Child and Adolescent Psychiatry Fellowship
Program Director: G. Renee Thomas-Clark, DO
Telephone: (814) 868-2476
Email: GThomas-Clark@mch1.org
Mission
The mission of the Millcreek Community Hospital Child and Adolescent Psychiatry Program is to provide fellows with a comprehensive structured cognitive and clinical education in both inpatient and outpatient settings that will enable them to become competent, proficient, and professional osteopathic child and adolescent psychiatrists.
Program Overview
Millcreek Community Hospital is the largest psychiatric inpatient facility in Northwestern Pennsylvania (and only D.O. Hospital). Fellows are exposed to all facets of Child and Adolescent Psychiatry that allow the fellows to be well rounded in the field.
The rotation schedule represents a multifaceted approach which thoroughly accommodates the requirements for fellowship as put forth by the American Board of Psychiatrists and Neurologists (ABPN). Fellows enjoy the opportunity to gain proficiency of practice in a variety of clinical settings, including to work in the public, private and rural sector.
Rotation Requirements: (each rotation is 4 weeks long)
First year:
1 rotation-Pediatric Neurology
1 rotation – Pediatrics
3 rotations-Inpatient Child and Adolescent Psychiatry and Child and Adolescent consultation-liaison
8 rotations-Outpatient (Ambulatory) Child and Adolescent Psychiatry for half day
4 rotations-Forensic Child and Adolescent Psychiatry for half day
4 rotations – Partial Hospitalization Psychiatry for half day
Second year:
13 rotations-Outpatient (Ambulatory) Child and Adolescent Psychiatry for half day
3 rotations-Residential Child and Adolescent Psychiatry
3 rotations-School-based Consultation Liaison Psychiatry
3 rotations-Dual-Treatment Psychiatry
4 rotations-Electives
Fellowship Evaluations are completed via an online form after each rotation block with the fellow present and co-signed by the attending, the fellow and the fellowship director. The fellow and the program director will meet every quarter to complete an overall evaluation.
Educational Program
Fellows are expected to attend a monthly journal club in which articles from The Journal of the American Academy of Child and Adolescent Psychiatry. We have a weekly board review program in which we review PRITE questions to help fellows prepare for the written boards. We also do yearly Mock Boards to prepare for the oral boards. Every week we have three hour didactic classes. Fellows attend two-hour weekly didactic sessions specific to teaching psychotherapy. Also to assist with the practice of psychotherapy, fellows meet weekly with an assigned psychotherapy supervisor to discuss their individual case load.
Fellow Responsibilities
1. Logs
Each fellow is expected to keep a monthly log consisting of the patients they see at each of their identified sites, a list of reading material they have covered, and a list of didactic sessions, conferences, meetings, and supervision sessions they have each attended. These logs are submitted to the program director and to the Department of Medical Education monthly.
2. Evaluations
Fellows obtain evaluations based on the core-competencies of fellowship training from each of their supervisors every two months and are to be submitted as they are obtained throughout the academic year to the medical education department. The program director will review the evaluations with the fellows quarterly. In addition, the Residency director will fill out an evaluation quarterly for each fellow. Fellows are given evaluations with the evaluator (one on one interaction) and are encouraged to have discussions regarding their progress in the Fellowship.
3. Fellows are expected to complete a project each year of the Fellowship, consisting of research, quality improvement or case studies.
4. The call schedule is formulated by the Chief Resident and reflects a fair approach to call distribution which allows for less time on call as each resident progresses through the program. The resident on-call has around the clock access to an attending psychiatrist functioning as a back-up for discussion of complicated cases or special circumstances.
5. Fellows must participate in the annual in-service examination (PRITE) that simulates Part I of the AOBNP Board Certification Examination.
Affiliated Institutions
Millcreek Community Hospital in conjunction with Sarah Reed, The Achievement Center, The Barber Center, Perseus House and many other agencies of Erie County, participates in the education of Child and Adolescent Psychiatry Fellows by offering specialty rotations to enhance the scope, volume, and variety of cases for both core and elective rotations.
Goals and Objectives
General
- Provide an educational program that offers a thorough understanding of the development, assessment, treatment, and prevention of psychopathology as it appears from infancy through adolescence.
- Provide an introduction to this knowledge base in child and adolescent psychiatry.
- Provide an interdisciplinary setting for the training of Child and Adolescent Psychiatrists to take a leadership role in working with other mental health professionals in the prevention and treatment of mental disorders in patients and understand the role of an effective consultant.
- Integrate findings in developmental neurobiology and neuroscience to develop an understanding of fundamental processes that may be involved in the etiology and treatment of psychiatric disturbances and developmental disorders.
- Provide treatment to patients and families on a non-discriminatory basis, always considering the welfare and perspective of the patient, family, community and utilizing evidence based approaches to clinical problem solving.
Educational
- Skill in diagnostic interviewing, formulation, treatment planning, and implementation of psychotherapeutic and pharmacological management.
- Familiarity with the theories of development pertaining to patients of all social and cultural backgrounds.
- Skill in consultation with primary care, non-psychiatrist mental health providers, schools, community agencies, and other programs serving patients.
- Skill in administration and teaching.
- Knowledge of the principles of research to encourage a scientific approach to clinical problems and skill in critical reading of the literature as it pertains to child and adolescent psychiatry and psychology.
- Familiarity with the function and organizations of health, education and welfare institutions to promote normal development.
- Understanding of legal and ethical issues in the practice of Child and Adolescent Psychiatry
Child and Adolescent Psychiatry Inpatient Unit
Patient Care
- Interviewing skills/data gathering skills
- Recognize/manage psychiatric emergencies
- Preparation for treatment and disposition
Clinical Knowledge
- Differential diagnosis
- Pharmacological interventions in acute care setting
- Non-pharmacologic interventions in acute care setting
- Interaction between psychiatric diagnosis and psychosocial problems
Interpersonal Skills and Communication
- Effective relationships with multidisciplinary staff
- Therapeutic relationships with patients/families
- Succinct and thorough oral presentations
- Written reports and documentation
Professionalism and Ethical Behavior
- Demonstrates professional appearance/respectfulness/courtesy
- Punctuality/arranges coverage appropriately
- Maintains equilibrium under stress
Practice-Based Learning
- Self-evaluation/knows limits of own knowledge
- Incorporates new info into practice/seeks out supervision and guidance
- Independently motivated/uses available resources
Systems-Based Practice
- Effective with outside agencies/aware of resources and obstacles
- Advocates for patient/family
- Understands role of inpatient hospitalization in continuum of care
Inpatient Consultation Liaison Service
Patient Care
- Perform psychiatric interviews on medically ill
- Recognize/manage psychiatric emergencies in medically ill
Clinical Knowledge
- Differential diagnosis and treatment planning for medically ill
- Pharmacologic/Non-pharmacologic interventions for medically ill
- Recognize the interaction between medical and psychiatric and psychological problems
Interpersonal Skills and Communication
- Effective relationships with patients and families
- Effective relationships with primary care team
- Succinct and thorough oral presentations
- Written reports and documentation
Professional and Ethical Behavior
- Demonstrate professional appearance/respectfulness/courtesy
- Punctuality/arranges coverage appropriately
- Maintains equilibrium under stress
Practice-Based Learning
- Self-evaluation/knows limits of won knowledge
- Incorporates new info into practice/seeks out supervision and guidance
- Independently motivated/uses available resources
Systems-Based Practice
- Understands role of psychiatry consultant
- Effective use of resources for Patient Care
On-Call
Patient Care
- Provide focused emergency assessments of patient and families in crisis
- Ensure patient safety
- Identify at-risk situations
Clinical Knowledge
- Awareness of types of emergency situations in patients and families
- Ability to diffuse and manage a crisis situation
- Understanding of statues regarding custody and guardianship as it relates to emergency assessment, emergency petition, and voluntary/involuntary admissions process
Interpersonal Skills and Communication
- Rapid establishment of therapeutic relationship in an emergency care setting
- Succinct written reports
- Cooperation with referral sources and disposition resources
- Clear communication with staff
Professionalism and Ethical Behavior
- Maintain professional appearance and demeanor
- Demonstrate respect, compassion, integrity, and honesty
- Respond punctually to requests for consultation
- Recognize limits of own knowledge/skills
- Arrange coverage as needed
Practice-Base Learning
- Seek out supervision
- Re-evaluate performance based on feedback
Systems-Based Practice
- Learn about the resources available for patients in need of acute psychiatric intervention
- Understand the public mental health care system and obstacles to accessing care
- Learn about the relationship between pediatric care providers and specialty services in an emergency care setting
- Learn to identify the need for adjunct services
Outpatient Clinical Rotations (Continuity of Patient Care)
Patient Care
- Interviewing/data gathering
- Engagement in treatment/effective relationships with patients and families
Clinical Knowledge
- Diagnosis/formulation/treatment planning
- Recognizes relationship between diagnosis and impairment
- Recognizes role of various interventions including individual, family, CBT, and parent management training
- Balancing family/patient needs
- Management of transference/counter-transference
Interpersonal Skills and Communication
- Effective relationships with patient and families
- Succinct and thorough oral presentations and written reports
- Effective relationships with referral sources
- Effective relationship with supervisor
Professionalism and Ethical Behavior
- Demonstrate professional appearance/respectfulness/courtesy
- Punctuality/arranges coverage appropriately
- Maintains equilibrium under stress
Practice-Based Learning
- Self-evaluation/recognizes own limits
- Incorporates new info into practice/seeks out supervision and guidance
- Independently motivated/uses available resources
Systems-Based Practice
- Aware of complex system of care
- Effective use of resources for Patient Care
- Advocates for patient and family
Specialty Clinics
Patient Care
- Perform comprehensive interviewing skills and data gathering
- Recognition/management of psychiatric emergencies
- Provides pharmacologic management and psychoeducational interventions in integrated manner to patients and families
Clinical Knowledge
- Recognizes relationship between diagnosis and impairment
- Recognizes role of various interventions including individual, family, CBT, and parent management training
- Diagnosis/formulation/treatment planning
Interpersonal Skills and Communication
- Effective relationships with patient and families
- Team participation/oral presentations
- Written reports/routine documentation
- Effective relationships with referral sources
Professionalism and Ethical Behavior
- Demonstrates professional appearance/courtesy/respectfulness
- Maintains equilibrium under stress
- Punctuality/arranges coverage appropriately
Practice-Based Learning
- Self-evaluation/recognizes limits of own knowledge
- Incorporates new information into practice/seeks out supervision
- Independently motivated/uses available resources
Systems-Based Practice
- Aware of complex system of care
- Effective use of resources for patient care
- Advocates for patient and family
Partial Hospitalization Psychiatry Program
Patient Care
- Perform comprehensive interviewing skills and data gathering
- Recognition/management of psychiatric emergencies
- Provides pharmacologic management and psycho education to patients and families
Clinical Knowledge
- Recognize the interplay between psychiatric and learning problems
- Understands role of psychiatric consultant in school setting and limits of school-based services
- Diagnosis/formulation/treatment planning
Interpersonal Skills and Communication
- Effective relationships with clinicians
- Team participation/oral presentations
- Written reports
Professionalism and Ethical Behavior
- Demonstrates professional appearance/courtesy/respectfulness
- Maintains equilibrium under stress
- Punctuality/arranges coverage appropriately
Practice-Based Learning
- Self-evaluation/recognizes limits of own knowledge
- Incorporates new information into practice/seeks out supervision and guidance
- Independently motivated/uses available resources
Systems-Based Practice
- Identifies obstacles to accessing care
- Aware of COMAR and other regulatory bodies regarding services
- Recognizes obstacles to care
Forensics
Patient Care
- Provide comprehensive clinical assessments patient and family before the court
- Manage relationships with patients and families in court setting
Clinical Knowledge
- Understand the difference between a clinical evaluation and a forensic evaluation
- Understand the different types of forensic evaluations and reports
- Understand the legal statutes as they relate to patients and families
Interpersonal Skills and Communication
- Ability to write reports that convey the appropriate information for judges
- Maintain relationships with court offices
Professionalism and Ethical Behavior
- Demonstrate respect, compassion, integrity, and honesty
- Maintain equilibrium under stress
- Complete paperwork in a timely manner
- Prioritizes appropriately
Practice-Based Learning
- Self-evaluation/seeks out supervision
- Incorporates new information into practice
- Demonstrates initiative
Systems-Based Practice
- Work effectively in coordination with outside agencies
- Understand the interrelationships between the multiple social agencies and the court system as it affects patients and families
Residents applying to our Sports Medicine and Child/Adolescent Psychiatry Fellowships are encouraged to submit a Residency/Fellowship Application (online application) to Medical Education, LECOM Health Millcreek Community Hospital. A copy of the Resident’s/Fellow’s board scores, medical school transcript, prior training records and at least two letters of recommendation (one of which must be from your base residency program director) are to be included.
Selection of residents and fellows shall not be based on age, disability, sexual orientation, status as a parent, religion, national origin, pregnancy, sexual harassment, race, color, sex, reprisal/retaliation, or veteran status, which would not directly impede the training process or any other characteristic protected by law.