Adolescent Fellowship Research Articles

33.5 CBT Supervision in Child and Adolescent Fellowship Training: A Milestone-Based Competency Model

The Accreditation Council for Graduate Medical Education (ACGME) mandates CBT training during child and adolescent psychiatry fellowship. Despite the training requirement, there is a lack of universally accepted standard methods for CBT supervision and training of psychiatrists. The high variability of CBT supervision across programs poses a challenge in meeting the milestone competencies designated by the current accreditation system for child and adolescent fellowships. We will share the milestone competency-based model for CBT training developed using well-defined principles of adult learning.

WHAT TO DO WHEN YOU DON’T KNOW WHAT TO DO

Those attending this Workshop will acquire a set of strategies and tools that they can use when their approach to treatment seems to be failing or at an impasse. These tools and strategies can also be helpful when training child and adolescent fellows or residents, or when providing supervision or consultation to another practitioner.

Child and Adolescent Psychiatry Fellowship Program Website Content and Accessibility.

ObjectiveWhen child and adolescent psychiatry fellowship applicants are applying to programs, many will use fellowship websites to gather information. This study assesses the accessibility and content available on child and adolescent fellowship websites.MethodsUsing the Electronic Residency Application Service (ERAS) list of child and adolescent fellowship programs for 2020, 139 child and adolescent fellowship training websites were compiled. Information on websites was evaluated within the following three categories: program overview, application information and recruitment, and educational opportunities. A total of 22 criteria were evaluated within these three categories. Descriptive statistics were used to analyze the websites.ResultsA list provided by ERAS and a Google search identified child and adolescent fellowship program websites. Analysis of content revealed most websites included an overview of the program (97.8%), but fewer included information such as the number of fellowship spots (51.5%), salary (45.5%), application deadline (41.0%), and call responsibility (19.4%).ConclusionResults suggest there is room for improvement in the comprehensiveness and accessibility of child and adolescent fellowship websites. Especially during a time when much of the programmatic information will be obtained virtually due to COVID-19, it is critical that fellowship websites are uniformly curated so applicants can more easily find information about programs.

Reflections on My Early Career: Nearly Trampled by Trauma

Reflections on My Early Career: Nearly Trampled by Trauma

To Increase Diversity, Medicine Should Rethink USMLE Scores, Psychiatrists Say

To Increase Diversity, Medicine Should Rethink USMLE Scores, Psychiatrists Say

Transitions in Care: A Workshop to Help Residents and Fellows Provide Safe, Effective Handoffs for Acute Psychiatric Patients.

IntroductionFocused training in care transitions is an ACGME-required component of resident education. However, there are limited published curricular resources specific to trainees in psychiatry to help develop this crucial skill.MethodsWe developed a 90-minute interactive workshop on care transitions in psychiatry for general adult psychiatry residents (PGY 2-PGY 4), child and adolescent fellows, and consult-liaison fellows. Trainees collaborated in interdisciplinary teams to explore a vignette in which a patient moved through four different venues of care (outpatient, emergency department, inpatient medical, and inpatient psychiatric). Guiding questions prompted discussions of critical issues related to logistics and clinical communication for each transition between care environments.ResultsIn a postworkshop anonymous survey, 100% of trainee participants (n = 30) felt the workshop was successful in creating the opportunity to develop relationships with, and learn from, colleagues at other levels of psychiatry training. Ninety percent responded affirmatively that they were able to identify key elements of an effective handoff for an acute psychiatric patient. Eighty-three percent identified being able to describe logistical steps for transferring the care of patients between mental health services at their institution.DiscussionTrainee participants found the workshop beneficial for understanding the steps needed to transfer patients between levels of care safely, discussing and debating gray areas with peers and faculty, and developing interdisciplinary relationships within psychiatry. Faculty participants described an interest in using the workshop as a faculty development exercise. This workshop fills a critical gap in available curricula on transitions in care in psychiatry.

Supreme Court Upholds DACA Program in 5-4 Decision, but Peril Remains

Supreme Court Upholds DACA Program in 5-4 Decision, but Peril Remains

Curricula for Teaching Clinical Practice Guidelines in US Psychiatry Residency and Child and Adolescent Fellowship Programs: A Survey Study

To determine the characteristics of curricula for teaching the content of clinical practice guidelines (CPGs) in psychiatric residency and child and adolescent fellowship programs as well as to determine if and how the learning of CPG content is applied in clinical care settings. We conducted a national online survey of directors of general psychiatry residency and child and adolescent fellowship programs in the USA. The survey questionnaire included 13 brief questions about the characteristics used to teach CPGs in the programs, as well as two demographic questions about each program and director. Descriptive statistics were reported for each questionnaire item by program classification (i.e., child and adolescent vs. general psychiatry). The survey response rate was 49.8% (146 out of 293). Just 23% of programs reported having written goals and objectives related to teaching CPGs. The most frequently taught aspect of CPGs was their content (72% of programs). Didactic sessions were the most frequently employed teaching strategy (79% of programs). Regarding the application of CPG learning in treatment care settings, just 16% of programs applied algorithms in care settings, and 15% performed evaluations to determine consistency between CPG recommendations and care delivery. Only 8% of programs utilized audit and feedback to residents about their adherence to CPGs. Faculty time constraints and insufficient interest were the leading barriers (39% and 33% of programs, respectively) to CPG teaching, although 38% reported no barriers. However, child and adolescent programs less commonly identified insufficient interest among faculty as a barrier to teaching CPGs compared to general programs (20% vs. 43%). Moreover, compared to general programs, child and adolescent fellowship programs taught more aspects of CPGs, used more educational activities to teach the content of specific CPGs, and used more methods to evaluate the teaching of CPGs. Although the majority of programs provided some teaching of CPGs, the rigorousness of the teaching approaches was limited, especially attempts to evaluate the extent and effectiveness of their use in clinical care. Child and adolescent fellowship programs provided more extensive teaching and evaluation related to CPGs.

Health Equity and Adolescent Health: A Call to Action for the Society for Adolescent Health and Medicine

Health Equity and Adolescent Health: A Call to Action for the Society for Adolescent Health and Medicine

Applications Sought for Child, Adolescent Fellowship

Applications Sought for Child, Adolescent Fellowship

Students Learn About Medical Career as Doctors Go 'Back to School'

Back to table of contents Previous article Next article Residents' ForumFull AccessStudents Learn About Medical Career as Doctors Go 'Back to School'Jacqueline Smith, M.D.Jacqueline SmithSearch for more papers by this author, M.D.Published Online:2 Oct 2009https://doi.org/10.1176/pn.44.19.0018During APA's annual meeting in San Francisco in May, I had the great fortune of participating in a rewarding offering that was not part of the meeting's formal program. As a part of the AMA's “Doctors Back to School” program, I visited the School of Saint Leo the Great across the Bay in Oakland, Calif. The “Doctors Back to School” program encourages minority youth to attend college and then medical school.APA participates in the program through the Commission to End Health Disparities, of which it is a member. APA's involvement in the program is in conjunction with major APA meetings such as the annual meeting and the Institute on Psychiatric Services. It represents a wonderful and unique opportunity for young students to learn about the rewarding and diverse field of psychiatry in particular and glean more general information about a career as a physician.More than 60 students from the sixth through eighth grades attended the presentation. Also attending were Marilyn King from the APA Office of Minority and National Affairs, who coordinated the visit; child and adolescent psychiatry resident Dr. Aeva Gaymon-Doomes; recent medical school graduate Dr. Onisha Lawrence; and medical student Byron Young.After we introduced ourselves, the students wasted no time asking questions.They wanted to know what our high school and college course loads were and if any of us had ever goofed off in school or made mistakes. We told them about our own choices of courses; for example, I was a biology and psychology major in college. However, we also emphasized that they could choose whatever classes interested them, as long as they met basic requirements for college and then medical school matriculation.Many of the students were particularly interested in what gross anatomy was like. When one youngster finally asked the question, a murmur rippled through the crowd. We of course gave them the basic spiel about using human bodies, learning the anatomy, and working with partners or as part of a team. But to satisfy their real question—was the course truly gross?—we gave a few more details about the odor in the rooms and what it was like to explore and handle all the organs.We also discussed other topics such as how we chose our undergraduate colleges and medical schools. For many of us, we wanted to be in particular cities (New Orleans, Atlanta); for others, there were practicalities such as the course offerings or cost; and for some, there were more profound reasons such as where the school's athletic teams ranked and availability of student tickets!We addressed the importance of balancing work and studies with fun. For my part, I was pretty straight-laced until college when I took time to be in the marching band, play intramural sports, and attend my fair share of parties. Dr. Gaymon-Doomes joined a sorority and met her husband in college.In explaining why we chose psychiatry as our specialty, the responses included working with at-risk populations and being able to have a diversity of experiences. The two child and adolescent fellows were able to share our experiences as physicians and psychiatrists. We discussed working in settings such as hospitals, clinics, and schools; seeing patients with various diagnoses, such as depression or ADHD; and getting to work with parents. Dr. Gaymon-Doomes discussed the use of telepsychiatry to reach rural populations.These young students were truly an enthusiastic and inquisitive group. One young man who sat in front asked the first question. Even though we made it clear we wanted to hear from everyone, he kept his hand raised almost the entire hour! He and some of the other students stayed and asked us questions after the formal program was over. They even asked to take a group picture with us. Who knew that a psychiatrist could feel like a rock star from time to time?Though this is generally a program provided at national meetings, resident and medical student APA members should consider implementing the“ Doctors Back to School” program in conjunction with local- and state-level meetings and conferences. It is easy to do and takes very little preparation other than setting up the visit. Ms. King and her office will help seek out the schools and set up visits. There is also a tool kit available at the Web site below.In short, it is fun and serves to inspire youth to believe that they too can become a physician and even a psychiatrist.More information about the “Doctors Back to School Program” is posted at<www.ama-assn.org/ama/pub/physician-resources/public-health/eliminating-health-disparities/doctors-back-school/doctors-back-school-kit.shtml>.▪Jacqueline Smith, M.D., is a PGY-5 child and adolescent psychiatry fellow at the University of North Carolina. ISSUES NewArchived

Pediatric Advocacy: Yesterday, Today, and Tomorrow

The reason that advocacy is so much embedded in the work of pediatrics is that children have little political voice of their own and rely on the proxy voice of others including pediatricians to speak out on their behalf. This voice is so important because of the overrepresentation of our children among the poor and underserved. It should be stated that the “shared voice” of pediatrics has been heard throughout our history—speaking on behalf of all children. As we proceed into the next millennium, it is proper to reflect on pediatrics’ past, our present, and future so that, as a profession, advocacy will continue to play a key role. At the turn of the century, there were about a half dozen practitioners devoted to the care of children. Today, the membership of the American Academy of Pediatrics (AAP) is >57 000 physicians. The role of advocacy in pediatrics dates back to the end of the 19th century when an epiphany within medicine crystallized the necessity that children deserved a cadre of professionals dedicated to their care. In addition, it was evident even then that an emphasis on advocacy and the protection of children would comprise a core aspect of the profession. In the United States, Dr Abraham Jacobi is considered the “Father of Pediatrics.” In 1859, he published his seminal text titled: Midwifery and Diseases of Women and Children. In addition, he was the first professor of pediatrics in America at New York Medical College, and in 1860 established the first free pediatric clinic in America.1 Dr Jacobi was one of the pediatric pioneers who understood the link between the environmental milieu children found themselves and the incidence of disease. His efforts characterized the beneficence of our profession. The emergence of the Industrial Revolution in the 19th century led … Reprint requests to (C.N.O.) Department of Pediatrics University of Minnesota Medical School Maternal and Child Health Division of Epidemiology School of Public Health West Bank Office Building, 1300 Second St South—Ste 300, Minneapolis, MN 55455. E-mail: oberg001{at}umn.edu

Issues in General Residency Training Pertinent to Recruitment of Child Psychiatrists: Can We Identify the Problems?

General psychiatry residency processes can influence the recruitment of child and adolescent psychiatry fellows at many levels through a variety of subtle events. General residencies differ in the extent to which they welcome and accommodate students with early interests in child and adolescent psychiatry, provide child and adolescent rotations during the general program that are likely to encourage rather than discourage additional interest in child and adolescent psychiatry, respect and enhance the professional status of child and adolescent psychiatry relative to general psychiatry, and facilitate or impede the transition from general residency to child and adolescent fellowships. Systematic study of these issues may provide directions for fruitful interventions at the level of the general residency likely to increase recruitment into child and adolescent psychiatry.

Some characteristics of the male membership of the society of adolescent medicine

During the process of obtaining information concerning the use of chaperones during the pelvic examination of adolescent females, background and practice data on the male membership of the Society for Adolescent Medicine (SAM) were determined (1). All male physician members of SAM were identified from the 1982 Society for Adolescent Medicine directory. As part of the questionnaire, the age, type of practice, percentage of practice devoted to adolescent medicine, and whether an adolescent fellowship had been completed were determined. Fivehundred seven male SAM members were mailed questionnaires. Two-hundred ninety-two questionnaires were returned (57.6%). The mean age of the members was 45.7 years. The mean percentage of practice devoted to adolescent medicine was 51.2%. The most common type of practice was private (51.7%), followed by academic (21.6%) and military (6.8%).