Opening for Child Fellowship in my same city - Conflicted

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Righteous in Wrath
10+ Year Member
Aug 6, 2013
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Hey everyone,
I'm a PGY3 and there is an opening for a child psych spot at a local university, and I am conflicted. I do enjoy my child outpatient days, particularly teenagers struggling with trauma, eating disorders, depression and anxiety; but I also find it exhausting. And I am not a big fan of autism. I also find parents exhausting, and that every patient visit takes forever due to overbearing parents. I haven't had any inpatient child experience either.

I guess the pros are that it would leave me fellowship trained, which would increase my value in the job market. I am in the midwest and would like to go to a bigger, warm city that is probably already saturated. I enjoy psychodynamic psychoanalysis and I feel attachment styles are so important, and that this interest would benefit child patients more than adult patients in leading to better overall life quality. But I am primarily concerned/interested in the additional opportunities a CAP fellowship would allow me.

Can anyone share some thoughts, insights, or other things to consider? I Have to make a decision pretty soon. Thanks.

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You do not need to worry about your value in the job market. Adult psychiatrists are in demand everywhere.

The only relevant question regarding doing a child fellowship is if you primarily want to work with children.
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It does not make any difference in the job market. I actually got better offers in adult psych than child.
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If you find parents exhausting, that's a good enough reason not to go into CAP. Of course, you can develop better skills to work more efficiently with overbearing parents, but it may be tough. You're also learning how to work with teens and families so it makes sense that it's exhausting. It does get easier over time.

Not finding autism interesting seems to matter very little. I feel like most child psychiatrists come out of training not knowing how to diagnose autism. Many have it as an exclusion criteria for their practices even when they are CAP trained! This is really unfortunate.

Job market will be just as good as it is for CAP as adult. You might get a 5-10% differential to start.

Go into CAP if you truly enjoy working with children and teenagers and their families. There's such a high demand and low supply right now, but you'll need to decide what's right for you personally.
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Interacting with families can be exhausting for sure...the question is, can you see yourself doing it for 2 years and stomach having to read more in your free time afterwards? Basically, is it a challenge you'd like to improve with or is it a burden you'd prefer to avoid?

The job market in the short term is not gonna make much of a difference. Long-term, having the CAP board cert might give you a leg up in an increasingly competitive and encroached-upon specialty. But that's still speculative.

A caveat here though is, why are you considering this only now that there's an opening? How come you didn't apply for fellowship this cycle if you were interested? And why does this program have an opening? Not to dissuade you, but might be telling of your true feelings.
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