Learning the basic skills of clinical assessment and treatment of children, adolescents and their families in an outpatient setting is central to the first year fellow experience. With on-site direct supervision, fellows train in establishing psychiatric diagnoses, formulate and implement treatment plans for the children, adolescents and families from the surrounding Bronx neighborhoods.
Training takes place in the Child Outpatient Department at Montefiore, a site of training for child/adolescent fellows, psychology interns and social work students.
A beautiful new out patient site opened in May of 2009. This new site will continue to provide excellent care to the community and teaching for the adult and child/adolescent psychiatric and affiliated programs of Einstein/Montefiore.
A crucial component of outpatient training in the Fellowship in Child/Adolescent Psychiatry is the continuation of the treatment of outpatient cases for the two years of the fellowship. This provides the trainee with experience in longer-term patient care while providing an important service to the community we serve. These cases are highly supervised for the two years by senior faculty with a broad range of therapeutic experience and expertise.
The BCT-CHAM comprises a significant training mandate of the first year of the Fellowship in Child/Adolescent Psychiatry at Einstein/Montefiore. A wide and varied spectrum of diagnoses among the children and adolescents admitted to the CHAM allows for a broad experience in consultation with the pediatric and ancillary staff. On-site supervision and teaching allows the clinical experiences to relate to the clinical teaching of the first year.
A two-month rotation through the Psychiatric Observation Suite at Montefiore allows the first-year fellow to have first-hand experience with the assessment, treatment, rapid return to the community and/or referral for further inpatient services of a population of children, adolescents and families in crisis. This experience in the emergency department, together with the on-site supervision and learning opportunities working with a varied and challenging patient population expands the professional growth of the first-year fellow.
The Adolescent Depression and Suicide Program provides training and didactics in Dialectical Behavior Therapy. Intensive academic training in Dialectical Behavior Therapy is taught during the Summer Orientation Program for the first year fellows. This weekly full-day program combines clinical and didactic materials taught in a seminar format by nationally renowned faculty. During the first year, fellows may elect to assess and treat a suicidal or depressed adolescent patient with DBT in a highly supervised training format.
Through core didactics in the first year, child/adolescent fellows become familiar with the key clinical literature pertinent to clinical psychiatric assessment, diagnosis and treatment of children, adolescents and families in outpatient and pediatric settings. This foundation laid in the first year will provide the structure for the second year advanced seminars.
New York City Children’s Center, Bronx Campus is the primary site for the second year of the Fellowship in Child/Adolescent Psychiatry. Fellows rotate on both a child and an adolescent inpatient service at NYCCC-Bronx staffed by senior faculty in Child/Adolescent Psychiatry. Children and adolescents from the underserved communities of the Bronx constitute the patient population that NYCCC serves providing unparalleled opportunity for training while serving this richly complex group.
Conducting formal psychiatric assessments, together with formulating and implementing psychopharmacological and psychological treatment plans with severely emotionally and developmentally disturbed youngsters form a major mandate of second year training in child/adolescent psychiatry. Fellows learn how to apply pharmacological, milieu, family, individual and systems-based treatments to caring for patients and families in a setting whose average length of stay is considerably longer than most comparable facilities. This provides optimal opportunities for training in continuity of care and responsiveness to the larger systems of health care. For the patients that NYCCC-Bronx serves, this inpatient hospitalization may be the first opportunity to have been appropriately diagnosed and treated by nationally recognized authorities in pediatric bipolar disorder and childhood schizophrenia.
During a three-month Consultation Rotation, fellows are exposed to hospital and community settings where children and adolescents are served. During this rotation, fellows work consultatively alongside other physicians and professionals in other health settings, schools and treatment settings.
Fellows rotate at the Bronx High School of Science, where Einstein/Montefiore fellows have a longstanding commitment to consulting with the guidance and teaching personnel so as to best provide short-term psychiatric consultation and treatment for the population of gifted students that attend the high school. Fellows also rotate at an elementary school in the Bronx, where a school-health team incorporates mental health treatment into school-based treatment for children. Fellows participate in classroom evaluations, treatment plan meetings and implementation of services on-site at the elementary school.
In addition, fellows rotate at the Bronx High School of Science, where Einstein/Montefiore fellows have a longstanding commitment to consulting with the guidance and teaching personnel so as to best provide short-term psychiatric consultation and treatment for the population of gifted students that attend the high school.
Fellows also rotate for three months at the Therapeutic Nursery at the JCC on the Palisades where they learn to work with high-functioning children on the autistic spectrum in a developmentally and language-based therapeutic nursery program. During the rotation, fellows are exposed to a unique treatment strategy that includes daily participation by parents of the autistic children, a program that is the only one of its kind in the tri-state area. Fellows also rotate at the Kennedy Center where they observe ADOS exams, a state-of-the-art assessment of autistic children. The Kennedy Center is the cornerstone of the Einstein/Montefiore Autism Center of Excellence.
These consultative services, combined with BCT-CHAM in the first year and the Family Court rotation, which occurs during the Second Year Summer Orientation Program, provides comprehensive exposure for our fellows in the consultative arena in Child/Adolescent Psychiatry. Upon graduation, the fellow is prepared to enter into a health, school or court setting as a fully trained and competent professional able to provide expert consultative opinions and treatment based on state-of-the-art training.