Triple Board Program

Transcription

1 Overview The University Health Centers of Pittsburgh Triple Board brings together premier programs in pediatrics, adult and child & adolescent psychiatry, as well as clinical and research strengths at the interface of these fields. Each component is outstanding in its own right, and we are striving to create a well-integrated training experience that builds upon these strengths. Western Psychiatric Institute and Clinic (WPIC) and Children's Hospital of Pittsburgh (CHP), under the auspices of the University of Pittsburgh School of Medicine, are the participating institutions and the primary clinical sites for Triple Board training. WPIC and the Department of Psychiatry are national leaders in clinical care, research and education. The Department of Psychiatry is one of the largest and most academically productive psychiatric departments in the nation, and offers advanced diagnosis and treatment for psychiatric disorders across the age range. The prominence of the academic activities in the department is reflected in its receiving more NIMH funding than any other department in the US. 289 inpatient bed facility at WPIC serving more that,000 patients a year. There were 2,738 psych ER visits last year to WPIC. There are 32,000 individuals under WPIC s care accounting for 400,000 outpatient visits. There are currently over 200 full-time faculty specializing in a variety of psychiatric disciplines, many of whom are acknowledged leaders in their fields. WPIC also provides psychiatric consultation to more than 2,000 patients annually within the University of Pittsburgh Medical Center (UPMC), one of the largest integrated health care delivery systems in the US. The Department of Pediatrics and Children s Hospital of Pittsburgh (CHP) have an excellent reputation for patient care, postgraduate teaching and academic excellence. CHP is consistently ranked among the top children's hospital in the country. A brand new 296 bed capacity hospital, opened May Children's is the only hospital in western Pennsylvania dedicated to the care of infants, children and young adults. More than 3,000 admissions a year, half of which are treated primarily by medical services. More than 400,000 outpatient encounters and about 60,000 visits to the emergency room, where residents have first line responsibility in the care of the patients. The academic program within the Department of Pediatrics continues to grow. Considering total NIH funding of Children's Hospital and the Department of Pediatrics, we now rank ninth in the country among all departments of pediatrics, whether they report funding through a children's hospital or a university. Triple Board Program (TBP) Residents Each year, two TBP residents will join 28 categorical pediatric residents, 4 medicine/pediatric residents, 2 family practice/psychiatry residents and 3 general or combined adult/child psychiatry residents at the PGY level. At the end of 5 years of training, TBP residents will have completed 24 s of pediatrics, 8 s of general psychiatry and 8 s of child & adolescent psychiatry. The program is designed to provide a planned and integrated educational experience, with graduated responsibility for patient care and teaching as residents advance. Interaction with pediatric and psychiatric resident colleagues is ongoing, both in the clinical settings and within didactics. The formal educational curriculum is ongoing throughout the 5 clinical years, with, on average, a minimum of 5 to 6 hours a week of classroom or other formal instruction. Additionally, a pediatric and/or child psychiatry faculty supervisor will meet with a resident regularly throughout training, to discuss clinical issues encountered in all training experiences. The Triple Board program actively tries to incorporate and integrate a combination of pediatrics, psychiatry, and child psychiatry into each of the five years of training. Page of 5

2 Year One The clinical emphasis during the PGY year is on pediatric medicine. Interns spend a total of 0 s that year in pediatrics - 6 s on inpatient units (general medical inpatient as well as neurology, pulmonology, endocrinology/ hematology, oncology, renal and GI), one in NICU, and the remaining 3 s in ambulatory care (emergency medicine, primary care and the newborn nursery). Call is a combination of night float and Q4 during the intern year. In addition, ½ day a week is spent in a pediatric continuity clinic, an experience that continues throughout the 5 years of training. During pediatric time, residents attend a daily one hour pediatric didactic session and participate in daily morning report and teaching rounds. PGY PSYCHIATRY 6 s 2 s 2 s Inpatient Units NICU ER primary care/newborn nursery DEC Two s of this year are spent in the Psychiatric Emergency Room (DEC), providing a vigorous introduction to psychiatry. Two weeks of this rotation are spent on the night shift with one to one attention by an attending psychiatrist. During either the first or the second half of the academic year, residents will join their PGY psychiatry colleagues for Thursday afternoon didactics for 6 s. This is scheduled concordant with the resident's DEC experience. Year Two Five s of PGY2 focus on pediatrics, with two weeks each of the Child Development Unit and adolescent medicine clinic and one each of the emergency room, NICU, PICU and as a senior on an inpatient unit. Responsibilities during these first 4 s build on the first year experiences and include supervision of more junior residents and medical students. As a senior on pediatrics, call is done via a night float system. There is also elective time on the pediatric side. PGY 2.5 s CDU/ adol/ elect IP SR - Inpatient senior adult C/L - adult consultation-liaison ER PICU NICU IP SR ADULT PSYCHIATRY 3.5 s 2 s Inpatient adult neuro adult C/L Units Interpersonal Psychotherapy Patient Residents will then transition to psychiatry where they complete rotations on the adult psychiatry inpatient units (3.5 s to include adult mood, psychosis, dual diagnosis and child and adolescent psychiatry) and on the adult psychiatry consultation/liaison service (2 s) at the large tertiary care adult medicine hospital within the UPMC Health System. Residents also begin seeing adult longitudinal psychotherapy outpatients during this time, the focus being on the use of interpersonal psychotherapy (IPT). Psychiatry call is approximately Q8. During PGY2, residents participate in weekly psychiatry didactics (on Thursday afternoons) for the entire academic year. This continues throughout the remainder of training. Residents will also complete one of adult neurology during this academic year. Residents will continue with /2 day per week in pediatric continuity clinic with the option of transitioning to a /2 day every other week depending on career goals. Page 2 of 5

3 Year Three This academic year typically begins with six s of pediatrics, one in the Neonatal Intensive Care Unit (NICU), two s as inpatient senior (subspecialty, adolescent and general medical), two weeks as the supervising resident for the Acute Concerns Service and 6 weeks of subspecialty elective. ADULT PSYCHIATRY 2 s 6 weeks 2 weeks 6 s PGY 3 child neuro NICU IP SR SSE ACS Outpatient Adult Psychiatry Long Term Dynamic Psychotherapy and CBT ACS - Acute Concerns Service SSE- Subspecialty elective The remaining 6 s are devoted to adult psychiatry outpatient training with exposure to diverse populations including: adult mood disorders, geriatrics, the chronically mentally ill and child and adolescent psychiatry. This completes all adult psychiatry training requirements for the triple board trainee. The resident's adult psychotherapy training resumes in the second half of the academic year with an emphasis on cognitive behavioral therapy (CBT). Additionally residents may begin seeing a longitudinal psychodynamic psychotherapy patient. Didactics also focuses on dialectical behavioral therapy (DBT), group therapy and family therapy. During the spring, the trainee also begins a child and adolescent psychiatry continuity clinic ½ day/week with senior triple boarders. Year Four This year includes four s of pediatrics subspecialty electives. This will complete the required pediatrics portion of the training, with the exception of the pediatric continuity clinic which will continue throughout the five years of training. CHILD & ADOLESCENT PSYCHIATRY 3 s 4 s 2 s 2 s PGY 4 IP SR SSE Inpatient Child and Adolescent Units AAPHP CHP C/L Child & Adolescent Psychiatry Continuity Clinic AAPHP - Adolescent Acute Partial Hospitalization Program CHP C/L- Children's Hospital consultation and liaison Eight s of the year are concentrated in child and adolescent psychiatry. Experiences include: 4s on inpatient units (2 s on general child & adolescent unit and 2 s on the John Merck Inpatient Unit for Mental Retardation, Autism and Developmental Disabilities), followed by 2 s at the Adolescent Acute Partial Hospitalization Program, Page 3 of 5

4 then 2 s on the pediatric psychiatry consultation/liaison service at CHP. There is also one of child psychiatry elective time this year. During this year, fellows begin longitudinal psychotherapy with a minimum of 2 child and adolescent patients (child CBT and child psychodynamic). The latter two experiences continue throughout the remainder of training. During this academic year, residents take call from home for the pediatrics psychiatry consultation-liaison service, an average of 7 weeks throughout the academic year. Year Five Child and adolescent psychiatry training is completed over the course of the remaining 2 s of this final obligatory training year. One focuses on the Infancy/Early Childhood population at Matilda Theiss Center for Child Development and one at the Center for Overcoming the Problems of Eating (COPE). Residents continue their child and adolescent outpatient continuity clinic /2 day per week and participate in a unique family therapy experience with the clinical psychology interns /2 day per week for 6 s. This clinic is supervised live by 2 instructors, providing hands on feedback and guidance for development of family therapy skills. CHILD & ADOLESCENT PSYCHIATRY 2 s PGY 5 Matilda Theiss Center - Center for Overcoming the Problems of eating (COPE) - Outpatient/Electives Forensics/School/Community Consultation Experiences Family Therapy Clinic - 4 s C & A Psychiatry Continuity Clinic The predominant focus of the remaining 0 s is on outpatient experiences and electives. Outpatient experiences which are required include forensics, school consultation, and community psychiatry. A wide range of elective experiences are available and include clinical and teaching senior residencies, neuropsychology, managed care, administrative and research experiences. Year Six/Research Fellowships Consistent with the guidelines developed by the ABP and ABPN, the University of Pittsburgh TB program seeks to prepare clinical physicians for the medical challenges of the 2 st century by training them to evaluate critically new and established approaches to the assessment and treatment of mental and emotional disorders across the age range. We also seek to recruit and training physicians who are likely to pursue academic and research careers and to make valuable contributions in the areas of scientific knowledge, education, program development and/or health and mental health care policy. In an effort to encourage academic development in the pediatrics/psychiatry interface, we offer research fellowships to qualified candidates with a talent for and interest in a research career. The Departments of Pediatrics and Psychiatry have faculty involved in research in all areas of mental disorders in childhood and adolescence, including developmental psychopathology, psychobiology of illnesses, neuroimaging, assessment and treatment, as well as services and outcome research. All TBP trainees will have a clinical and academic mentor throughout their training to assist in career development and decision making. We continue to be excited about this program, by the quality of applicants drawn to the challenge of triple board training and the possibility of having such individuals train here at the University of Pittsburgh. The program also gives two very strong and nationally recognized academic departments the opportunity to shape the future direction of our fields by training tomorrow s leaders in clinical care, research and education. Page 4 of 5

5 APPLICATION PROCEDURE & ADDITIONAL INFORMATION Applicants for the Triple Board Residency Training Program must be a senior in an approved medical school or hold an MD degree. We encourage applications from minority students. Applicants with specialty training in other areas of medicine are also welcome. Applications are accepted through the Electronic Residency Application Service (ERAS). We require a complete application form, personal statement (including a statement regarding areas of interest), medical school transcript and three letters of reference. Applications will be accepted until December 3. After completion of the review process by the Selection Committee, applicants will be notified by or mail. Dates for the interview will be determined at the time of the invitation. We generally interview on Mondays, November through early January. For more information, please contact: Abigail B. Schlesinger, MD Director, Child & Adolescent Psychiatry Residency Training Western Psychiatric Institute & Clinic 38 O'Hara Street Pittsburgh, PA 523 Telephone: (42) schlesingerab@.upmc.edu Page 5 of 5