Child and Adolescent Psychiatry Fellowship

Introducción

The hallmark of our training program is the nationally recognized managed care clinic in which our child and adolescent psychiatry fellows see the majority of their outpatients over the two-year period. In this setting, fellows learn to manage resources while providing their patients with quality care, including assessment, medication management, and psychodynamic, cognitive-behavioral, family, or group therapy. The patient population in the Scott & White system is culturally diverse and socioeconomically varied, with a rich variety of disorders and symptom severity as well as the gamut of payment sources. Fellow caseloads are monitored to provide a representative sampling of this population.

Supervision is provided regularly. Each fellow meets weekly with an outpatient therapy supervisor as well as a medication supervisor. In addition, each rotation is individually supervised weekly by the on-site attending faculty responsible for the rotation. Additional individual supervision is provided for cases requiring specific therapeutic techniques, such as cognitive-behavioral therapy and family therapy. Faculty members are also available for immediate supervision.

During the first year of the program, fellows devote their time primarily to conducting inpatient and partial hospital care at the Metroplex Pavilion Hospital in nearby Killeen, and studying child neurology, child development and genetics at Baylor Scott & White Health. A school consultation experience is also provided at the elementary and middle school levels in both mainstream and alternative learning settings in the Temple Independent School District.

In the second year, fellows concentrate on outpatient care at Baylor Scott & White Health. This is supplemented with work in forensic psychiatry in a private clinic and the Bell County Juvenile Justice Department, administrative psychiatry in the Baylor Scott & White system as well as in community settings. Second-year electives in research, consultation or clinical areas, in community, school, clinic or hospital settings allow fellows to obtain further training in areas of interest. An interest in research is encouraged and supported by a seminar in epidemiology and research methodology and a well-developed Research and Biostatistics Department at Scott & White. Interested fellows may work to obtain a master's degree in Rural Public Health from our School of Rural Public Health, part of the Texas A&M Health Science Center.

Throughout both years, fellows provide consultation to our well-established primary care programs. More than 60 clinics in a 29,000-square-mile service area across Central Texas refer many of our patients, providing intensive interaction with family practice and pediatrics. In addition, inpatient consultation is provided to pediatrics, orthopedic surgery, trauma and hematology-oncology services.

Conferences

Didactics are provided on a two-year cyclical basis. The two-year Integrated Child and Adolescent Psychopathology and Psychopharmacology; Developmental Theory, Issues, and Practicum; and Theories and Therapies series form the backbone of the seminar plan and are complemented by specialty series given every other year.

Seminars

• Integrated Child & Adolescent Psychopathology and Psychopharmacology
• Consultation/Liaison Psychiatry
• Developmental Theory, Issues and Practium
• Forensics/Ethics
• Epidemiology and Research Methodology
• Theories and Therapies: Cognitive Behavioral Therapy
• Supervision and Teaching
• Administrative Psychiatry and Health Care Policy
• Cross Cultural Psychiatry

Conferences

Department of Psychiatry Grand Rounds

Grand Rounds are held approximately three times per month. Speakers include guest lecturers, faculty members and fellows. Many speakers are of national prominence. Clinical issues, research topics/projects, mental health policy issues and psychopharmacology are some of the topics presented.

Practice Improvement Meeting

This is a quarterly conference that is attended by all faculty and fellows within the department. In this conference, a difficult case or a difficult outcome is discussed from a risk management perspective.

Journal Club

Once per month, fellows meet to discuss articles from recent child and adolescent psychiatric literature. All residents will read the article prior to the meeting and discuss them with emphasis on evaluating the background of the research and research methodology and interpretation of the significance of the findings.

Case Conference

Interesting or instructive cases are formally presented by fellows using PowerPoint slides and presentation of literature relating to the case. The case is discussed in a multidisciplinary group setting.

Board Review

Fellows meet weekly with staff to follow curriculum designed to prepare fellows for the child and adolescent board exam.

Rotations

During the second year, a rich variety of rotations exists, including forensic evaluation of youth from the juvenile court system, a community/administrative rotation, a pediatric consultation rotation to medical inpatient units and an elective rotation with options which include inpatient, outpatient and research experiences in a variety of settings.

Call duties

During the six-month Metroplex inpatient rotation, first year fellows take home call once per month for the child and adolescent psychiatric unit.

Faculty members are assigned for supervision and consultation by phone 24 hours per day and in person when appropriate.