Child adolescent programs

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PsychMD1987

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Hello

current treading through the 2020 interview season. Was wondering what’s everyone opinion on best programs in terms of Didactics, clinical experience, research. I know it’s dependent on what the applicant is exactly looking for but I’m just curious on everyone’s outlook.
Thanks !

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I am also currently in the middle of interviews and wondering the same. I would expect that the big cities (NYC, Boston, LA) would have the best training experiences and didactics due to the fact that they have a diverse patient population and better resources, but this is just speculation. I've heard good things about Stanford, UCSD, UCLA, NYU, New York Pres, Mount Sinai, Penn, MGH and Boston Children's to name a few.

Any other advice or knowledge would be greatly appreciated!
 
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Yes I heard the same about those programs being top. Same for WashU

just wondering what’s makes them diff from Mayo Clinic and Baylor, etc etc. Baylor is in a big city, very diverse. Mayo may not be in a big city but has resources And research. ‍♂️
 
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Quality of CAP program is generally related to the quality of the adult program but there are some instances where there is a large difference. If you could pick only one factor, I would start with the strength of the adult training. Differences that arise can be related to funding, structure of a program (CAP being part of adult with an adult chair who has little interest in CAP for example), or just happenstance related to recent turnover. No one is simply going to post a list of programs to avoid or that are relatively weaker online, even relatively anonymously, for pretty obvious reasons.

I strongly recommend speaking to every CAP attending and fellow you know to get a better understanding of people's perspective on this. PDs in particular that have held that job for a number of years will be fairly well versed on what's happening across the "competition".
 
In addition to the above, I would also look at how robust the clinical services offered are at that program. More volume, more subspecialty clinics, more unique rotations offering training in a specific disorder or modality is probably better for training unless you know you want to do a specific thing (research, private practice, etc.) and don't care about the rest.
  1. Some examples of the variety in rotations include eating disorder inpatient vs outpatient vs RTC, OCD, inpatient/residential ASD, learning how to do ADOS/ADI-R for ASD, strength of the children's hospital, early psychosis clinic, mood disorder clinic including seeing pediatric bipolar patients, adolescent addiction clinic vs inpatient vs residential, seeing young children under 6 years of age, school-based rotations, integration with the juvenile justice system, integration with child neurology and developmental-behavioral pediatrics, how young the inpatient units will take patients (some admit patients as young as 3 years old) if there even is an inpatient unit, if fellows rotate or cover emergency psych cases, the integrative/collaborative care models with primary care, how much forensic exposure you get, exposure to patients with rare genetic abnormalities, if there's a trauma clinic.
  2. You also want to gauge the strength of the psychotherapy program at the fellowship: training in CBT, play therapy/psychodynamic, parent management training or parent-child interaction therapy for ODD/Conduct Disorder, true DBT (rather than just DBT principles), Comprehensive Behavioral Intervention for Tics and Habit Reversal Therapy, exposure and response prevention for kids with OCD, and maybe even some exposure to Applied Behavior Analysis/Pivotal Response Training for ASD.
  3. Location is also a big factor as it determines what types of patients you might be seeing and where you'll be practicing afterwards usually. Access to private practice psychiatrists as adjunct/volunteer faculty is also helpful in having exposure to a different practice model.
  4. Call is obviously important for both training and lifestyle. Some programs have as little as no call to some being extremely call heavy.
  5. If you care about research finding a program that has an established T32 would be nice (none of this "we are working toward it and you can be the first!" nonsense).
There's going to be lots of debate because the "best" or "top" programs are subjective. The fit into your career goals is what is most important. The best programs in general are probably NYU, Columbia-Cornell, any of the Harvard programs (MGH/McLean, Cambridge Health Alliance, Boston Children's Hospital, etc.), Yale, Stanford, UCLA. Other notable programs include UW, Mt. Sinai, Brown, UCSD.
 
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In addition to the above, I would also look at how robust the clinical services offered are at that program. More volume, more subspecialty clinics, more unique rotations offering training in a specific disorder or modality is probably better for training unless you know you want to do a specific thing (research, private practice, etc.) and don't care about the rest.
  1. Some examples of the variety in rotations include eating disorder inpatient vs outpatient vs RTC, OCD, inpatient/residential ASD, learning how to do ADOS/ADI-R for ASD, strength of the children's hospital, early psychosis clinic, mood disorder clinic including seeing pediatric bipolar patients, adolescent addiction clinic vs inpatient vs residential, seeing young children under 6 years of age, school-based rotations, integration with the juvenile justice system, integration with child neurology and developmental-behavioral pediatrics, how young the inpatient units will take patients (some admit patients as young as 3 years old) if there even is an inpatient unit, if fellows rotate or cover emergency psych cases, the integrative/collaborative care models with primary care, how much forensic exposure you get, exposure to patients with rare genetic abnormalities, if there's a trauma clinic.
  2. You also want to gauge the strength of the psychotherapy program at the fellowship: training in CBT, play therapy/psychodynamic, parent management training or parent-child interaction therapy for ODD/Conduct Disorder, true DBT (rather than just DBT principles), Comprehensive Behavioral Intervention for Tics and Habit Reversal Therapy, exposure and response prevention for kids with OCD, and maybe even some exposure to Applied Behavior Analysis/Pivotal Response Training for ASD.
  3. Location is also a big factor as it determines what types of patients you might be seeing and where you'll be practicing afterwards usually. Access to private practice psychiatrists as adjunct/volunteer faculty is also helpful in having exposure to a different practice model.
  4. Call is obviously important for both training and lifestyle. Some programs have as little as no call to some being extremely call heavy.
  5. If you care about research finding a program that has an established T32 would be nice (none of this "we are working toward it and you can be the first!" nonsense).
There's going to be lots of debate because the "best" or "top" programs are subjective. The fit into your career goals is what is most important. The best programs in general are probably NYU, Columbia-Cornell, any of the Harvard programs (MGH/McLean, Cambridge Health Alliance, Boston Children's Hospital, etc.), Yale, Stanford, UCLA. Other notable programs include UW, Mt. Sinai, Brown, UCSD.
This was so thorough and helpful!

Out of curiosity, how did UCSD end up on here? Not saying it is incorrect, but I'm curious because I love San Diego but wasn't too sure about the program historically and with new transitions.
 
This was so thorough and helpful!

Out of curiosity, how did UCSD end up on here? Not saying it is incorrect, but I'm curious because I love San Diego but wasn't too sure about the program historically and with new transitions.
I would talk to current folks there if its of interest to you. I too have heard about transitions.
 
Cleveland Clinic CAP has rotations you won't find elsewhere and definitely on the list.

But ultimately, the advice I gave a friend years ago, was choose the program with less call...
 
I don't know anyone there...would you please elaborate?
You'll find relatively few strangers willing to say anything negative, even on a mostly anonymous forum, in writing. It's just not how the field of medicine works. I personally feel okay mentioning when staff have had significant turnover (happens to plenty of good programs), past that I can recommend you discuss with current or recently finished fellows.
 
Does anyone have any info or insight they’re willing to share about the CAP fellowships in Philadelphia? In particular CHOP? And maybe Jefferson and Drexel?
 
Drexel doesn't have any training programs anymore I'm pretty sure. I don't know much about the other 2 programs, but I've been told that CHOP is great for peds but not so much for psychiatry. I think because you have to travel to Delaware for the inpatient psych experience. I don't have too much information on Jeff though.
 
Does anyone have any info or insight they’re willing to share about the CAP fellowships in Philadelphia? In particular CHOP? And maybe Jefferson and Drexel?
I interviewed here last year. I don't recall specific details (will have to return to my notes) but they have a strong CL department. You do have to drive to get to their inpatient facility, which I don't believe is in Delaware as one of the posters mentioned (unless I was zoning out during the presentation). Calls are on the heavier side but they are generously compensated, which is nice. Fellows seemed happy w their experiences and many from the adult residency program stay on for their fellowship, which I think says a lot about a program in general. My interaction w the PD was short (30-minute interview) but she seemed supportive and nice. The leadership team at CHOP is diverse, which I appreciated.
 
You'll find relatively few strangers willing to say anything negative, even on a mostly anonymous forum, in writing. It's just not how the field of medicine works. I personally feel okay mentioning when staff have had significant turnover (happens to plenty of good programs), past that I can recommend you discuss with current or recently finished fellows.
I don't think it's about how the field of medicine works, it's more a factor of how small these programs are. The smaller the program, the greater the chance that you'll be identified, meaning the higher threshold before you speak negatively about your program.

With that said, I will absolutely ream my medical school with any chance that I get, so long as it'll take more than a few minutes to find out who I am. My experience was so negative that I honestly feel honor-bound to warn students away from it.
 
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How is the call schedule in UCSD Child Psych fellowship?
Pretty rough. Both CAP1 and CAP2s are in the call pool. It's weekday overnight as well as the full weekend (Fri after 5pm until Mon morning). CAP1s do something like ~7 full weekend calls and ~30 weeknight calls whereas CAP2s do ~4 full weekend calls and ~30 weeknight calls. You cover hospital consults including the ER as well as the inpatient unit.
 
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This was so thorough and helpful!

Out of curiosity, how did UCSD end up on here? Not saying it is incorrect, but I'm curious because I love San Diego but wasn't too sure about the program historically and with new transitions.

They get fellows from reputable residency programs; the clinical rotations seem excellent and include a med-psych unit for eating disorders, an inpatient unit for adolescents which I've heard was great, a dedicated rotation for ER; pretty supportive faculty; what seems like a great IOP rotation; lots of outpatient rotations including college students and community clinics; and you'll definitely see enough volume and mix of patients (from insured to medicaid) to graduate with a feeling of competency in child & adolescent psychiatry. I haven't heard about these new transitions.

I would avoid programs that lack a certain critical aspect of child psychiatry, such as never seeing a patient in the ER, doing an eating disorders rotation, no school based rotation, no young child experience, limited psychotherapy options (only CBT without DBT, family therapy either PMT or PCIT, or play therapy exposure), or no center of treatment for autism.
 
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Hello

current treading through the 2020 interview season. Was wondering what’s everyone opinion on best programs in terms of Didactics, clinical experience, research. I know it’s dependent on what the applicant is exactly looking for but I’m just curious on everyone’s outlook.
Thanks !
I would probably go to a major academic center with balance of clinical service & education. You need to see a good amount of clinical cases to be comfortable with your patients. Some programs are very relaxed and you might not see wide variety of cases. Also look for speciality services such as eating disorder units, substance abuse services, early childhood mental health, school mental health, community psychiatry/juvenile patient population, autism, behavioral programs (IOP, PHO settings) etc. Some service heavy programs have fellows in ER&consultation areas for suicide risk assessment&disposition, mainly for service related reasons, you can learn it very easily, no need to do it for months. Try to get a good sense of developmental disorders and learn psychological/neuropsychological testing.
 
Pretty rough. Both CAP1 and CAP2s are in the call pool. It's weekday overnight as well as the full weekend (Fri after 5pm until Mon morning). CAP1s do something like ~7 full weekend calls and ~30 weeknight calls whereas CAP2s do ~4 full weekend calls and ~30 weeknight calls. You cover hospital consults including the ER as well as the inpatient unit.
Thanks for the reply! Are both the weekend calls and weeknight calls from home at UCSD? I heard at some fellowship programs the general psychiatry residents working at the hospital see the patients and then call the fellow on call to staff. Do you know if that's how call is at UCSD?
 
Thanks for the reply! Are both the weekend calls and weeknight calls from home at UCSD? I heard at some fellowship programs the general psychiatry residents working at the hospital see the patients and then call the fellow on call to staff. Do you know if that's how call is at UCSD?

That's not how it's done at UCSD as far as I know unless they've changed something recently. The model you're talking about is at UCLA, Columbia/Cornell, NYU, Cambridge Health Alliance, University of Virginia, etc.
 
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