Sir.—I applaud Alan Bedrick's1 acknowledgment in his editorial in the February 1990 issue of AJDC that 6 months of neonatology in a 3-year pediatric residency is excessive. I also concur with his justification for his specialty's presence in residency training. However, I believe he has omitted several important issues relevant to the title of his editorial.
Neonatal nurse practitioners (NNPs) do, in fact, cost a lot more money, but rather than admonishing us to "keep [that] in mind," why not confront the issue head on, indicating that few institutions have found the ability to solve that financial conundrum.
The neonatal intensive care unit (ICU) is a great place to learn critical care medicine, and 15 to 20 years ago that and the pediatric ICU were the only places in which it could be learned. Now, however, most large, free-standing children's hospitals are veritable ICUs from top