legacy. In teaching the importance of physiology and diagnostic precision in cardiovascular care, Regan has influenced a generation of trainees and young faculty. Her contributions in the field of neonatal hemodynamics will continue to guide us for years to come.
Dr. Patrick J McNamara
On behalf of the Neonatal Hemodynamics Program, University of Iowa and
Neonatal Hemodynamics Research Centre