Pediatrics training for child psychiatry

[pixella]

I'm an MS4 applying to psych residencies, planning on pursuing child and adolescent psych. A number of programs I've applied to have an option to do peds during intern year instead of medicine, which I really like for two reasons: 1) I like peds more than medicine!, 2) it seems it would be really beneficial to have training in the medical care of my future patients, and more importantly, I think one could learn a lot about child development, the interplay of childhood illness and emotional health, and family dynamics from peds training.

So the caveat... there is one program that I really love for a variety of reasons, but probably wouldn't choose over some other more CAP-oriented programs, except there are some personal/family related reasons that I feel very strongly about ranking it #1. However, there is no option to do pediatrics during intern year there. Any input from current residents interested in CAP, CAP fellows, or CAP attendings on the importance of the pediatrics experience? Thanks!

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[notdeadyet]

It may vary a bit by program, but at most of them, the "child option" in your PGY-1 year amounts to replacing one of the internal medicine rotations with pediatrics and sometimes one of the inpatient neurology rotations with child neurology.

It's fun having a couple of months working with kids when that's your thing, but I don't see how missing out on it could really have a negative impact on your career going into CAP. I'd be careful about overestimating the amount of time you'll spend learning about things like

child development, the interplay of childhood illness and emotional health, and family dynamics

I enjoyed working more with children than I would have otherwise, but as a visiting intern, I spent most of my pediatrics time managing URIs, DM, asthma exacerbations, and a lot of well children with worried parents. Fun, but nothing that I think that would make or break you down the road.

 

[Daftrage]

It may vary a bit by program, but at most of them, the "child option" in your PGY-1 year amounts to replacing one of the internal medicine rotations with pediatrics and sometimes one of the inpatient neurology rotations with child neurology.

It's fun having a couple of months working with kids when that's your thing, but I don't see how missing out on it could really have a negative impact on your career going into CAP. I'd be careful about overestimating the amount of time you'll spend learning about things like

I enjoyed working more with children than I would have otherwise, but as a visiting intern, I spent most of my pediatrics time managing URIs, DM, asthma exacerbations, and a lot of well children with worried parents. Fun, but nothing that I think that would make or break you down the road.

I completely agree here. I subbed one med inpatient month for Peds and although I enjoyed it and am glad I did it, I don't know I really learned anything that applicable for child psych. And I did my child psych month 1 month after finishing peds.

 

[Sneezing]

The option for doing a peds month is so far down the list of things to consider when ranking a program, you may as well not even consider it.

 

[TexasPhysician]

I found my peds months to be excellent! Definite plus of my program.

I think my peds months made me a better psychiatrist, and I would definitely do it again.

 

[Chimed]

If you know without any doubt that you want to to a CAP fellowship, then doing peds during your intern year is a good idea. I was fairly certain I'd go into child psych as an intern, but wasn't 100% positive until my 2nd year. I ended up doing adult medicine because it was easier logistically and because I wanted more background for Step 3. It was a good experience and helped with my adult training. In retrospect, I would have liked more ped's experience. However, I have enough of a background through medical school that I feel comfortable with medical issues in my child fellowship. In general, you'll see less psych related medical issues in child then in adult.

 

[pixella]

I should clarify that the programs I'm looking at do not just pay lip service to peds, but actually substitute it for medicine, such that interns would do 4-6 months of peds (or even more at some programs), and 0-1 month medicine. Does that change any of your opinions?

TexasPhysician, how would you weigh the opportunity to do the peds training against other factors, such as a personal/location factors? I know it's hard to say for sure since I'm being nebulous about what exactly those factors are, but anonymity is important to me

 

[TexasPhysician]

Location is pretty huge. My opinion - location trumps all as long as the location has a decent program. Peds is much more fun than IM!

 

[billypilgrim37]

Just like pre-meds worry way too much about M1 year when making decisions about med schools, medical students worry way too much about intern year when making residency decisions. Having peds available for your medicine rotations is about as important as having good parking options at all of your sites. That sounds demeaning to pediatrics, but it's totally not. Parking is a big deal! And lots of things are a big deal. But not much is bigger than location and family related issues and just your general comfort around the place.

 

[pixella]

Just like pre-meds worry way too much about M1 year when making decisions about med schools, medical students worry way too much about intern year when making residency decisions.

Ha, this is so true! I give tours to med school applicants and I'm always cautioning them not to forget to think about school differences in the clinical years. I should probably extrapolate that advice to myself, huh?

And lots of things are a big deal. But not much is bigger than location and family related issues and just your general comfort around the place.

This is very true, and the reason I will probably end up ranking the no-peds program #1 anyway.

 

[Socrates25]

I'm not a psychiatrist, but IMHO if you know for sure you want to do child psych then doing a peds intern year should be a no-brainer.

Doing IM for a year wont teach you anything about pediatric behavior and development whereas a peds intern year will. Peds behavior/development exposure is crucial to doing child psych as a career IMHO

 

[pixella]

I'm not a psychiatrist, but IMHO if you know for sure you want to do child psych then doing a peds intern year should be a no-brainer.

Doing IM for a year wont teach you anything about pediatric behavior and development whereas a peds intern year will. Peds behavior/development exposure is crucial to doing child psych as a career IMHO

Are you a pediatrician? I have received this advice from a developmental peds person I know. While it makes sense, remember, pediatric behavior and development should be covered extensively during child psych fellowship (thoughts from fellows/prior fellows on whether this is true?).

 

[strangeglove]

You would be wise not to short-shrift adult medicine. Even as a child psychiatrist, you will likely see more adult patients with medical problems in your career than child patients with medical problems. Also, you don't want to be the PGY 2 resident who doesn't know how to work up chest pain or delirium (both more commonly encountered in adults than children). This is especially true if you plan to moonlight in a hospital with an adult psych unit at any point.

 

[pixella]

Good point, unless of course I focus on child C/L.