Starting psychiatry residency soon - will be fast-tracking to CAP fellowship, seeking advice

[milan95]

Hello all,
I am starting psychiatry residency soon, and will be fast tracking to a CAP fellowship in 2+ years. Since I will need to show a clear interest in child psychiatry in the next 2 years in order to match into fellowship, I would like some advice on what I can do to develop my resume. Thank you!

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[Celexa]

Honestly, you don't need to do anything special to demonstrate your interest in child. Fellowship applications aren't like residency. No one thinks you're applying to child psych for any reason other than to be a child psychiatrist.

The best thing you can do for your app is focus on performing well in residency, on all of your rotations, regardless of their proximity to child.

 

[ksharp33]

Child psych is not a competitive fellowship.

 

[annoyedpsychiatrist]

matching into child psych will be cake, unless you have a very specific place in mind. Even then its likely still very doable. a lot of psych fellowships struggle getting people

 

[wolfvgang22]

Agree with all the above. The only time it's hard to match into child psych, assuming you do a good job as a resident, is when everyone in your class wants to be in your home fellowship program and there aren't enough fellowship spots. Happened to me. I ended up matching anyways at a different "prestigious" program. I was odd man out because I came from another state.

 

[Fluidity of Movement]

Sorry to hijack but I've just started researching CAP and this post showed up. How does the fast-track work? Is it 4 years or 5 years? Do you have to transfer programs or can you only apply to things in-house? Do you still sit for the regular psych boards?

 

[TexasPhysician]

Hello all,
I am starting psychiatry residency soon, and will be fast tracking to a CAP fellowship in 2+ years. Since I will need to show a clear interest in child psychiatry in the next 2 years in order to match into fellowship, I would like some advice on what I can do to develop my resume. Thank you!

1. Maintain a pulse
2. Complete PGY1-3
3. At least attempt to complete the child applications

 

[Coupd'Cat]

Sorry to hijack but I've just started researching CAP and this post showed up. How does the fast-track work? Is it 4 years or 5 years? Do you have to transfer programs or can you only apply to things in-house? Do you still sit for the regular psych boards?

1. Residents apply for fast-track in PGY3 year to be able to start CAP fellowship in lieu of a fourth year in their home residency. The standard length of CAP fellowship is two years.
2. You can choose to transfer or apply to your home residency's CAP fellowship. Some residency programs have spots for incoming residents who already know they would pursue CAP fellowship and commit to continuing on in the home institution's CAP fellowship. These programs may have more tailored requirements for their CAP-destined residents (such as rotating on the child unit versus another month on the adult inpatient unit).
3. From AACAP: "
In order to be Board-eligible in general ("adult") psychiatry, you need to complete four years of post-graduate training. One year of this can be spent in the first year of a CAP residency, and this will count toward general psychiatry Board certification. Therefore, if you enter CAP training as a PGY-4, but decide after a year that it's not for you, and you decide not to do the second year of your CAP residency, you will still be able to take your general psychiatry Boards.

In order to be Board-eligible in child and adolescent psychiatry, you’ll need to complete two years of child and adolescent psychiatry training, and be Boardcertified in general psychiatry. Residents entering their residency as PGY-4s usually take their general psychiatry Boards in their PGY-5 year (the second year of the CAP residency), and take their CAP Boards after they are out of training and have passed their general psychiatry Boards. However, residents can opt to wait to take any Board examination until all training is completed."

 

[Fluidity of Movement]

Thanks so much! I browsed the sites but finding the right info is difficult, and always worried I'll miss something important.

 

[Merovinge]

Thanks so much! I browsed the sites but finding the right info is difficult, and always worried I'll miss something important.

Just for background, they make CAP fast tracking very easy intentionally. This whole plan was put into place to increase the number of people going in to child psychiatry when the numbers showed such a huge gap in care. Whoever had the idea was a genius, as a significant majority of people do fast track, and I am so glad that I did so. The only people I know who have anything resembling regret for fast tracking have plans to practice a significant amount of adult psychiatry and missed some electives.

 

[psyqe21]

1. Maintain a pulse
2. Complete PGY1-3
3. At least attempt to complete the child applications

I very much hope this is still holding up as the status quo. General psychiatry has become fairly competitive. I am on an accelerated child track at my institution and am a PGY-2. We do not have a fellowship, but I will be applying to fellowships this July to start training in 2024. I have a list of about 20 programs, but there is one I really want to match into: they have a lot of seats for fellowship (they have nine current first-year fellows...).

I am part of the inaugural class of my residency program, so I wonder if that will hinder my chances: we are unknown as of yet, but my training has been excellent as our faculty came from a university setting.

 

[TexasPhysician]

I very much hope this is still holding up as the status quo. General psychiatry has become fairly competitive. I am on an accelerated child track at my institution and am a PGY-2. We do not have a fellowship, but I will be applying to fellowships this July to start training in 2024. I have a list of about 20 programs, but there is one I really want to match into: they have a lot of seats for fellowship (they have nine current first-year fellows...).

I am part of the inaugural class of my residency program, so I wonder if that will hinder my chances: we are unknown as of yet, but my training has been excellent as our faculty came from a university setting.

Most child programs heavily favor internal applicants. Some years child fellowships have more internal applicants than spots. Outsiders have an almost 0% chance those years. Those same programs can end up with 0 internal applicants the next year and be desperate for anyone.

The constant is that there are always unmatched open positions. Competitiveness at each program is just highly variable because most people don’t want to move for 2 years.

I could have easily matched at a more prestigious child program, but I already had my moonlighting jobs, knew awesome co-residents that would do the fellowship with me, had minimal call, and I essentially had my first future job lined up. The group of us only applied to 1 child program each - our own.

 

[Celexa]

I very much hope this is still holding up as the status quo. General psychiatry has become fairly competitive. I am on an accelerated child track at my institution and am a PGY-2. We do not have a fellowship, but I will be applying to fellowships this July to start training in 2024. I have a list of about 20 programs, but there is one I really want to match into: they have a lot of seats for fellowship (they have nine current first-year fellows...).

I am part of the inaugural class of my residency program, so I wonder if that will hinder my chances: we are unknown as of yet, but my training has been excellent as our faculty came from a university setting.

Psych in general is becoming more competitive for several reasons: lifestyle, pay, job market. Good tangible reasons. Easy to see.

The thing is there's no economic incentive to do fellowships in psychiatry. You don't earn more money. The opportunity cost is huge. You don't need them to get a good job.

Therefore, the forces making psychiatry more competitive do not affect the competitiveness of the fellowships and are not expected to in the foreseeable future.

 

[esob]

Psych in general is becoming more competitive for several reasons: lifestyle, pay, job market. Good tangible reasons. Easy to see.

The thing is there's no economic incentive to do fellowships in psychiatry. You don't earn more money. The opportunity cost is huge. You don't need them to get a good job.

Therefore, the forces making psychiatry more competitive do not affect the competitiveness of the fellowships and are not expected to in the foreseeable future.

I have noticed that CAP in academics (all other things being equal) does pay slightly more than gen psych. That's not to say that reimbursement should be the sole reason someone does a fellowship, but I also remember an attending noting that CAP was the only subset of psych that was reimbursed better. This goes against the common logic that pedi specialties pay less because of Medicaid. Hence, I'm curious about what drives the pay differential (at least in academics).

 

[TexasPhysician]

I have noticed that CAP in academics (all other things being equal) does pay slightly more than gen psych. That's not to say that reimbursement should be the sole reason someone does a fellowship, but I also remember an attending noting that CAP was the only subset of psych that was reimbursed better. This goes against the common logic that pedi specialties pay less because of Medicaid. Hence, I'm curious about what drives the pay differential (at least in academics).

CAP pays a tiny bit more usually from more therapy codes and 90785. More academia centers have a standard time frame for patients, so the difficulty attracting CAP and slightly better codes leads to better pay.

That said, this doesn’t translate to private practice. True volume practices will earn more with adults than children. Child training does increase the odds of a successful cash only practice though.

 

[comp1]

The competition involved with getting into medical school is so traumatizing for us that we have a lot of trouble seeing something as different from that. It's really important that people conceptualize everything as decreasing in competitiveness after that. Yes, psychiatry is competitive, but the numbers are much more in your favor than they ever were to get into med school. Fellowship in pretty much anything is...not competitive. Certain locations might be and if you're deadset on one specific location, then you need to be schmoozing the people AT that location. Regardless, it's not about building some sort of general competitiveness. This becomes even more true when you are looking for real jobs. Yes, if you want that 100% telework, never come to the office ever again high salary job, it might be a little competitive. But it's still less competitive than psych residency was to get into.

 

[psyqe21]

The competition involved with getting into medical school is so traumatizing for us that we have a lot of trouble seeing something as different from that. It's really important that people conceptualize everything as decreasing in competitiveness after that. Yes, psychiatry is competitive, but the numbers are much more in your favor than they ever were to get into med school. Fellowship in pretty much anything is...not competitive. Certain locations might be and if you're deadset on one specific location, then you need to be schmoozing the people AT that location. Regardless, it's not about building some sort of general competitiveness. This becomes even more true when you are looking for real jobs. Yes, if you want that 100% telework, never come to the office ever again high salary job, it might be a little competitive. But it's still less competitive than psych residency was to get into.

I think you hit the nail on the head - I definitely have trouble seeing something as different from that. I also didn't match into psychiatry residency in my first attempt and did a transitional year residency program in internal medicine prior to matching into residency. Add that to the trauma list!

I tried not to be, but I have become deadset on a particular program in the south. However, I am making my list of programs to apply to and making sure I'd be happy at any/all of them. It seems that the significant majority of CAP fellowships are great as is, so I am selecting mostly based on location. I also want to do academics as I've come to really enjoy the teaching aspects of the work, so that does make academic programs far more alluring to me.

 

[Mad Jack]

Matching into a decent C&A program is so easy you would basically have to go out of your way not to do so. Having a specific program in mind makes it more challenging since programs are quite small, and quite frankly 95% of it seems to come down to personality and fit more than anything you can change on a sheet of paper.

 

[Mad Jack]

1. Maintain a pulse
2. Complete PGY1-3
3. At least attempt to complete the child applications

4. Having failed to complete PGY-1-3, beg for accomodations of missed months.
5. Having failed to complete the child applications, make a few phone calls after the match to places with open slots.

 

[Mad Jack]

I have noticed that CAP in academics (all other things being equal) does pay slightly more than gen psych. That's not to say that reimbursement should be the sole reason someone does a fellowship, but I also remember an attending noting that CAP was the only subset of psych that was reimbursed better. This goes against the common logic that pedi specialties pay less because of Medicaid. Hence, I'm curious about what drives the pay differential (at least in academics).

The pay difference comes down to demand. It's really, really hard to get a C&A attending