Clinical and Scholarly Effort

Clinical Work

Year 1 Clinical Rotations

• Inpatient Services, URMC [4 months]—fellows evaluate and direct the treatment of children and adolescents, ranging in age from 5 to 18, who require acute, intensive intervention.
• Consultation Services [4 months]—fellows are part of an active, multidisciplinary consultation program providing service to the Department of Pediatrics.
• Outpatient Clinic, URMC [Duration]—fellows develop the skills of the primary provider of mental health services. The clinic is multidisciplinary, and clinical care is provided by social workers, nurse clinicians and clinical psychologists in addition to resident and faculty child psychiatrists.
• Community Consultation and Subspecialties [10 weeks]—fellows complete experiences in the following settings: Rochester City School District, Monroe County Family Court, Golisano Children's Hospital Pediatric Sleep Medicine Clinic, Child Neurology Faculty Practice Clinic and Movement Disorders Clinic, Andrew J. Kirch Developmental Services Clinic, Rochester Mobile Crisis Team, Child and Adolescent Psychiatry for Primary Care
• Elective [2 weeks]—fellows focus on a clinical experience of interest based on their individual educational goals.

Year 2 Clinical Rotations

• Chief Resident/Administrative Rotation [Duration]—fellows are mentored by the Program Director regarding clinical and educational administrative practices and issues; participate in department administrative, incident review and quality improvement committees; and complete a discrete quality improvement project. Fellows also participate in didactic instruction to General Psychiatry and/or Pediatrics Residents and have other educational opportunities based on individual educational goals.
• Adolescent Partial Hospital Service [Duration]—fellows work closely with the attending child and adolescent psychiatrist and the multidisciplinary team in this intensive treatment program, focusing on the more discrete role an attending psychiatrist typically plays in such teams (as opposed to the primary clinician/therapist role which is the focus in the first year rotations), including diagnostic evaluation, treatment plan formulation, and team member collaboration to achieve treatment goals.
• Residential Treatment and Substance Use Disorders [6 months, 20 hours/week]—Villa of Hope operates a residential treatment center for youth from a variety of cultural and socio-economic backgrounds. Fellows work with child psychiatry faculty in the care of adolescents who require long term residential treatment, or suffer with substance use disorders. The emphasis of this rotation is on the development of skills as a consultant rather than as a primary caregiver for these intensely troubled youth.
• Outpatient Clinic [Duration]—fellows continue to follow selected cases in the Child and Adolescent Outpatient Clinic at URMC. In addition, they serve as psychopharmacology consultants as a part of that clinic's psychopharmacology service.

Seminars

• Crash Course in Child and Adolescent Psychiatry [Years 1 & 2, Week 1]—brief review of major topics in Child & Adolescent Psychiatry with a particular focus on working with youth and providing content relevant to new fellows.
• Development Seminar [Year 1, 8 weeks]—intensive course, approximately 6 hours per week, focusing on major topics in Development.
• Psychotherapy Seminar [Year 1, Duration]—led by Child Psychiatry and Psychology Faculty and attended by trainees from both, focused on psychotherapy treatment techniques and evidence based psychotherapies for children and adolescents.
• Psychopathology and Treatment Seminar [Years 1 & 2, Duration]—overview of the most common psychopathologies affecting children and adolescents and approaches to treatment, including psychopharmacology.
• Classic Readings and Case Formulation Seminar [Years 1 & 2, Duration]—series focused on leaders in the field and developing comprehensive biopsychosocial formulations for cases.

Independent Project

An important part of the second year curriculum is an independent project. For six months, one day of the schedule is allotted to this activity, which can take a number of forms. Some fellows choose to design and carry out a limited clinical research project in collaboration with research faculty. Others elect to examine a clinical or theoretical question in depth through literature review. Part of this time can also be spent on elective clinical experiences depending on the educational goals of the individual trainee. Faculty is readily available to advise and assist in this process. All fellows present their project in poster form at the annual department Trainee Poster Day.

Training Context

In addition to the fellowship in Child Psychiatry, the Department of Psychiatry sponsors a nationally recognized training program in Clinical Child Psychology. Four child psychology interns and two child psychology postdoctoral fellows participate in this program. While child psychiatry faculty provide the majority of the teaching and supervision for the child psychiatry fellows, child psychology faculty enrich and inform the program. The clinical activities at URMC are all interdisciplinary in nature, and the interaction between the two advanced training programs is lively and constructive.

Medical student education is a central part of the mission of the Department of Psychiatry, and there are many opportunities for child psychiatry fellows to teach and interact with medical students in both pre-clinical and clinical situations.