Is it time for a separate residency and department in "Neonatal Critical Care Medicine"?

Recent changes in pediatric residency curriculum require reductions in the duration of NICU rotations. Low interest in pediatrics among medical students coupled with reduced exposure to neonatology during residency are likely to decrease applications to neonatology fellowships. We propose a separate neonatal critical care residency combining 1-2 years of pediatrics followed by 3 years of neonatology rotations (total 4-5 years) to enhance recruitment. There is also a need to reengage the neonatology community to be role models and inspire and attract medical students to neonatology. Academic neonatology is facing a crisis. Long hours, high productivity expectations, and significantly lower compensation compared to non-academic settings is contributing to physician disengagement. A transparent cFTE definition, better governing structure, strategic allocation of resources to recruit, retain and nurture neonatal physician-scientists and engaged clinician-educators are needed. If these measures are not effective, a separate department of neonatal critical care medicine should be considered.