First Year Program: Clinical
The first year launches training in diagnostic evaluations, long-term psychotherapy and psychopharmacological management in our outpatient Child Psychiatry Continuity Clinic. 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.
During the first year, fellows will concentrate on the treatment of children, adolescents and their families in the following areas:
- Psychopathology
- Psychopharmacology
- Psychosomatic medicine/Consult-Liaison psychiatry
- Emergency Psychiatry
- Multiple psychotherapeutic modalities including psychodynamic, cognitive behavioral, interpersonal, play, supportive, family, group and dialectical behavioral therapies.
The first year of fellowship focuses on the following areas of training:
- Outpatient Continuity Clinic
- Consultation/Liaison Service
- Psychiatric Emergency Service
- Adolescent Depression and Suicide Program (ADSP)
Service meetings and rounds—held at the clinic and with the ADSP team—ensure fluid communication in the outpatient services, as well as interdisciplinary collaboration. First year fellows have the opportunity to teach and mentor PGY2 adult psychiatry residents, as they rotate on child psychiatry. This allows them to form strong bonds with their junior colleagues and begin to develop their clinical teaching skills.
One first year fellow serves as Chief Fellow for the year, coordinating activities of both child psychiatry fellows and adult psychiatry residents rotating through Child/Adolescent Psychiatry, while acting as liaison to the faculty.
We also offer two first year fellows a one-month elective rotation in child global mental health in Uganda or Colombia.
First Year Training Facilities and Rotations
Outpatient Clinic
First year fellows spend the majority of their time in the Outpatient Division, where the Intake Clinic conducts supervised intakes. Fellows evaluate children, adolescents and families, and provide 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 supervised fellows with an opportunity to treat suicidal and depressed patients.
A crucial component of our outpatient training is the fact that fellows continue to treat their own group of patients for the full two years of their fellowship. This offers them experience in longer-term patient care, while providing an important service to the community we serve. Senior faculty with a broad range of therapeutic experiences and expertise closely supervise these cases.
Consultation/Liaison Service
For three months, first year fellows also work on the Consultation-Liaison Service, consulting with the Department of Pediatrics at the Children's Hospital at Montefiore (CHAM). This rotation provides fellows with a unique opportunity to both assess and do short-term interventions with children and adolescents with a wide range of diagnoses and to collaborate closely with the pediatric staff.
During the first year, on-site supervision and teaching ensures that the clinical experiences relate to the clinical teaching. The attending staff on the service supervises consultations and cases are presented at the weekly C/L Rounds.
Psychiatric Observation Suite
First year fellows spend two months with the child/adolescent psychiatric emergency team at Montefiore, where they evaluate and treat children, adolescents and families in crisis. There, the rotation in the Psychiatric Observation Suite provides hands-on exposure to crisis evaluation and intervention with acutely ill psychiatric child/adolescent patients. Fellows will receive on-site supervision by a member of the Child/Adolescent Psychiatry faculty.
This rotation allows first-year fellows to have hands-on experience with patient assessment, treatment, and rapid return to the community and/or referral for further inpatient services. 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.
Adolescent Depression and Suicide Program/DBT
The Adolescent Depression and Suicide Program (ADSPP) provides training and didactics in Dialectical Behavior Therapy (DBT). First year fellows receive intensive academic training in Dialectical Behavior Therapy during their Summer Orientation Program taught by nationally renowned faculty. Throughout the academic year, first year fellows participate in biweekly interdisciplinary meetings to discuss shared patient cases.
Didactics: First Year Curriculum
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
- Knowledge about pediatric consultation-liaison and emergency psychiatry
First year fellows attend classes throughout the week and meet weekly with assigned outpatient supervisors, and they receive direct supervision on their service rotations.
The curriculum for the first year is comprised of introductory classes in:
- Child psychopathology
- Adolescent psychopathology
- Psychopharmacology
- Family therapy
- Working with parents
- Psychotherapy with children and adolescents
We also include courses that cover areas, 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 outpatient cases to senior faculty.
Second Year Program: Clinical Experience
During the second year of training, fellows 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 SeniorPaper.
Supervision in the second year continues with outpatient supervisors, service attendings on each rotation, as well as on-site supervision by faculty at each of the consultative sites. In addition to continued mentorship, the supervisory faculty is able to help the second year fellow transition from their trainee status to that of their new role as a child and adolescent psychiatrist administrative supervisor regularly.
Second year fellows rotate for three months at an adolescent inpatient unit and three months at a child unit at the New York City Children's Center-Bronx Campus (NYCC-Bronx Campus). For the other six months of the second year, fellows rotate on our consultation rotations:
- The Kennedy Center, an interdisciplinary service program for children with intellectual and developmental disabilities
- School-Based Mental Health Programs at a middle school in the Bronx
- College Aged Mental Health at the Counseling Center at Fordham University
- Child and Adolescent Inpatient Services at NYCCC
These consultation blocks have the goal of expanding the experience of the fellowship into the consultative role of the child psychiatrist and exposing fellows to additional clinical opportunities or cutting edge research.
In order to ensure a continuity of care experience, fellows continue to see their outpatients from the first year clinic for 1.5 days a week.
There is an opportunity for elective research in the second year.
Second Year Clinical Rotation Sites
Child and Adolescent Inpatient Rotation
New York City Children’s Center (NYCCC)-Bronx Campus is the site for our second year fellows to learn about adolescent inpatient psychiatry. Fellows rotate on an adolescent service at NYCCC-Bronx, staffed by senior faculty in Child/Adolescent Psychiatry. The inpatient service offers a milieu, in which fellows learn about cutting-edge psychopharmacological treatment, while concentrating on the individual care of hospitalized children. Case conference is held once a week to discuss challenging cases, and fellows have the opportunity to run groups on the unit. Treating the underserved and complex patient population of the Bronx provides an unparalleled and rich training opportunity. This rotation provides optimal opportunities for training in continuity of care and responsiveness to larger systems of health care.
School Based Mental Health
Fellows rotate at a middle school in the Bronx where a school-based team provides mental health treatment. Fellows participate in classroom evaluations, treatment plan meetings and implementation of services on-site at the middle school.
Developmental Disorders Rotations
The Kennedy Center is the cornerstone of neuroscience and research of developmental disorders for the Albert Einstein College of Medicine. Trainees rotating here work at an onsite psychopharmacology clinic with senior faculty, observe multidisciplinary evaluations and consult with a wide-range of interdisciplinary treatment team members.
Fordham College Mental Health Service
Our program represents one of a few fellowships of its kind providing an onsite college mental health experience. Second Year fellows join a team of highly trained college mental health psychologists and psychiatrists for six months to provide short term care of Fordham college students with a vast range of mental health needs. This is a unique experience for the fellows to work with a different socioeconomic demographic. Experienced college mental health professionals supervise fellows on-site.
Second Year Curriculum: Didactics
During the second year of training, the curriculum includes core didactics in child development, advanced psychopharmacology, and journal club and an advanced seminar under intense faculty supervision, which culminates in a senior Paper.
The curriculum of the second year further supports the year’s clinical experience in inpatient child/adolescent psychiatry, school consultation, forensic child psychiatry and continued outpatient child/adolescent psychiatry.
Fellows also have research opportunities. A cornerstone of the second year is the preparation of a senior project, under the mentorship of a faculty member. Fellows participate in a class given by the Directors of Training, which supports the planning of this project. As a culmination of the second year, fellows present their projects to the entire faculty and fellowship at a luncheon in their honor.
Available Library Resources
The D. Samuel Gottesman Library at the Albert Einstein College of Medicine has a substantial collection of in house journals and texts, as well as 24-hour access to on-line journals and periodicals available to the Einstein Community through its website library.einsteinmed.org. Montefiore has the full service on-site Montefiore Medical Library, as well as 24-hour access to online periodicals and journals.