Path to Pediatric Consult-Liaison Psych

[mm2021]

Hi,
I am an M4 applying this year with an interest in eventually going into pediatric consult-liaison psych (or a pediatric psycho-oncology would be cool too, but I imagine those jobs are pretty rare). I'm wondering how difficult it is to find this kind of a position after residency? Are there certain residencies/child fellowships that offer more clinical exposure or research in this area (I'm aware of triple boards, but there are only a few programs in my geographic region)?

---

Members don't see this ad.

 

[nexus73]

I’d try to match at a large academic center with good exposure to inpatient consults, good child psych fellowship, and has a cancer treatment center where psych residents rotate for consults.

 

[Sushirolls]

Cleveland Clinic will likely be on the list to consider.

 

[Merovinge]

This is one of the very few cases where I would highly encourage you to consider triple board programs. Past that, simply google top Children's Hospitals in America and I believe 10/10 will have the CAP fellowships you want. You must do fellowship at a location with a very strong children's hospital, 98% of CAP do not do CAP C&L so many very strong programs will not have the same things you are looking for.

All that said, don't lock yourself in. I was strongly considering CAP C&L and now it's probably the only area of CAP that I would not take a job in after 4 years of attendinghood.

 

[kopftonmd]

All that said, don't lock yourself in. I was strongly considering CAP C&L and now it's probably the only area of CAP that I would not take a job in after 4 years of attendinghood.

Why is that?

 

[letsdothis2020]

This is one of the very few cases where I would highly encourage you to consider triple board programs. Past that, simply google top Children's Hospitals in America and I believe 10/10 will have the CAP fellowships you want. You must do fellowship at a location with a very strong children's hospital, 98% of CAP do not do CAP C&L so many very strong programs will not have the same things you are looking for.

All that said, don't lock yourself in. I was strongly considering CAP C&L and now it's probably the only area of CAP that I would not take a job in after 4 years of attendinghood.

I'd like to know why as well. thank you!

 

[TexasPhysician]

I agree with going to a top 10 referral children’s hospital. Most programs do not emphasize peds C&L. It is a tiny field outside of massive systems, and it generally doesn’t pay well.

 

[reca]

This is one of the very few cases where I would highly encourage you to consider triple board programs. Past that, simply google top Children's Hospitals in America and I believe 10/10 will have the CAP fellowships you want. You must do fellowship at a location with a very strong children's hospital, 98% of CAP do not do CAP C&L so many very strong programs will not have the same things you are looking for.

All that said, don't lock yourself in. I was strongly considering CAP C&L and now it's probably the only area of CAP that I would not take a job in after 4 years of attendinghood.

We do a month of peds C&L at my program. Surprisingly, although we have quite a few triple boarders, none of them do peds C&L. All the C&L attendings are normal CAP trained (albeit at programs associated with large children's hospitals).

 

[mm2021]

This is one of the very few cases where I would highly encourage you to consider triple board programs. Past that, simply google top Children's Hospitals in America and I believe 10/10 will have the CAP fellowships you want. You must do fellowship at a location with a very strong children's hospital, 98% of CAP do not do CAP C&L so many very strong programs will not have the same things you are looking for.

All that said, don't lock yourself in. I was strongly considering CAP C&L and now it's probably the only area of CAP that I would not take a job in after 4 years of attendinghood.

I am very interested in knowing why this is also!

 

[Merovinge]

Why is that?

C&L CAP work essentially ties you to being an academic clinician, and while I love to teach and could possibly see myself in a clinical educator role, you lose several things: 1) Money (huge paycut on the order of 30-50%, the best programs often pay the least) 2) Geographic flexibility (must be at very specific places for small openings) 3) Call (even with fellows covering primary, taking call when getting paid pennies is hard to swallow as an attending).

I do find the work itself profoundly meaningful, and it is great to work with pediatric specialists of other disciplines who are likely at the top of their game. Many people in CAP will tell you that finding a way to work with adults during the day can be intellectually refreshing and I can't imagine many ways to stay better intellectually refreshed then academic CAP C&L work.

If you are instead talking about CAP C&L in a more rural or non-academic hospital, I've done a bit of that and it's frustrating for an entirely different set of reasons. 1) Lack of resources both inhouse for the patient and following discharge 2) Poor reimbursement, these remain some of the most complicated cases if you work on RVUs or even collections neither will remotely make up for the time it takes to do high quality work 3) Difficulty transferring to inpatient psychiatry - somehow family's, primary teams and even hospital administration will have negative transference towards you when you note that the kid who ODed on antifreeze needs inpatient psych following medical stabilization... (definitely has not ever happened to me ).

 

[alina_s]

It’s been a while, but I think we did 3 months of C&L at U. Washington. I think Stanford had lots as well. Freestanding children’s hospitals probably help with the exposure.

 

[Marasmus1]

Cleveland Clinic CAP have you do 6 months of core C/L in the first year which I found a little excessive.