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Child & Adolescent Psychiatry

 



Residents enter the child and adolescent psychiatry program in much the same way as they enter the general psychiatry program. A two year fellowship in child and adolescent psychiatry is offered to residents who have completed the equivalent of three years in general psychiatry training. WPIC trainees who enter this program in general psychiatry and later decide to pursue subspecialty training here in child/adolescent psychiatry are able to do so if there are positions available. Additionally anyone wishing to switch must decide by the beginning of their third year of adult training and are required to be in good standing with the program.

 

The Combined Five Year Adult and Child/Adolescent Training Program, begun in 1970 here at WPIC, was one of the first such integrated programs nationally. Trainees may enter the combined program following graduation from medical school, as a PGY1, or after completion of a separate one-year internship, as a PGY2. This integrated approach to training allows the trainee to build, in stepwise fashion, on their basic adult psychiatry training, and gain more exposure and experience with child and adolescent psychiatry as early as their PGY2 year of training. Otherwise the first 3 years of training are similar to those of adult trainees.

PGY1    PGY2    PGY3   PGY4    PGY5
5-year Rotation Schedule
Course Descriptions for Child Fellowship
Application Procedures

PGY1

The first year, the internship, is designed to provide a foundation for subsequent training in psychiatry.  The clinical rotations and didactic curriculum are integrated to prepare residents to competently manage a broad variety of medical and psychiatric disorders and emergencies.  This is the first step in acquiring mastery over a wide variety of skills that are required by a modern-day psychiatrist.  

3 Months1 Month2 Months3 Months3 Months
PediatricsMCPPNeurology
(1 month Child
Neurology & 1
month Adult
Neurology
Psychiatric
Emergency
Services
Substance-
related &
Anxiety
Disorders

While identical to the PGY1 in the 4-year adult program in goals and objectives, as well as most clinical experiences, residents in the combined 5-year program can elect to complete 3 months of pediatrics at Children's Hospital of Pittsburgh, instead of internal medicine, and will complete one month of pediatric neurology, in addition to a month of adult neurology.

Residents rotate through the Psychiatric ER for 3 months and continue to take overnight call in the ER throughout their 2nd year. The free standing Psychiatric Emergency Room, separate from the medical Emergency Department at UPMC, provides psychiatric evaluation, brief counseling and crisis intervention, routine pharmacologic management, and referrals for acute inpatient hospitalization, partial day programs, and outpatient clinics.  During the evenings, the residents are the primary medical doctors in the emergency room, working with a supervising attending, "in house", with child attending supervision by phone as needed. 

A 3-month rotation in Substance-related disorders and anxiety disorders is divided into a 1-month rotation at the Center for the Treatment of Addictive Disorders (CTAD) and Post Traumatic Stress Disorder Clinic, VA Pittsburgh Healthcare System - Highland Drive, and a 2-month rotation at WPIC on an inpatient service specializing in acute treatment of substance-related disorders.

The formal didactic curriculum during PGY1 focuses on fundamental psychiatric knowledge base upon which subsequent training and education will build on.  The curriculum includes lectures, seminars, case conference, grand rounds and workshops.  These programs are directed  and taught by faculty, many of whom are renowned experts in their areas.

Chief Resident discusses PGY1 and 2

Residents class picturePGY2

The second year of residency training is an exciting year that provides a core set of experiences that essentially define the scope of psychiatry.  Residents undergo clinical rotations in adult, child, geriatric and Consultation and Liaison psychiatry services.  The didactic curriculum is closely integrated with these clinical experiences.  Residents begin psychotherapy training with patient assignments and individual supervision towards the middle of PGY2.  At the end of the second year, residents will be able to competently diagnose and treat a wide variety of common psychiatric disorders.   

2.4 Months2.4 Months2.4 Months2.4 Months2.4 Months
Mood Disorders Unit"Schizophrenia Unit"Geriatric Psychiatry UnitChild & Adolescent UnitConsultation/Liaison Service
Outpatient Evaluation Clinic & Long-term Psychotherapy

During the PGY2 in the combined program, residents join their adult training colleagues in all clinical and didactic experiences. In addition, combined residents begin to see child and adolescent outpatients along with their adult outpatients. This allows for a more longitudinal experience in psychotherapy treatment of children and adolescents than then would otherwise be possible in the two year training program.

Residents spend 10/11 weeks four specialty services, reflecting the four broad divisions in clinical psychiatry.  Each inpatient service has "teaching teams" with one resident supervised by one attending.  Residents carry no more than 8 patients at any given time.  On each service, residents work closely with the supervising attending and the treatment team, comprising nurses, social worker and other clinicians.  Residents are given increasing and graduated independence in managing the assigned patients.  There is onsite medical coverage and specialty consultations are available through Presbyterian Hospital, which is physically connected to WPIC.

The Consultation and Liaison (C/L) Psychiatry service provides psychiatric consultation to all units (medical, surgical, transplant, intensive care units, oncology, obstetrics, gynecologic, etc.) at Presbyterian Hospital, and on occasion, the UPMC Emergency Service.  Presbyterian Hospital is connected to WPIC by and indoor tunnel.  Residents are assigned patients for consultation and, under supervision, provide a set of management recommendations and follow these patients for the duration of the patients' hospital stay.  There are daily lectures and seminars on C/L topics while on this service.  Residents on this service are exempt from call at WPIC.  Instead, they provide evening and weekend coverage to the C/L service.

Residents continue to take overnight call at WPIC throughout their 2nd year, except while on C/L rotation. 

The formal didactic curriculum during PGY2 expands on acquiring fundamental psychiatric knowledge that began during PGY1, and is closely linked to the clinical experiences during this year.   The curriculum includes lectures, seminars, case conferences, journal clubs, grand rounds and workshops.  These programs are directed  and taught by faculty, many of whom are renowned experts in their areas. 

Chief Resident discusses PGY1 and 2

PGY3

The third year of residency training is focused on extending the skills and knowledge acquired during the first and second years of residency.  During PGY3 residents work in several general and specialty clinics that provide an opportunity to learn about different models of care utilized today.  These models include following patients independently, seeing patients with counselors,  and working closely with treatment teams.  Residents are required to complete  two year-long clinics as well as the six-month requirements of Geriatric and Child psychiatry.  In addition to these requirements, residents are required to choose at a minimum of 3 six month electives.  An elective typically occurs once per week for a half-day per week.  Each clinic is directed by faculty who are experts in their fields.  Residents continue psychotherapy training with additional patient assignments and individual supervision.  At the end of the third year, residents will be able to competently diagnose and treat patients, and provide longitudinal care in a variety of outpatient settings.  They will achieve increasing levels of competency in psychotherapy.

6 Months6 Months
Geriatric Psychiatry
Neurobehavior Clinic
Neuropsychiatry Clinic
Child & Adolescent Psychiatry
Magee Women's Clinic
Center for Psychiatric and
Chemical Dependency Service
Bellefield Clinic
(primarily mood, anxiety and personality disorders)
Comprehensive Care Services
(primarily chronic psychoses)

Long-term Psychotherapy

The formal didactic curriculum during PGY3 provides a series of advanced topics, including the psychiatric literature.  These programs are directed and taught by faculty, many of whom are renowned experts in their areas.

PGY4 (First Year Child/Adolescent Fellowship)

This first year of full-time child and adolescent psychiatry training is designed to provide a broad clinical and didactic exposure to the field, building on adult training and past experiences in child and adolescent psychiatry. The resident works with patients of all ages, infancy through adolescence, in a variety of treatment settings, using a variety of treatment modalities, both within the main hospital and out in the community. By the completion of this year, the resident should have an appreciation of the particular needs of children and adolescents and their families in the mental health system, and how these needs differ from those of adults. They should have developed the basic skills needed to assess and treat their child and adolescent patients, with particular appreciation of the impact of developmental variables.

Clinical rotations include equal experiences each on these services: Child inpatient unit, John Merck inpatient unit, acute adolescent partial program, Mathilde Theiss Child Development Center and the psychiatric Consult/Liaison service at Children's Hospital of Pittsburgh (CHP).

 

2.4 Months2.4 Months2.4 Months2.4 Months2.4 Months
Child Inpatient UnitJohn Merck Inpatient UnitMathilde Theiss Child Development Center and COPEAcute Partial ProgramConsultation/ Liaison Service at Children's Hospital
Continuity Clinic & Long-term Psychotherapy

Child Inpatient Program

This service treats mostly school aged and younger patients. The resident works with a seasoned attending, managing all aspects of the care of a team of 7 – 9 patients, including psychopharmacology, individual and milieu needs, educational and larger systems needs (e.g., child welfare) and family treatment. The resident also has the opportunity to interact with managed care entities, depending on individual patient needs.

John Merck Program

The program specializes in special needs children, particularly those with MR and co-morbid psychiatric disorders, and autism and other pervasive developmental disorders. This unique program offers a wide selection of treatment contexts and modalities within which the resident will have the opportunity to train. The Inpatient unit has 11 child and adolescent beds. The resident will, similar to the experience on the general child inpatient unit, manage all aspects of care of a team of 7 – 9 patients, under the supervision of an attending experienced with this special population.

Mathilda Theiss Child Development Center

This is a unique clinical setting within a local community which allows the resident to observe normally developing infants and toddlers along side of children with developmental and other behavioral disorders. The Center’s Behavioral Health service offers a parent/infant assessment and treatment program as well as a toddler day treatment program.

Residents will evaluate and treat patients and families within both settings, working with psychiatrists and psychologists with expertise in these age groups.

Acute Adolescent Partial Program 

The program is situated in a local community and provides intensive day treatment to adolescents not in need of an inpatient setting but whose clinical acuity is nonetheless quite high. Residents manage a team of 9 - 12 patients under the supervision of an experienced child psychiatrist, and have the opportunity to provide individual treatment, participate in group interventions and family work, as well as manage medication treatment.

Center for Overcoming Problems of Eating (COPE)

COPE inpatient treatment consists of a 11-bed inpatient unit, which is a highly structured environment for the treatment of anorexia and bulimia. The program specializes in cognitive-behavioral treatment. Patients participate in meals and group therapy seven days per week, as well as working independently on specific psychoeducational materials related to eating disorders, coping skills, depression, emotion skills, and many other topics. The unit is staffed by an interdisciplinary team of psychiatrists, physicians, social workers, therapists, dietitians, nurses, and other mental health specialists to provide an intensive but rewarding treatment program. Inpatient treatment is typically for those who are severely malnourished, requiring nutritional stabilization or weight gain.

Consult/Liaison Service at CHP 

Residents pictureC/L Psychiatry service at CHP provides inpatient and outpatient consultation to a wide variety of general and specialty services within this large pediatric hospital. Residents see patients and present them to one of a team of child psychiatrists who work in this setting. 24 hour on call services are provided by the residents during this year to the C/L service and the emergency room at CHP.

Continuity Clinic

The ½ day/week clinic continues throughout the 2 years of child and adolescent training, and is designed to provide the resident broad experiences in the psychopharmacologic assessment and treatment of outpatients.

Formal didactics during the first year of full time child/adolescent training are focused on developing a fundamental knowledge base in child and adolescent psychiatry, both in assessment and treatment.

PGY5

This second and final year of full-time child and adolescent training is designed to build on the skills and knowledge base gained in the first training year, with the opportunity for the resident to electively focus on particular areas of interest. Experiences over the year are designed with an eye on the future career of an individual resident. There are no call responsibilities during this year. Forensics, school consultation, community psychiatry,  neurology (if not previously done) are all required experiences during this year, as well as senior resident teaching activities and a scholarly project, continuity clinic and longitudinal psychotherapy cases. Electives, which provide the remaining experiences during this year, are as numerous as the clinical, administrative and research activities ongoing within this large UPMC system of behavioral health care. There are a number of already existing elective opportunities and new ones are regularly proposed by residents and faculty.

Outpatient Clinics
Electives
Long-term Psychotherapy

Forensic Experience
Community Psychiatry
Scholarly Project
School Consultation

Formal didactics build on the knowledge base attained in the first year of child/adolescent training, and address more advanced and specialized topics designed to add depth to knowledge and skills. There is also a classroom focus on career transitioning and decision-making in anticipation of the completion of residency training.

APPLICATION PROCEDURE & ADDITIONAL INFORMATION

Applications are accepted for:

  • 5-year General/Child and Adolescent Combined Residency Training Program
  • 2-year Child and Adolescent Residency Training Program

5-year General/Child and Adolescent Combined Residency Training Program

The applicant must be a senior in an approved medical school or hold an MD degree.  We encourage applications from minority students.  Applicants with specialty training in in other areas of medicine are also welcome. 

Applications are accepted through ERAS (Electronic Residency Application Service).  We require a complete application form, personal statement (including a statement regarding areas of interest), medical school transcript and three letters of reference. Applications will be accepted until mid-December. After completion of the review process by the Selection Committee, applicants will be notified by email or mail.  Dates for the interview will be determined at the time of the invitation.  We generally interview on Mondays, November through early January. 

2-year Child and Adolescent Residency Program

Application for the 2-year Child/Adolescent Residency Program is not through ERAS but we do, on occasion, participate in the National Residency Match Program (NRMP).  The application includes:

Applicants requiring ECFMG certification must ensure that USMLE transcripts are are available for review on the ERAS application.  

Further information may be obtained by contacting:

Sansea Jacobson, M.D.
Director, Child & Adolescent Psychiatry Residency Training
Western Psychiatric Institute & Clinic
University of Pittsburgh
3811 O'Hara Street
Pittsburgh, PA 15213
(412) 246-5320
Email: jacobsonsl@upmc.edu