Ideas for CAP Fellowship Electives

[Ψ-117]

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Any child & adolescent psychiatrists out there who have some recommendations for electives to take during fellowship? My program is asking me what I'd like to do for my electives, and they say I can do whatever I want, but when I ask what's available I only receive limited information. For example, I know I can do forensics, school consults, developmental peds, neurology, and additional months of inpatient (acute care, state hospital, or consults). But what else is there? I'd like to get as broad an education as I can while I'm in training. Any ideas would be much appreciated!

 

[OldPsychDoc]

Addiction.

 

[DD214_DOC]

Pediatric neurology was infinitely helpful, especially pediatric sleep stuff.

I second the addiction thing. Most child shrinks -- myself included -- seem to be completely lost when it comes to substance use in adolescence.

Get familiar with DBT for adolescents.

School consults would probably be useful to understand better the interactions with the education system

 

[SmallBird]

Any child & adolescent psychiatrists out there who have some recommendations for electives to take during fellowship? My program is asking me what I'd like to do for my electives, and they say I can do whatever I want, but when I ask what's available I only receive limited information. For example, I know I can do forensics, school consults, developmental peds, neurology, and additional months of inpatient (acute care, state hospital, or consults). But what else is there? I'd like to get as broad an education as I can while I'm in training. Any ideas would be much appreciated!

I agree with the addiction idea. I think the school piece (And I open myself up to criticism here) is actually pretty straightforward - it comes down to understanding what is financially possible in a specific district, and making recommendations that balance the ideal with the pragmatic... Addiction experience, on the other hand, is a little harder to come by in the course of general CAP training. There may not be significant "psychiatric" things to understand but its a large and complex system, and having experience in it gives you something of a niche.

 

[shan564]

I'm not a child psychiatrist, but I've noticed that a lot of child psychiatrists tend to underrecognize/undermanage tic disorders in their patients whose primary problem is ADHD or OCD/anxiety. I think I primarily notice this because I have a specific interest in tic disorders. I wonder if it'd be useful for more child psychiatrists to rotate in a Tourette's-oriented clinic just for a few days. At my residency program, we do that for a total of about 4-5 afternoons in PGY2 (under the supervision of a psychiatrist who is subspecialized in tics), and it made a big difference in my comfort level with managing tics.

 

[DD214_DOC]

I'm not a child psychiatrist, but I've noticed that a lot of child psychiatrists tend to underrecognize/undermanage tic disorders in their patients whose primary problem is ADHD or OCD/anxiety. I think I primarily notice this because I have a specific interest in tic disorders. I wonder if it'd be useful for more child psychiatrists to rotate in a Tourette's-oriented clinic just for a few days. At my residency program, we do that for a total of about 4-5 afternoons in PGY2 (under the supervision of a psychiatrist who is subspecialized in tics), and it made a big difference in my comfort level with managing tics.

Hence the pediatric neurology rotation. Honestly, though, I don't find tics that difficult. As long as the kid isn't bothered by them, there's not a more serious underlying diagnosis, and really no impairments from the symptom, I usually tell parents, "Who cares". 9/10 the parents are merely bothered by the presence of the symptom, which isn't enough to warrant medicating them.

 

[shan564]

Hence the pediatric neurology rotation. Honestly, though, I don't find tics that difficult. As long as the kid isn't bothered by them, there's not a more serious underlying diagnosis, and really no impairments from the symptom, I usually tell parents, "Who cares". 9/10 the parents are merely bothered by the presence of the symptom, which isn't enough to warrant medicating them.

I think that people often don't have enough insight to realize the extent to which tics are interfering with their lives. I think that's why they removed the "clinically significant distress" part from the DSM-5 criteria for Tourette's. I'm disclosing a lot here, but I grew up with moderate tics, and never sought medical attention for it partly for the reasons that you describe. But now that I have more psychiatric training, I am starting to realize how much they interfered with life in ways that I didn't recognize until just now.

 

[Ψ-117]

Thanks, everyone, for your responses! I appreciate the ideas you provided and I believe all of these are available at my program.