Training programmes

[mnc2006]

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Hi, I am in the UK and I am starting my CAMHS training. I would like to hear about the psychiatric training in the US to look at areas that I need to focus on.

I wonder how the basic psychiatric training is organised. and specifically about how child & adolescent psych training is organised. I have heard bits and pieces like dedicated liaison psych training, neurology placement. But what would a good training programme look like...

 

[Sneezing]

Well, for starters, a good program is most often the ones that offer you interviews.

Psychiatry is a 4 year residency to be a general adult psychiatrist. After this training you may seen child/adolescent if you wish but few do (unless rural) due to litigious nature and uniqueness of the specialty. The acrediting agency, ACGME, has minimal rotation standards that must be met. 2 months neurology, 4 months primary care, 6 months inpatient psychiatry, 2 months consult liasion, etc... Most programs will exceed the minimum of these rotations and have other sub specialty rotations like geriatric psych, or pain, or sleep to round off the education.

In the US after you finish a residency you are an attending. There is no lengthy weird hiearchial system like europe has. You can then call yourself a psychiatrist who is board elgible. Or like most people do you can take the boards (pass them) and say you are a board certified psychiatrist. (utility of board certification is its own topic) Since we aren't europe the reason we have a shorter pathway to be an attending after 4 years is because we work people longer and harder during those 4 years. There are no 56 hour work weeks here and vacation is anywhere from 2-4 weeks a year max.

You mentioned child. If you are interested in that you have two options. 1) complete 4 years of general psychiatry then apply (some time late in 3rd year) for 2 year child fellowships. 2) apply sometime in 2nd or 3rd year to get an overlap fellowship that starts in your 4th year and is still for 2 years. Think 3+2 as opposed to 4+2. Both will permit you to stall call your self an adult psychiatrist and sit for both boards.