Would doing a CAP fellowship be worth it for me?

[Buzzwacket]

I'm finishing up 4th year of medical school and I am strongly considering CAP given my previous experience and rotations.

The program I am most likely to get into has a fast track program, which means I would be done after 5 years. I really feel like I would benefit from the extra training, but I do not see myself only seeing CAP, but I would also like to see adults.

Ultimately, it seems that completing a CAP fellowship has it perks when it comes to jobs, and from what I have read, some CAP jobs are in higher demand. I understand the salary is basically the same per hour after time spent talking with the family. However, if I will be practicing for decades, it seems that 1 extra year isn't really anything in the grand scheme of things. Given the midlevel creep, I feel that specializing further would also be a little helpful.

Maybe I am incredibly naïve and have no clue what I am talking about but I would appreciate any feedback.

Thank you.

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[wolfvgang22]

You have 3 years in residency to decide. No rush. If you plan to see children and adolescents, or want to be a more well rounded psychiatrist for your own reasons, go for it. If not, don't. It's not something you do to make money.

 

[MacDonaldTriad]

There is no reason to commit to a 5 year program. It is easy to fast track into child after 3 years of training in adult. Except in academics, almost all child psychiatrist see some adults.

 

[Sushirolls]

What they said ^^^^

Also be aware there is a trickle down effect, many people start the Psychiatry training gauntlet enamored by the image of being CAP, but then reality strikes a sobering blow and many of these people change their mind.

Some stick it out, but after they finish fellowship they don't practice CAP.

Some less ideal programs have residents fleeing into CAP because their program is malignant and it is a way to reduce the pain by one year - in theory.

 

[Buzzwacket]

There is no reason to commit to a 5 year program. It is easy to fast track into child after 3 years of training in adult. Except in academics, almost all child psychiatrist see some adults.

Thank you for mentioning that! I did not know it was easy to fast track into a different program after 3 years.

 

[Merovinge]

Thank you for mentioning that! I did not know it was easy to fast track into a different program after 3 years.

It's easy as long as your program knows you want to do this, should be a brief discussion with your PD to make sure you met the ACGEM requirements by end of year 3. Don't worry 30-40% of your class is having the same conversation with her/him, they're used to it, it will also be fine if you stay and don't fast track.

 

[Bartelby]

CAP is the most valuable psychiatry fellowship. You go from in-demand (general psych) to basically a unicorn. If you like child psychiatry I think the fast track option is very much worth it.

With that said, see if you like it as a resident before getting too ahead of yourself. I actually wanted to fast track for personal/family reasons but couldn't get myself to enjoy CAP the way I enjoy working with adults, so I dropped the idea.

 

[NewYorkChildPsych]

CAP isn't a competitive fellowship, and a lot of people who start residency with plans to apply for it don't follow through. I wouldn't choose a 4-year "combined" adult/child program, and I wouldn't commit to a 5-year "fast-track" option out of medical school--because it's so easy to fast-track, you keep other options open (e.g. pursuing another fellowship or no fellowship at all), and you're fully trained in adult through the PGY3 year.

I lean heavily on skills I learned in adult training every day: I see and treat mostly adults now, and much of the child/adolescent work that I take on revolves around adult-aged family members. That said, my child training made me a more developmentally-informed (and trauma-informed) adult psychiatrist.

There's a huge demand for psychiatrists, even more so for CAP.

 

[clozareal]

I was also in the same boat as you but decided on a non-CAP track. Even when I decided to apply to CAP to fast-track, I wasn't 100% I wanted to do it, but enjoyed my CAP rotation enough to apply. I agree with everyone else—go to the general residency program that you like best and you can always fast track later on easily enough.

Now that I'm a CAP fellow, I realize that I enjoy working with children and adolescents (and their families) probably just as much if not more than adults. Being in high demand is a real thing I've felt during residency. Many families who come to the emergency room have a tough time finding a child psychiatrist for their kid. At least once during an ED shift, I have parents asking me if I had a private practice to take on their kid.

What they said ^^^^

Also be aware there is a trickle down effect, many people start the Psychiatry training gauntlet enamored by the image of being CAP, but then reality strikes a sobering blow and many of these people change their mind.

Some stick it out, but after they finish fellowship they don't practice CAP.

Some less ideal programs have residents fleeing into CAP because their program is malignant and it is a way to reduce the pain by one year - in theory.

Not just in theory. I know of one program where they didn't have any PGY4s for a few years (albeit being a new residency program) because all of them fled to fast-track CAP.

 

[pisekar]

Half on my class wanted to do child before starting residency (it was a large program), only 2 of us had the same desire when we finished the adult program. I really liked CAP training, it is different than adult psych. Do CAP if 1) you like treating kids etc or 2) you want to stay academia. Don't do because of money or prestige because you will lose 2 years of attending salary.