CAP Fellowships with Strongest Inpatient Training

[scruffy821]

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Which CAP fellowship programs do you all consider strongest for academic inpatient unit training?

Is this something that can be gauged by comparing the amount of time spent in the curriculum on inpatient rotations, or are there better measures to consider? Thanks everyone! 🙂

 

[Merovinge]

Given your specifier of academic inpatient unit (which is a teeny tiny portion of inpatient CAP beds), you will almost assuredly be best served at a large children's hospital or program that has you at a quaternary inpatient unit (where pts are transferred that are failing at other inpatient units). You can essentially take the list of top 10 children's hospitals in american and the majority have CAP associated fellowships. Your interest is actually a relatively rare passion, as most CAP is outpatient and most inpatient is private, so I would make sure to specifically discuss this with programs if this is a true specialization area you envision your career being in. If you are looking for specific inpatient experiences (e.g. eating disorders, early onset psychosis) some places will have specific programs in place and training in this will undoubtly help with that population.

 

[dassie]

Given your specifier of academic inpatient unit (which is a teeny tiny portion of inpatient CAP beds), you will almost assuredly be best served at a large children's hospital or program that has you at a quaternary inpatient unit (where pts are transferred that are failing at other inpatient units). You can essentially take the list of top 10 children's hospitals in american and the majority have CAP associated fellowships. Your interest is actually a relatively rare passion, as most CAP is outpatient and most inpatient is private, so I would make sure to specifically discuss this with programs if this is a true specialization area you envision your career being in. If you are looking for specific inpatient experiences (e.g. eating disorders, early onset psychosis) some places will have specific programs in place and training in this will undoubtly help with that population.

I think any large, freestanding children's hospital is probably going to have a solid child psych CL service experience but it doesn't always necessarily correlate to an inpatient psych experience.

IIRC, most places I interviewed at had pretty similar amounts of time on inpatient/CL/ED (all in your first year of CAP fellowship). I found it kind of difficult to compare which was the "strongest" and at this point in your training, it's just going to come down to what you want to do when you grow up and how chill you want your last 2 years of training to be.

The big distinctions would be how much time at a state hospital vs private/university hospital (length of stay, population, pathology will vary), exposures to particular populations (first break psychosis, ED, forensic, med/psych/functional symptoms), is there particular faculty who does research in something you're interested in, etc.

 

[scruffy821]

Thank you so much for your responses! Yeah, I’m mostly curious to learn about academic programs with strong inpatient training, particularly in first-break psychosis and mania. I’ve noticed (from websites) there has been a range in the number of inpatient hours and types of inpatient sites at many of the major academic CAP programs, so I was curious if there are any that specifically have a good reputation in the field for their inpatient exposure/units. Extra curious about the major programs in the NE, West Coast, and Midwest (and trying to differentiate between them).

 

[Monocles]

So out of the Boston programs that I know of, MGH was particularly proud of how rigorous their inpatient rotation was and I think it may have been 1-2 months longer than the other CAP fellowships in the city? (Tufts and Cambridge both rotate at Cambridge which I heard is lighter, and Boston Childrens has it's internal Bader 5 inpt but their emphasis is more on consults/medical commodities).

At MGH the inpt is at Franciscans and I can't remember how many months it was but the medical director seemed really great and provided a solid experience. I loooooove inpt but didn't want to deal with the brutal MGH call schedule so I ended up not going there.

EDIT: Also OP if you want a more intensive inpt experience you can always go "above and beyond" and ask for more patients than the typical fellow caseload if you are able to handle the workload and provide safe quality care! 🙂

 

[scruffy821]

So out of the Boston programs that I know of, MGH was particularly proud of how rigorous their inpatient rotation was and I think it may have been 1-2 months longer than the other CAP fellowships in the city? (Tufts and Cambridge both rotate at Cambridge which I heard is lighter, and Boston Childrens has it's internal Bader 5 inpt but their emphasis is more on consults/medical commodities).

At MGH the inpt is at Franciscans and I can't remember how many months it was but the medical director seemed really great and provided a solid experience. I loooooove inpt but didn't want to deal with the brutal MGH call schedule so I ended up not going there.

EDIT: Also OP if you want a more intensive inpt experience you can always go "above and beyond" and ask for more patients than the typical fellow caseload if you are able to handle the workload and provide safe quality care! 🙂

This is super helpful, thank you @Monocles!

 

[Duloxetini]

Don't discount state schools with ties to state hospitals with C&A beds.

 

[scruffy821]

Don't discount state schools with ties to state hospitals with C&A beds.

Any particular places you’d recommend applicants look at?

 

[mechuck]

Which CAP fellowship programs do you all consider strongest for academic inpatient unit training?

Is this something that can be gauged by comparing the amount of time spent in the curriculum on inpatient rotations, or are there better measures to consider? Thanks everyone! 🙂

I've heard MGH, CHA, or BCH in-patient rotations are great, but also not so talked about places like, The Menninger clinic and Cincinnati Children's have huge in-patient C&A services, would love to hear if people know more about these programs. I feel in-patient in psychiatry generally has compromised academic value due to shorter stays and insurance issues, situation with C&A may be little better with slightly longer stays. As someone mentioned above, state hospitals might have a better chance that way as they keep patients for a meaningful length of stay.

 

[reca]

I've heard MGH, CHA, or BCH in-patient rotations are great, but also not so talked about places like, The Menninger clinic and Cincinnati Children's have huge in-patient C&A services, would love to hear if people know more about these programs. I feel in-patient in psychiatry generally has compromised academic value due to shorter stays and insurance issues, situation with C&A may be little better with slightly longer stays. As someone mentioned above, state hospitals might have a better chance that way as they keep patients for a meaningful length of stay.

I know Cincinnati has a stand-alone inpatient child psych facility. It's at College Hill with 92 inpatient beds and 33 residential beds. They've got an inpatient eating disorders unit at Linder Center of Hope as well and then two PHP's.