To anyone who has done Child Psych fellowship, was it it worth it?
Pros/cons of doing the fellowship?"
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I can offer the best insight if I might reframe your question slightly. If you want to work with children and adolescents, then you should absolutely, absolutely do the fellowship. You close off many job opportunities by not having it - I looked at 5 child and adolescent psychiatry jobs for post fellowship, in academic, community, and county settings and all of them required the fellowship. In private practice its important in most parts of the country also. This fellowship, unlike what has been said about some fellowships, exposes you to completely new settings and clinical problems and you will definitely learn many new things.
And so the second question is whether child and adolescent work is sufficiently rich to justify the extra training, and whether its worth going into at all. Having now done this work for two years, I would cite these pro's. Firstly, I experience greater scope for crafting sophisticated formulations that consider not only the patients phenomenology, but how it can be best accounted for in terms of their cognitive profile, developmental stage, and psychosocial context. It is of course possible and important to think in these terms in adult psychiatry, but there is greater impetus for this in child psychiatry, particularly as the DSM nosology is of limited utility (for example, one can diagnose ODD in a child much the same way you would diagnosis MDD in an adult. However in a child this label is of basically no utility, and treatment planning will require a more detailed understanding across multiple dimensions. By contrast, when an adult meets 5/9 criteria for depression, you are already in a position to recommend at least some type of treatment). I also feel like systems are more aware of the need for complex formulations in children; as such, we frequently carry fewer patients (e.g. my new job is 8 adolescents and the adult folks see 11), are given more time for certain evaluations (e.g. people can bill school districts for 8 hours to do a robust consult), and I do feel that there is a greater appreciation for whatever contribution I can make to the treatment team. Again, I do not deny that all of this is possible and important in adult work, but it just seems to be more prominent in child psychiatry - I see less of the 'race to the bottom' that splik has described as a more general issue.
There are cons. Despite systems making some accommodations, things can still take longer in child psychiatry. It is important to get collateral from schools, parents and other family members, and then answering questions not only by the patient but also by his family. Family work can be rich and rewarding but also very draining and one may be verbally attacked more often.
Overall I would think about how much you have enjoyed this work and if you found it rewarding, go for it!
