Children's Evaluation & Rehabilitation Center

Program Description 2014

Fellowship Training Program in Developmental-Behavioral Pediatrics

A Collaboration of the
Children's Evaluation and Rehabilitation Center (CERC)
and
The Rose F. Kennedy Center
University Center for Excellence in Developmental Disability
Education, Research and Service
Albert Einstein College of Medicine
and
The Children’s Hospital at Montefiore
Maris Rosenberg,M.D., Director
Blanche Benson,M.D., Associate Director
Ruth E.K. Stein,M.D., Research Director
Program Description

First, Second and Third Year Fellows receive benefits and are salaried at the same level as PL4, PL5 and PL6 House Officers at Montefiore Medical Center. Specific policies such as maternity and sick leave are determined by the sponsoring organization, Albert Einstein College of Medicine.
Applications will be processed through ERAS in accordance with the NRMP subspecialty fall match for Developmental-Behavioral Pediatrics. Information is available on the NRMP website: http:/www.nrmp.org/fellow/match.
For additional information, contact Dr. Maris Rosenberg, Program Director, at 718-839-7069 or maris.rosenberg@einstein.yu.edu.

 
 
 

Developmental-Behavioral Pediactrics Fellowship Program

A three-year ACGME-accredited fellowship training program for pediatricians in Developmental-Behavioral Pediatrics (DBP) is offered by the Department of Pediatrics, Albert Einstein College of Medicine/Montefiore Medical Center. The training takes place at two primary sites: The Children's Evaluation and Rehabilitation Center, and the Children's Hospital at Montefiore, both located in the Bronx, New York. The program represents the unification of two well-established fellowship programs at Albert Einstein College of Medicine (AECOM). Developmental Pediatrics and the Care of the Child with Disabilities, formerly directed by Herbert J. Cohen, M.D., has been offered for over 43 years. Behavioral Pediatrics, formerly directed by Ruth E. K. Stein, M.D. has been in existence for over 21 years. The current program has been designed in accordance with eligibility requirements set forth by the American Board of Pediatrics for subspecialty certification in DBP. Graduates of both of the original programs have had outstanding records of achievement in the developmental disability, child development and behavioral pediatrics fields.

The Department of Pediatrics has over 160 full-time faculty, 50 fellows in 14 fellowships, and 76 residents. It is responsible for about 5,500 pediatric admissions, 65,000 primary care visits, and almost 50,000 emergency departments and 75,000 specialty visits annually. The department has a long history of service and research in primary care and D-B pediatrics. It continues to have fellowship programs in a range of related disciplines including emergency pediatrics, adolescent medicine, as well as the traditional sub-specialties. The department has a number of prominent faculty in D-B pediatrics. A listing of faculty and staff and their major areas of interest are provided in Appendix C.

The Children’s Evaluation and Rehabilitation Center (CERC) is a N.Y. State licensed Article 28 freestanding clinic and center, operated by the Albert Einstein College of Medicine. It is certified by both the New York State Department of Health and the Office of Mental Retardation and Developmental Disabilities (OMRDD). CERC has been primarily located in the Rose F. Kennedy Center (RFKC) for Research in Mental Retardation and Human Development since it opened on June 1, 1970 and will be relocating to the newly-renovated Van Etten building on the Einstein campus. Also located in the Van Etten Building is the Cognitive Neruophysiology laboratory directed by CERC. The Kennedy Center is a federally NIH-funded Developmental Disability Research Center.

In addition to the activities in the RFKC, CERC operates clinical sites at the Fisher Landau Center for the Treatment of Learning Disabilities, housed some 500 yards from RFKC and the Early Childhood Center, 300 yards from the RFKC. It has affiliations with close to 40 community agencies and 15 colleges and universities who use CERC as a training site. See attached description of CERC – Appendix A.

The Children’s Hospital at Montefiore (CHAM) is a state of the art 108-bed facility opened in 2001 that houses inpatient/outpatient facilities of the Department of Pediatrics and related services. Most of the clinical activities involving developmental and behavioral pediatrics are located on the “Horizon Floor”, which is also home to Otolaryngology, Genetics/Craniofacial, and LINCS (chronic illness program). CHAM’s inpatient services are organized by age: Infant’s, Children’s and Adolescent Services. There is also a 14-bed Pediatric Intensive Care Unit. Developmental-behavioral residents are available to provide consultations to all of these inpatient services as are members of the Child Psychiatry Department who provide consultation-liaison services. A detailed description of services at CHAM and related programs offered in the Department of Pediatrics and Medical School is available in Appendix A.

 
 
 

Goals of Developmental-Behavioral Subspecialty Training

The program goals can be summarized as follows:

a) To offer a comprehensive interdisciplinary (ID) training experience to all developmental-behavioral subspecialty residents in relevant developmental and behavioral disorders.

b) To prepare developmental-behavioral pediatricians with excellent skills as clinicians, researchers, teachers, and advocates, and to eventually be leaders in the field.

c) To provide an understanding of basic science, research methodology and the application of clinical practice guidelines.

 
 
 

General Outline of Training

First-year subspecialty residents (fellows) are simultaneously assigned to two interdisciplinary (ID) teams (Rehabilitation and one of four [Infant-Toddler, Preschool, School Age or Adolescent] where they perform evaluations, participate in weekly team meetings and function as case managers. They begin longitudinal experiences in behavioral management, follow-up of children with neuromuscular and genetic disorders, and psychopharmacological and anticonvulsant management (medication management and seizure clinics). Involvement with research begins with course work in research methodology and bi-weekly meetings with research mentor(s). Residents participate in selected neuroscience lectures and visit molecular genetics laboratories. Fellows attend didactic sessions (both required and optional) and function as consultants in one of several community-based sites (e.g., St. Joseph’s School for the Deaf, CERC’s Early Childhood Center).

Second-year fellows continue in the above activities with decreased time allotted to the Rehabilitation Team and are given the opportunity to choose from among “selective options” offered (see Appendix B). They begin longitudinal experiences with children affected by chronic illness, and rotate through school-based health clinics that offer mental health services. Research-related time increases, didactic participation and consultation assignments continue. Second year residents begin to teach pediatric and family medicine residents during their block rotation n D-BP.

Third-year fellows may reduce their clinical activity to allow for supervisory/teaching roles, continue selective experiences and allot a significant proportion of time to completion of research projects.

Fellows are supervised with an individual in-person preceptorial review of both the history and examination findings on every new evaluation that they perform. They have an attending Developmental-Behavioral Pediatrician on site for consultation for all follow-up visits. In the case of certain specialty clinics at which the resident may spend time, they may be supervised, for example, by a pediatric rehabilitation attending in the motor examination of a child with a physical disability, by a pediatric neurology attending in the seizure management clinic, or by a child psychiatrist in the psychopharmacologic component of the medication management program.

Schematic representations of the three years of training and sample monthly schedules are included in Appendix B.

 
 
 

Research

Our research program fulfills the American Board of Pediatrics’ scholarly activity requirements for subspecialty training. It is comprised of four main components:
1. Individual mentorship
2. Developmental-Behavioral Pediatrics Research Seminars
3. Department of Pediatrics Fellowship Course
4. Formal coursework towards advanced degrees
 

Beginning in the first year of training, the Director of Research Training meets individually with each fellow on a regular basis. The frequency of these meetings varies throughout the course of their projects, but averages about once every two weeks. The purpose of these individual meetings is to foster the development of the fellow’s own research project in an area of the individual’s own interest. These sessions are directed towards seeing the projects through the design and implementation phases to the analyses, preparation of material for presentation at scientific meetings, and the publication of the data in peer reviewed journals as is required by the American Board of Pediatrics for subspecialty certification.

In addition there is a bi-weekly research seminar, in which fellows are active participants that involves active discussion and learning about the fellows’ project and other research issues. The Department of Pediatrics also hosts a monthly seminar for fellows in all divisions that covers research methodology and other topics that are important in preparing for an academic career. All of the above sessions can be supplemented by formal course work in research design and biostatistics. Some trainees have pursued master’s degrees in Public Health (offered at the Columbia University Mailman School or at Einstein) or in clinical research at Einstein’s Clinical Research Training Program. Fellows are guaranteed the time and scheduling flexibility needed to pursue advanced coursework.

Research opportunities are available in many venues from wet bench to clinical to health services. In addition to the vast array of laboratories conducting research related to behavioral and developmental topics, the resources include the Preventive Intervention Research Center for Child Health. This center, housed in the Department of Pediatrics, has a long history of conducting behavioral research on children with chronic conditions
and adolescent risk behaviors. It has an interdisciplinary faculty that includes pediatrics, psychology and sociology expertise and its faculty members are actively involved in teaching research to the subspecialty fellows.

 
 
 

Didactics

D-B residents attend a variety of didactic sessions offered at CERC, CHAM and Einstein. Appendix B offers a partial listing; past years’ curricula can be furnished on request.

 
 
 

Salary/Fringe Benefits

First, Second and Third Year Fellows receive benefits and are salaried at the same level as PL4, PL5 and PL6 House Officers at Montefiore Medical Center. Specific policies such as maternity and sick leave are determined by the sponsoring organization, Albert Einstein College of Medicine.

Applications will be processed through ERAS in accordance with the NRMP subspecialty fall match for Developmental-Behavioral Pediatrics. Information is available on the NRMP website: http:/www.nrmp.org/fellow/match.

For additional information, contact Dr. Maris Rosenberg, Program Director, at 718-839-7069 or maris.rosenberg@einstein.yu.edu.

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