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Child & Adolescent Psychiatry Program Description

For those who have decided to pursue child and adolescent psychiatry training, the University of Michigan program is an outstanding choice. The program here is demanding but educationally geared.

Rotations and Clinical Activity

The Child and Adolescent Psychiatry fellowship program at The University of Michigan is a fully accredited two year program that accepts six fellows each year. During the two years of training, child psychiatry fellows spend six months covering the inpatient unit and consultation services and 18 months in our outpatient clinics located at the Depression Center and Ambulatory Psychiatry facility, in the Rachel Upjohn Building. This stunning building, which opened in October 2006, is the first among the National Network of Depression Centers and combines clinical expertise, cutting edge research, and innovative teaching for a new generation of leaders in child and adolescent psychiatry.

Inpatient and Consultation Liaison Service:
The Child and Adolescent Psychiatry inpatient unit is a 14 bed unit located at Mott Children’s Hospital, part of the University of Michigan Health System. There are typically three first year child and adolescent psychiatry fellows (CF-1’s) on service at any given time along with rotating adult psychiatry residents and medical students. Under the supervision of two faculty members, child psychiatry fellows provide comprehensive and highly specialized treatments to children and adolescents with complex and severe mental health challenges. As a part of the multi-disciplinary team, fellows work in a supportive and nurturing environment while learning the interface between child psychiatry, consultation-liaison service, social work, nursing, education, occupational recreational therapy and nutritionist services. For two months of this rotation, one fellow is dedicated to the consultation service which provides clinical and educational services at Mott Children’s Hospital. Consultations are provided to all pediatrics inpatient services, including general pediatric inpatient services, pediatric intensive care, neonatal intensive care unit, pediatric physical medicine and rehabilitation, pediatric neurology, and other pediatric subspecialty services.

Throughout the hospital-based rotations, child psychiatry fellows are provided with protected time to attend the core lecture series, journal clubs and collaborative case conferences.

During outpatient rotations, a full-time clinical commitment consists of approximately 24 hours of direct patient contact per week.  Child psychiatry outpatient services includes both general and specialty clinics. Child psychiatry fellows rotate through these clinics throughout their 18 months.

CBT/IPT Clinics: One-half day per week for 12 months. Fellows receive didactics and training in both cognitive behavioral therapy and interpersonal therapy. Supervisors for these clinics include expert social work and psychology faculty members. Each fellow is expected to carry two therapy cases. Fellows receive real-time supervision and feedback via a one-way mirror.

School Rotation: One-half day per week for two months. During the first year of training, fellows spend time in the school setting (elementary, middle and high schools). This rotation allows fellows to observe normal childhood development. Child psychiatrists often need to distinguish between normal variance in development and psychiatric illness. This rotation helps cement the learned developmental milestones.

ADHD Clinic: One-half day per week for two months. Fellows participate in clinical interviews and collaborate with neuropsychology to determine diagnosis and treatment plans. This clinic provides fellows with the opportunity to take an in-depth look at ADHD and potential co-morbidities.

ASD Clinic: One-half day per week for two months. This multidisciplinary clinic consists of psychiatrists, speech and language pathologists, neuropsychologists and social workers. The team works together to evaluate children with suspected autistic spectrum disorders, clarify diagnoses and develop treatment plans.  This is a unique educational experience that trains fellows to recognize and treat this often overlooked disorder.

Treatment Resistant Depression Clinic: One-half day per week for two months. In this clinic, fellows learn to thoroughly evaluate and manage patients with severe depression. These patients have often failed numerous medication trials prior to seeking out consultative care. Fellows will also have the chance to work closely with the ECT team.

During the two years of clinical training, community psychiatry rotations are integrated into the training schedule. These rotations have consistently been among the favorites of the fellows. These rotations include:

Community Mental Health Centers (Corner Clinic, Ypsilanti Pediatrics and Huron Valley child Guidance Clinic): One-half day per week for six months. This rotation provides fellows the opportunity to participate in an integrated care clinic, working with low-income families.  Patients have a variety of disorders, including depression, anxiety and PTSD. Fellows collaborate with medical students, adult psychiatry residents, primary care providers and case managers.

Washtenaw County Trial Court, Juvenile Division (JCWC): One-half day per week for one month. Fellows visit the Washtenaw Juvenile Court and detention center in the second year of training. The rotation is designed to augment the core lectures on forensic/legal topics provided by staff from the forensic center. During this rotation fellows observe the juvenile court proceedings, attend assessments of court involved youth and accompany a case worker in the Intensive Probation Program on community visits.

Center for Forensic Psychiatry: One-half day per week for one month.
Fellows visit the Center for Forensic Psychiatry in the second year of training. Fellows participate in in-depth supervised case reviews, directed and self-initiated reading and literature searches,  case evaluations, treatment team meetings, trial preparations and testimony, where possible, with an in-depth review of at least one forensic report.

University of Michigan Addiction Treatment Services (UMATS): One-half day per week for one month.  The University of Michigan Addiction Treatment Services provide  a broad continuum of diagnostic and treatment substance use services for patients thirteen years and older. Learning objectives for the UMATS rotation are met through a variety of activities, including didactics, varied clinical experiences, assigned readings, learning videos, and extensive patient discussion regarding diagnosis and treatment of substance use disorders and substance induced disorders.

Pediatric Neurology: One-half day per week for two months. Fellows participate in an observational learning opportunity, working with attending pediatric neurologists. This clinic is a favorite of the fellows and the exposure is an important tool in studying for board exams.

Psychiatry Emergency Services (PES): Fellows take a 5-10 p.m. call shift approximately 1-2 times per month in the psychiatry emergency room. PES is a fully staffed ER, with administrative staff, social workers, psychologists, nurses and psychiatrists. PES has a collaborative and congenial atmosphere. Fellows provide emergency consultation to children, adolescents and their families.