Fast-track to C&A?

[Member49238]

Hello,

So I'm uncertain if I should fast track to C&A, and I'm planning on seeing a equal mix of adults/child. Should I fast-track? And any notable C&A programs out there that people typically apply to, disregarding geographical preference. Or any programs that I should definitely avoid?

Also I just saw a thread below this one, that talked about regret going into child psych...I'm scared of making the wrong decision but I do enjoy working with kids (I think they are adorable, and I enjoy interacting with them - that's literally the main reason of wanting to do child psych and I'm not even sure if that's the right reason to do child psych) but my adult psych program only offered a few opportunities in child psych interactions. Any comments regarding whether fast-tracking is the way to go would be much appreciated, thanks. Or comments on what I should think about when thinking about whether to apply fast track or not, or even whether to go into child psych or not. (It was very distressing to read the other thread about all the administrative work that I did not really get exposed to as a resident on child psych rotations). Any comments would be helpful.

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[Shufflin]

if you want to work with adorable children, switch into Peds

if you want to work with abused and neglected children who have depression and hallucinations, a fair portion of whom may have eating disorders and oppositional traits, many from broken homes, and throw in those who are entitled, then do Child psych... at least that's been my experience with the vast majority working in a C&A unit. It's not like you'll be enjoying children all day. It's more like you'll have this protective barrier so you can handle all the depressing things you'll hear and see. you'll come across an adorable child maybe once in a while, but then be completely thrown by their terrible life story. a foster mom selling her 13 year old into prostitution and abusing her while doing drugs? or the girl bullied at school who got raped by dad and tried to kill herself by driving his car into a tree suffering a subdural hematoma at the tender age of 16?...

 

[hamstergang]

I don't regret my C&A fellowship at all. I now work outpatient seeing exclusively C&A cases, and while many do have sad stories many don't. I was exposed to the numerous administrative tasks of outpatient C&A work during my fellowship.

So I'd recommend talking to some C&A people, possibly in person at your program, to get a more varied sense of what it entails. It seems different people have different experiences.

 

[ryerica22]

if you want to work with adorable children, switch into Peds

if you want to work with abused and neglected children who have depression and hallucinations, a fair portion of whom may have eating disorders and oppositional traits, many from broken homes, and throw in those who are entitled, then do Child psych... at least that's been my experience with the vast majority working in a C&A unit. It's not like you'll be enjoying children all day. It's more like you'll have this protective barrier so you can handle all the depressing things you'll hear and see. you'll come across an adorable child maybe once in a while, but then be completely thrown by their terrible life story. a foster mom selling her 13 year old into prostitution and abusing her while doing drugs? or the girl bullied at school who got raped by dad and tried to kill herself by driving his car into a tree suffering a subdural hematoma at the tender age of 16?...

This. Don't expect to be going into child psych just to see plain n simple ADHD. You will get the tough cases. ADHD and adorable kids are just for Pediatricians to handle.

 

[DD214_DOC]

This. Don't expect to be going into child psych just to see plain n simple ADHD. You will get the tough cases. ADHD and adorable kids are just for Pediatricians to handle.

Really? Because most of them don't and just refer.

 

[Merovinge]

1) Definitely fast-track - PGY4 year is low yield and designed for specialization anyway... which is what you are doing in CAP. The extra 1 year of not fast tracking is going to cost you roughly $200k, so keep that in mind when deciding. Plus being a fellow/attending is more enjoyable.

2) If you enjoy kids, you will enjoy CAP. Not only because you get to take care of kids (which I word that way because almost every pediatric field you take a small to huge paycut to take care of kids compared to adult except for CAP) but also because your colleagues will also be people who like to take care of kids. If you go to a party of IM residents and compare it to a party of Peds residents, that is roughly the difference I have noticed between adult psych and child psych.

3) Please do not let the peds naysayers from SDN dissuade you. The overwhelming majority of people I know that did CAP practice mostly or exclusively CAP because they like it better. This board can get very anti CAP at times but it is absolutely not representative of the field. I just left my local CAP meeting with about 40 attendings and you will rarely find a room of cooler/chill folk.

4) Taking care of trainwreck kids is not for everyone in CAP but the patients Shufflin is describing are actually my favorite patients. This week alone I have:
A) Diagnosed a middle schooler with schizophrenia - extremely "classic" first rank sx for just over 6 months, responding very well to first atypical trial. Spoke to outpatient doc who was "afraid" he might have schizophrenia and coordinated his continued care
B) Admitted a teenage girl who successfully eloped from a different psychiatric hospital a year ago, has been on the run since, and has been human trafficked for the past 8 months. Coming in emaciated and scared of her pimp. What an absolute honor to be one of the first people in a year to make her feel safe (if we are being honest, probably in her whole life).
C) Treated a preadolescent year old girl who was recently raped and struggling to deal with her anger and emotions but is able to discuss the issues in the hospital that she has otherwise been unable to voice.

If you have any other questions about the process, feel free to shoot me a msg.

 

[milesed]

I did it and have no regrets. I love working with a variety of ages and about 90% of my patients are under 18.

There are ups and downs. I see former patients in arrest records, going to prison, etc. I also have former patients at Harvard. Most are in the middle.

 

[Lunzio]

How important (if at all) would y'all consider boards scores (Level 3/Step 3) in the CAP fellowship application?

 

[Member49238]

Also do I need a letter of recommendation from a child and adolescent psychiatrist or can they all be from adult psychiatrist? Also does it matter if you upload medical school transcript yourself or via the medical school?

 

[MedMan80]

Also do I need a letter of recommendation from a child and adolescent psychiatrist or can they all be from adult psychiatrist? Also does it matter if you upload medical school transcript yourself or via the medical school?

I believe I had my school upload the transcript. I did have a letter from a CAP (not the strongest letter), so it can only help your application. Keep in mind that last year was one of the most uncompetitive years...this isn't a competitive field, so letters from Adult psychiatrists can be fine (will help if they can attest to your work with kids, say in the ED for consults etc..)

 

[Mad Jack]

This. Don't expect to be going into child psych just to see plain n simple ADHD. You will get the tough cases. ADHD and adorable kids are just for Pediatricians to handle.

Most of the pediatricians out here refuse to prescribe stimulants in younger children because they feel unqualified and won't in older children because they fear they can't separate real cases from kids that just want some addies