Child psychiatry combined program

[Dr1990s]

3rd year medical student here planning on applying to psych/child psych residencies this fall! I love both child and adult psychiatry, but working with children in their families is a MUST in my future practice. I am seeking advice on some great psychiatry residencies that either…

1) Offer combined acceptance into their adult residency/child fellowship and integrate the child training into the adult years

2) Don’t have an integrated track but still have a great psychiatry fellowship

Geographically, I would prefer to stay in the Midwest! I would also consider going north, south, or west. I DONT see myself going to to the northeast even though I know a lot of great programs are there.

I have considered triple board programs but probably won’t go that route… I feel like a great child psych program will give me the child development perspective that I need to ultimately just practice child psych. I consider myself more clinically oriented (vs research). It would be nice to go to a program that values psychotherapy. I don’t need prestige- Ultimately I just want to go somewhere where people are happy 🙂

Any advice is appreciated!

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[sloop]

I’m not a child psychiatrist but I am a psychiatrist (current forensic psych fellow). I don’t have a lot to specifically recommend with regard to different fellowships, but I wanted to comment on the idea of a combined psych/child psych program.

Maybe I am missing something but the idea of such a program seems like it would be mostly pointless. Perhaps you could run into some trouble if your entire class wanted to do child or something (highly unlikely), but my experience was that, generally, well-regarded graduating residents at my institution were welcome to stay on to do a fellowship there, including child. I imagine this is the case at most places, where it’s pretty unlikely that a decent resident wouldn’t get one of the fellowship slots at that program if they wanted it.

With regard to “integrating the child training into the adult years,” I’m not sure what you mean by this. Isn’t this effectively what fast tracking does? Your first year of child counts as your last year of residency, effectively integrating the two. I suppose you mean that there might be programs that allow you do some extra child in years 1-3 in exchange for doing some adult psych in year 4 or something. I am just not sure why this is desirable.

I only mention this to say that I’m not sure how useful it is to pursue a combined acceptance to psych and child psych. Personally, I would probably just focus on going to a good residency with a good child program. I don’t think I would let the combined program thing sway me much.

 

[Taddy Mason]

The only substantial benefit to combined general psych/CAP programs is a guaranteed fellowship spot (so long as you don’t f up in the first 3 years) without having to apply again. The overall content of training or length of training isn’t going to change as you still have to meet the ABPN requirements of at least 30mo of adult training to be board eligible for either general adult psych or CAP. Also, while CAP is the most “competitive” psych specific fellowship, it’s really not that competitive in the broader sense. I can’t remember the exact numbers and am too lazy to look them up, but ~50% of CAP positions go unfilled (the exact number is closer to either 40% or 60%). I would honestly just focus on matching to a strong general adult psych residency that you feel will be a good fit and then fast track as a PGY-3. This will leave you with more potential opportunities and as per above the benefit of a guaranteed CAP fellowship spot going into residency is pretty negligible. You might also find that your interests may change as you gain more experience and exposure to other aspects of psych. I personally know multiple people who went into psych dead set on CAP but ultimately changed their minds, people who disliked CAP enough to either leave fellowship or only work with adults after fellowship, and several people who transferred into general psych residencies from triple board programs because their perception of working with kids and families going into residency did not mesh with reality.

 

[CAPdoc]

There are some combined programs that accept you into both adult residency and child fellowship at the same time, called integrated.

Integrated Training Programs (aacap.org)

The benefit of this type of training is more pediatric training. Typically there are different rotations for your intern year in which you do pediatric rotations in general medicine, neurology, or FM instead of IM. There are also programs that don't accept you into fellowship but give you the option of doing pediatric medicine rotations for a couple of the months instead of adult. My year there were options in ERAS to apply to both just adult and the integrated at some places. It certainly may change based on funding and things and you would have to look around for ones that offer peds rotations as an option during adult training.