Child & Adolescent Psychiatry Program Description
For those who have decided to pursue child and adolescent psychiatry training, the University of Michigan program is an outstanding choice. The program here is demanding but educationally geared.
Rotations and Clinical Activity
The Child and Adolescent Psychiatry fellowship program at The University of Michigan, is a fully accredited two year program that accepts six fellows each year. During the two years of training, child psychiatry fellows spend six months covering the inpatient unit and consultation services and 18 months in our outpatient clinics located at the Depression Center and Ambulatory Psychiatry facility, in the Rachel Upjohn Building.
Inpatient and Consultation Service:
Fellows complete a six-month rotation during their first year of child and adolescent psychiatry training. The Child and Adolescent Psychiatry inpatient unit is a 14 bed unit located at Mott Children’s Hospital, a part of the University of Michigan Health System. There are typically three first year child and adolescent psychiatry fellows (CF-1’s) on service at any given time along with rotating adult psychiatry residents and medical students. Under supervision of two faculty members, child psychiatry fellows provide comprehensive and highly specialized treatments to children and adolescents with complex and severe mental health challenges. As a part of the multi-disciplinary team, fellows work in a supportive and nurturing environment and learn the interface between child psychiatry, psychology, social work, nursing, occupational, recreational therapy and nutritionist services. For two months of this rotation, one fellow is dedicated to the consultation service that provides clinical services and teaching at Mott Children’s Hospital. Consultations are provided to all pediatrics inpatient services, including general pediatric inpatient services, pediatric intensive care unit, neonatal intensive care unit, pediatric physical medicine and rehabilitation, pediatric neurology, and other pediatric subspecialty services. Throughout the fellowship training, including the inpatient rotation, child psychiatry fellows are provided with protected time to attend the core lecture series, journal clubs and collaborative case conferences. They also meet with the program director on a monthly basis during the Residency Education Meeting.
After the completion of the inpatient and consultation service rotation, fellows move to outpatient clinics that are located at the Depression Center and Ambulatory Psychiatry facility, in the Rachel Upjohn Building. This stunning building, opened in October 2006, is the first among the proposed National Network of Depression Centers and combines clinical expertise, cutting edge research, and innovative teaching for a new generation of leaders in child and adolescent psychiatry.
During the first year (six-month outpatient block) and the twelve months of the second year, a full-time clinical commitment consists of approximately 24 hours of direct patient contact per week. Child psychiatry outpatient services are divided into multiple specialty clinics where child psychiatry fellows rotate through these clinics and spend one half day per week for a specific set of months. These clinics include the following:
Youth and Young Adult Mood and Anxiety Clinic (YYAM):
YYAM is a six month, one-half day per week outpatient clinic, occurring during the second year of training. Fellows evaluate and treat patients with mood and anxiety disorders.ADHD Clinic:
Fellows spend one-half day per week for six months in the ADHD clinic. The main function of the clinic is to provide diagnostic services to children and adolescents, between the ages of four and eighteen years, with suspected attention deficit hyperactivity disorder (ADHD). Patients receive a comprehensive physical, neuropsychological and psychiatric assessment in this clinic.General Clinic:
In this clinic, fellows evaluate and treat patients with a broad range of psychiatric disorders.Outpatient Consults:
Collaboration with community physicians and medical facilities is one of the main focuses of the training program. In this clinic, community physicians refer patients with specific questions and seek help regarding multiple psychiatric issues. After a thorough psychiatric evaluation, child psychiatry fellows make appropriate recommendations to the community physicians.Psychosocial Therapy/CBT Clinic:
During this clinic, fellows treat two to four patients with direct supervision by psychologists in order to learn the techniques of cognitive behavioral and psychosocial therapy.Family Therapy/IPT Clinic:
This clinic is established on the same model as the psychosocial therapy/CBT clinic. Fellows treat several patients under live supervision to learn interpersonal and family therapy. Fellows usually spend one-half day per week for six months in these two therapy clinics.
During the two years of clinical training, some community psychiatry rotations are also integrated into the training schedule. These rotations have consistently been among the favorites of the fellowship class. These rotations include:
Saint Thomas School:
During the first year of training, child psychiatry fellows spend four half days for one month at St. Thomas school where they learn the patterns of normal development and understand the school policies and procedures. They also observe the children in the classroom, resource rooms and during free time to get a better understanding of the trajectories of different developmental patterns.Community Mental Health Centers (Corner Clinic, Ypsilanti Pediatrics and Huron Valley Child Guidance Clinic):
Child psychiatry fellows spend one-half day per week for six months to provide integrated services to low income families in one of the above mentioned community mental health clinics.Washtenaw County Trial Court, Juvenile Division (JCWC):
Residents visit the Washtenaw Juvenile Court and detention center in the second year of training. The rotation is designed to augment the core lectures on forensic/legal topics provided primarily by staff from the forensic center. During this rotation child psychiatry fellows observe the juvenile court proceedings, attend an assessment of court involved youth and accompanying a case worker in the Intensive Probation Program on community visits.Center for Forensic Psychiatry:
Fellows visit the Center for Forensic Psychiatry in the second year of training. Fellows participate in in-depth supervised case reviews, directed and self-initiated reading and literature searches, case evaluations, treatment team meetings, trial preparations and testimony where possible with an in-depth review of at least one forensic report.University of Michigan Addiction Treatment Services (UMATS):
Child psychiatry fellows spend one afternoon per week for one month at the University of Michigan Addiction Treatment Services to provides a broad continuum of diagnostic and treatment substance use services for patients thirteen years and older. Learning objectives for the UMATS rotation are met through a variety of activities, including didactics, varied clinical experiences, assigned readings, learning videos, and extensive patient discussion regarding diagnosis and treatment.
Pediatric Neurology:
Fellows rotate through the outpatient pediatric neurology service one-half day per week for two months, generally within the first year of training. Extensive participant and observational learning opportunities occur during direct patient care with the attending neurologist.Psychiatry Emergency Service (PES):
Fellows take two PES calls per month during the first year of training and one call per month during the second year. Calls are from 5 – 9 p.m. and fellows provide clinical services to children and adolescents in need of acute psychiatric care.
All the above rotations are seamlessly integrated with each other and provide a venue for child psychiatry fellows to learn the fundamentals of child and adolescent psychiatry.