Child and adolescent fast track

[Second Doctor]

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I just started my psychiatry residency. Right now, I’m 99.44% certain that I want to do a C&A fellowship. My residency has a C&A fellowship and I’m almost certain that I want to stay and do the “fast track” thing at this institution. But if I decide in the next two years that I don’t want to stay here for my fellowship, what are the RRC requirements that have to be met so that I’m not forced to ask the fellowship to pick up a couple months of something I haven’t yet done (a scenario I’ve seen in a couple posts)? I tried searching for this but I don’t know if I found the correct info. I don’t want to ask anyone at my residency, obviously, and I most likely will never need to use the info because I like the program, but I’d still like to know. And I think this info would be helpful to others in the upcoming interview season.

From the posts I’ve read, you need to have some Child & Adolescent, some Consultation/Liaison, and some Addiction Psychiatry by the end of PGY-III. What else do you need and how much of each of these do you need?

Thank you

 

[Chimed]

Someone else can answer your question directly. However, if your program allows you to fast-track into their own C&A fellowship, then my guess is that you will have meet the requirements and could apply to any program.

Also, I think asking your program this question is perfectly fine. You've already matched there and I'm sure they don't expect everyone to stay for their C&A program. You're in their program and they have every bit of interest in making sure you do well what ever you decide. Obviously, you'll let them know you're also very interested in staying...😉

 

[atsai3]

I don’t want to ask anyone at my residency, obviously, and I most likely will never need to use the info because I like the program, but I’d still like to know. And I think this info would be helpful to others in the upcoming interview season.

From the posts I’ve read, you need to have some Child & Adolescent, some Consultation/Liaison, and some Addiction Psychiatry by the end of PGY-III. What else do you need and how much of each of these do you need?

Thank you

This is a very reasonable question to ask people in your own residency program. Doesn't really need to be anything furtive about it.

Generally, the requirements are: 4 months medicine, 2 months neuro, 9-18 months inpatient psych, 2 months child, 2 months C/L. It is program-specific as to whether your program's requirements will keep you from fast tracking to a different program if you change your mind. For example, (someone please correct me if I'm wrong) at Columbia the C/L months are done during the PGY-4 year. I can see how that would prevent any kind of fast tracking.

-AT.

 

[Doc Samson]

Here's the RRC link:

http://www.acgme.org/acWebsite/downloads/RRC_progReq/400_psychiatry_07012007_u_04122008.pdf

In short, the recs are:

Medicine - 4 mos
Neuro - 2 mos
Inpatient - 6-16 mos (the only one with an upper limit)
Outpatient - 12 mos
C&A: 2 mos
Geri: 1 mo
Addictions: 1 mo
CL: 2 mos

Plus nebulously defined "experience" in emergency, community, and forensics. There's a whole section on what can and cannot be double counted for C&A requirements.

 

[rpkall]

Thanks for that info, Doc Samson. Do you know how much of the "medicine" and "neurology" can be pediatrics medicine and peds neuro? My school was telling me I could do two months of peds and one month of peds neuro. Is this the norm, or are there programs out there that will let you do exclusively peds? I'm fairly set on C&A psych for a future career--and I certainly don't deny that an adult medicine experience would be useful--but I also want to get as much peds training as an intern without having to look at peds/psych/child psych triple board programs exclusively...

Thanks for any info you can provide!

 

[billypilgrim37]

Is this the norm, or are there programs out there that will let you do exclusively peds?

It's a crapshoot for all programs. Some encourage peds, some discourage. MGH has a track where you do a peds intern year with the categorical peds folks (of course, this is probably the single most competitive program on the psychiatric planet). Many schools would swallow their tongues before they would let you out of their make-a-real-doc-out-of-you medicine rotations. Some let you split your time. If you could imagine a permutation, there are many programs that probably offer that permutation.

My program personally, I could do either all of my medicine months except for one at the children's hospital, or I could do normal inpatient medicine. For neuro, I could do two months adult or one adult and one peds (I'm pretty sure ACGME requires at least one be adult). I personally chose the inpatient medicine and a month of pediatric neurology, since much of inpatient peds is dealing with developmental issues of very small children who are typically younger than you commonly see as a C&A psychiatrist.

Even as an inpatient, many of your "kids" are going to have as many "adult" medical complaints as "pediatric" ones. But I think that many people who do lots of peds, or do triple board, have great reasons for doing so.

 

[Doc Samson]

It's a crapshoot for all programs. Some encourage peds, some discourage. MGH has a track where you do a peds intern year with the categorical peds folks (of course, this is probably the single most competitive program on the psychiatric planet). Many schools would swallow their tongues before they would let you out of their make-a-real-doc-out-of-you medicine rotations. Some let you split your time. If you could imagine a permutation, there are many programs that probably offer that permutation.

My program personally, I could do either all of my medicine months except for one at the children's hospital, or I could do normal inpatient medicine. For neuro, I could do two months adult or one adult and one peds (I'm pretty sure ACGME requires at least one be adult). I personally chose the inpatient medicine and a month of pediatric neurology, since much of inpatient peds is dealing with developmental issues of very small children who are typically younger than you commonly see as a C&A psychiatrist.

Even as an inpatient, many of your "kids" are going to have as many "adult" medical complaints as "pediatric" ones. But I think that many people who do lots of peds, or do triple board, have great reasons for doing so.

The MGH program is also the one with which I am most familiar. I don't know any more details on how much peds you can substitute. If you can't find it in the RRC documents, you could always call the ACGME to ask.