During the second year of training, Child Residents consolidate their experience, further define their interests while broadening and deepening their ability to treat child/adolescent patients. This curriculum includes core didactics in child development, advanced psychopharmacology, journal club and an advanced seminar under intense faculty supervision, which culminates in a Senior Paper.

The curriculum of the second year supports the clinical experience of the year in inpatient child/adolescent psychiatry, pediatric neurology, school consultation, forensic child psychiatry and continued outpatient child/adolescent psychiatry.

During the second year, fellows rotate onto the inpatient services at Bronx Children's Psychiatric Center. While there, they spend three months on a children's service, three months on an adolescent service and three months on a young adult service, treating older adolescents between the ages of 16-18.

These rotations are structured so that approximately 2/3 of their clinical time is spent on their inpatient rotation and the rest of their time is spent in the outpatient clinic treating their outpatients who have continued in treatment from the first year.

There is a three- month consultation rotation during which time fellows rotate off the inpatient units and onto pediatric neurology at the Children's Hospital at Montefiore (CHAM), school consultation at Bronx High School of Science and the Therapeutic Nursery at the JCC on the Palisades where they work with high-functioning autistic preschoolers and their families.

During these three months fellows continue to see their outpatients in the afternoon in the child clinic. Continuity of care becomes a hands-on experience in our training program to the benefit of trainee and patient alike. In addition, the fellow is able to begin to envisage the life of a child psychiatrist who combines work in the consultative or inpatient arena with that of private practice.

The goals of training in the second year fit with the clinical service and the structure of the curriculum. Bronx Children's provides an ideal clinical setting to learn to treat complex patients with a combination of milieu, individual and family psychotherapy as well as state-of-the-art psychopharmacology. Bronx Children's is nationally known for its work with treatment-resistant patients and its pioneering efforts with Clozaril treatment in youth as well as monitoring and treatment of metabolic syndrome.

A site that combines excellent clinical and supervisory experience for psychiatric and allied mental health trainees, BCPC also offers opportunities for supervised research with its varied patient population.

The second year curriculum complements the clinical work. Fellows study both child and adolescent development, at a time in their training when they are better equipped to absorb the more theoretical material, after mastering treatment of children and adolescents together with basic psychopathology and psychopharmacology.

Fellows have advanced seminars in outpatient continuous case and inpatient continuous case presentations, developmental origins of personality disorders and family therapy. Second year fellows join their colleagues in the continuation of family therapy and the two- year inpatient conference where they present cases, which are then reviewed and interviewed by an attending.

The advanced psychopharmacology series in the second year is divided into two segments: the first semester is devoted to inpatient psychopharmacology, in particular to treatment resistant patients and complements the inpatient work during the year. The second semester covers outpatient psychopharmacology practice and is dedicated to helping the fellows transition to the world of private practice, particularly in the arena of psychopharmacology practice.

A cornerstone of the second year is the preparation of a senior paper. Fellows participate in a class given by the Directors of Training, which supports the research and writing of this paper. In addition, each fellow chooses a mentor who meets with the fellow as the paper is being researched and written. As a culmination of the second year, fellows present their papers to the entire faculty and fellowship at a luncheon in their honor.

Supervision in the second year continues with three outpatient supervisors, supervision by service attendings during each rotation and on-site supervision by faculty at each of the consultative sites. In addition to continued mentorship and clinical competence, the supervisory faculty is able to help the second year fellow transition from their trainee role to that of their new role as child psychiatrist. The Co-Director of Training meets weekly to mentor the group of second year fellows facilitating communication, ensuring the individual needs of fellows are met and the transition to the end of training is a smooth one. Faculty also assist in this process, including teaching classes about jobs, private practice, research and mentoring fellows as they move towards graduation.

Clinical rotations are structured with fellows' interests in mind, and our trainees are exposed to a variety of clinical populations at both a state and a voluntary hospital. The descriptions below summarize the standard program year by year designed to facilitate the professional growth of our trainees.