Pediatric Neuropsychiatrist

[MissAmanda]

What is the most direct / shortest route of training to become a child neuropsychiatrist?

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[Manicsleep]

I guess that depends on what you really want to focus on.

There is no triple residency.
However you can do a Child fellowship and a neuropsych fellowship after either neurology or psychiatry. Both will be slightly different in their approaches.

Also you can do pediatrics, then do a portal program and then a neuropsych fellowship. This way you will be quadruple boarded 😱

 

[nancysinatra]

Also you can do pediatrics, then do a portal program and then a neuropsych fellowship. This way you will be quadruple boarded 😱

You mean, in pediatrics, adult psychiatry, child psychiatry, and neuropsychiatry? As opposed to being boarded in actual neurology?

You could also do child neurology, which is one residency, and then do a neuropsych fellowship which I presume is open to child neuro residency grads?

It depends on your interests...

 

[Manicsleep]

You mean, in pediatrics, adult psychiatry, child psychiatry, and neuropsychiatry? As opposed to being boarded in actual neurology?

Exactly, no neurology board. Actual or virtual.

You could also do child neurology, which is one residency, and then do a neuropsych fellowship which I presume is open to child neuro residency grads?

It depends on your interests...

Since the post is in a psychiatry forum I would think the OP would want a decent foundation in psychiatry. The child neurology program will not provide this. The vast majority of the psychiatry will have to be gleaned from the neuropsychiatry fellowship...which really isn't enough.

 

[nancysinatra]

Exactly, no neurology board. Actual or virtual.

Well if the person is mainly interested in psychiatry and secondarily in neuropsych, that seems fine, but then why bother with three years of pediatrics training? That was my point. A person interested in neuropsych who is going to be quadruple boarded MIGHT want one of their four boards to include neurology, I would think. Unless they are randomly choosing 4 specialties to be boarded in. Or, unless they want to do neuropsych but do not LIKE neuro, which seems odd.

Since the post is in a psychiatry forum I would think the OP would want a decent foundation in psychiatry. The child neurology program will not provide this. The vast majority of the psychiatry will have to be gleaned from the neuropsychiatry fellowship...which really isn't enough.

Yes I agree but your post also mentioned how they could do a child fellowship and then a neuropsych fellowship after neurology OR psychiatry residency. I assume with the neuro version of this you are referring to child neurology not child psychiatry since neuro residents cannot go into child psych fellowships. This in turn would be faster if done just by starting with the child neuro residency, I would think. No, of course someone mainly interested in psychiatry won't be well served with 4+ years of neuro training that don't address the psychiatric perspective. That's obvious. ;-)

The real problem is that there aren't that many neuropsych fellowships to begin with, and it isn't even all that clear that child neuropsychiatry is that distinct or developed of a field, although I suppose it depends how you define it.

 

[strangeglove]

I would be clear about what you were interested in treating as a "child neuropsychiatrist." There are certainly "neuropsychiatric" disorders that affect children (e.g. Tourette's, PANDAS, MR related to brain trauma), but these are commonly treated by child psychiatrists without any subspecialization. Neuropsychiatry as a subspecialty of psychiatry is mostly focused on dementias and neurodegenerative diseases that largely affect older adults, and most fellowships will expose you primarily to this population. There are combined psychiatry-neurology residencies, but most people who graduate from these programs practice either mostly neurology with a psychiatric bent or mostly psychiatry with a neurologic bent. None of these programs offer much in the way of pediatric exposure. If you are interested in developmental disorders, there is a developmental-behavioral pediatrics fellowship that is a subspecialty of pediatrics, which you can also enter through neurology, but usually not psychiatry, I imagine. This deals mostly with MR and its various causes.

 

[Manicsleep]

Well if the person is mainly interested in psychiatry and secondarily in neuropsych, that seems fine, but then why bother with three years of pediatrics training? That was my point. A person interested in neuropsych who is going to be quadruple boarded MIGHT want one of their four boards to include neurology, I would think. Unless they are randomly choosing 4 specialties to be boarded in. Or, unless they want to do neuropsych but do not LIKE neuro, which seems odd.

I have seen the portal program pathway done. Which was also why I put the 😱 after it. I wouldn't do it. It would be for someone who wants to be a pediatrician first, I am guessing here completely.

Yes I agree but your post also mentioned how they could do a child fellowship and then a neuropsych fellowship after neurology OR psychiatry residency. I assume with the neuro version of this you are referring to child neurology not child psychiatry since neuro residents cannot go into child psych fellowships. This in turn would be faster if done just by starting with the child neuro residency, I would think. No, of course someone mainly interested in psychiatry won't be well served with 4+ years of neuro training that don't address the psychiatric perspective. That's obvious. ;-)

The real problem is that there aren't that many neuropsych fellowships to begin with, and it isn't even all that clear that child neuropsychiatry is that distinct or developed of a field, although I suppose it depends how you define it.

A full neurology residency has a lot more elective opportunity to be exposed to psychiatry than does the child neurology residency which is very controlled. I am not familiar with child neurology fellowships.

Mostly I was using the neurology as an option to look into as opposed to psychiatry. I am quite familiar with psychiatry ACGME training requirements but for neurology its mostly a mix of conjecture, hearsay and assumption with a few facts thrown in.

RE: the field and whats available. Not much but you never know. Neuropsychiatry is relatively new as well. However, it is older than behavioral neurology 😀

 

[MissAmanda]

Great thoughts!

I have heard of a "pediatric neuropsychiatrist" and thought that would combine my interests into one package.

I like the research aspect and the training neurologists receive, but I envision myself practicing child psychiatry. Not sure if that makes sense.

I am most interested in focusing in autism, tourettes, MR.

The only path I can think of is doing a 5 year fast track psychiatry/child psychiatry program, and then a fellowship in neuropsych, which is 2 years as far as I know (any one year ones?). That is seven years.

Are there neuro fellowships child psych residents can do?

Are people who do a child neurology residency not eligible for any psych fellowships? I wonder if these fellowships would give a solid basis in psychiatry.

How much psychiatry can a child neurologist do anyway?

 

[rgerwin]

there are definitely 1 year neuropsych fellowships. i'm not sure how much peds is involved.

 

[maranatha]

Great thoughts!

I have heard of a "pediatric neuropsychiatrist" and thought that would combine my interests into one package.

I like the research aspect and the training neurologists receive, but I envision myself practicing child psychiatry. Not sure if that makes sense.

I am most interested in focusing in autism, tourettes, MR.

The only path I can think of is doing a 5 year fast track psychiatry/child psychiatry program, and then a fellowship in neuropsych, which is 2 years as far as I know (any one year ones?). That is seven years.

Are there neuro fellowships child psych residents can do?

Are people who do a child neurology residency not eligible for any psych fellowships? I wonder if these fellowships would give a solid basis in psychiatry.

How much psychiatry can a child neurologist do anyway?

Sorry, I can't really comment on the neuropysch fellowship, but can offer my thoughts on the more broad topic.

I know it's already been said above, but you really need to define what patient population you want to treat. If you're just interested in Autism, Tourettes, and MR, then you need to decide what aspect of those disorders you're more interested in. Neurologist and behavioral pediatricians are more often on the front lines of seeing those kids in regards to general diagnosis and basic treatment. You can easily go into pediatric neurology OR behavioral pediatrics and be an expert in those areas and run a clinic in developmental disorders.

In pediatric psychiatry, we don't usually see those kids until there is some type of co-morbid psychiatry problem. Examples include an autistic kid who is head banging, an MR kid with various behavioral issues, a Tourette's kid with ADHD, an MR kid who is really anxious, etc. Kids with autism and MR have high rates of co-morbid psychiatric symptoms, so you can end up doing a lot of work with them if you set that as your area of focus. Having a psych background can be very beneficial when those kids have more complicated problems. But if the kid is stable and not causing problems, then the other two specialist are more likely to treat them. Also, ped's neuro and behavioral ped's do have a background in some of the psych aspects, but not nearly as much training if you add in all the training from your adult residency.

If you're just interested in just those disorders, I would encourage you to look into pediatric neurology or behavioral pediatrics. It really is a great background for the 3 disorders you mentioned. However, if you also want to study other disorders such as anxiety, childhood schizophrenia, OCD, ADHD etc, then pediatric psych is the way to go. Also, if you're interested in a research career in those disorders you mentioned, you can definitely work in psych and be a valuable asset. In fact, much of the interesting autism work is coming from the psych side.

I hope that helps!

 

[MissAmanda]

Thank you for that response, I understand what you are saying. I like both psychiatry and neurology, these are the two fields I am torn between. I also know I would want to work with children. While I know these conditions we have been discussing are more often primarily treated by a neurologist, I like the life of a psychiatrist better than what I hear about neurologists. Both are fields I like though, and I thought pediatric neuropsychiatry would bridge these two field and combine my interests.

 

[MissAmanda]

bump

 

[Manicsleep]

bump

After one day?!

Please do neurology!

 

[MissAmanda]

After one day?!

Please do neurology!

lol!

is that because a psychiatrist would need a little more patience than one day for a post response?

 

[Manicsleep]

Well especially a child psychiatrist.
Most of the problems and headaches are with the parents. They don't change or get fixed. So you have to have infinite patience.

I like working with kids and still do sleep consults with FPs and pediatricians in our group. I cannot deal with child psychiatry because usually, in my experience at least, the patients aren't half as ill as the parents.