The goal of the MGH NICU rotation is to develop the ability of residents to evaluate and manage critically ill infants with a broad range of medical and surgical problems. The rotation is based in an 18-bed level III neonatal intensive care unit. Learning will occur in a multidisciplinary team-based system. Interns will be the primary caregivers for their patients, under the close supervision of staff neonatologists and intensive care fellows. The most important goal of the intern experience in the NICU is to develop a comprehensive knowledge of one’s patients and establish a relationship with the family as the primary physician on the NICU team. Residents return to the MGH NICU as senior residents in a supervisory role and have opportunities to teach as well as further develop their neonatal intensive care skills while covering the patient care overnight every fourth night. The NICU Senior rotation is designed to allow seniors to demonstrate the confidence and competence necessary to manage an intensive care unit for critically ill neonates.