Located exclusively at Montefiore Medical Center, clinical work during the first year focuses on the diagnosis and treatment of child and adolescent outpatients, pediatric patients requiring psychiatric consultation/liaison services as well as the management of psychiatric emergencies in the child and adolescent age group. Evaluations and multi-modal treatments are offered to patients and families under the direct supervision of senior faculty who assist the fellows in acquiring comprehensive evaluation and treatment skills.
Spending the majority of their time in the Outpatient Division, fellows evaluate and treat children and adolescents. The Intake Clinic in the outpatient department conducts supervised intakes. Fellows see children, adolescents and families in different modalities of treatment including individual psychotherapy, pharmacotherapy, group psychotherapy and family therapy. Training in intensive Dialectical Behavior Therapy (DBT) in the Adolescent Depression and Suicide Program (ADSP) provides Fellows with an opportunity to treat suicidal and depressed patients under supervision.
Fellows also work on the Consultation-Liaison Service providing consultation to the Department of Pediatrics at the Children's Hospital at Montefiore. First year fellows rotate for two months with the child/adolescent psychiatric emergency team at Montefiore where they evaluate and treat children and adolescents in crisis. Fellows also receive training with the Adolescent Suicide and Depression Program utilizing Dialectical Behavior Therapy.
The two-month rotation in the Psychiatric Observation Suite provides hands-on exposure to crisis evaluation and intervention with acutely ill psychiatric child/adolescent patients. This is a training rotation with on-site supervision by a member of the Child/Adolescent Psychiatry faculty.
The year-long experience on the Behavioral Consultation Service at the Childrens’ Hospital at Montefiore (BCT-CHAM) is a unique opportunity to both assess and do short-term interventions with the pediatric population at Montefiore. Consultations are supervised by the Attending staff on the service and cases are presented at the weekly Ombudsmans’ Rounds. A weekly literature seminar on topics in pediatric consultation liaison is also attended by all members of the BCT-CHAM.
Service meetings and rounds are vital to the communication of the outpatient services and the development of collegial relationships with other disciplines. These are held at the clinic and with the ADSP team. First year fellows have the opportunity to teach and mentor adult PGY2 residents as they rotate on child psychiatry, frequently forming strong bonds with their junior colleagues and beginning to develop their clinical teaching skills.
The core curriculum of the first year is designed to meet the training goals of competence in the clinical assessment of children, adolescents and their families, basic psychopharmacology of children and adolescents, multiple treatment modalities including individual, group, family psychotherapy and Dialectical Behavior Therapy, and knowledge about pediatric consultation-liaison and emergency psychiatry.
First year fellows attend classes two days per week and meet weekly with three assigned outpatient supervisors in addition to direct supervision on their service rotations.
The curriculum for the first year is comprised of introductory classes in:
A broad topics course is also included covering selected topics such as child abuse, adoption, genetics, ethics, neuroscience, play therapy and cultural influences on child psychiatry.
In addition to the core curriculum, a monthly case conference at the outpatient clinic gives fellows the opportunity to present particularly challenging outpatients to senior faculty. First year fellows meet weekly with a mentor who plays a vital role in communication between the fellows and the faculty as well as mentoring the group's professional development.
Fellows have three outpatient psychotherapy and psychopharmacology supervisors, an administrative supervisor and participate in group CBT supervision. In addition to these supervisors, they are supervised in their work in consultation/liaison, emergency child psychiatry and DBT by the service attendings on site. This supervision is a crucial part of the learning that takes place in the first year and complements the clinical and academic program.