Clinical Opportunities

The child and adolescent psychiatry program takes advantage of San Diego’s diverse population to provide a rich educational experience.  Much of the first year is devoted to inpatient training at Rady Children’s Hospital.  This takes place both on the inpatient unit and on the consultation–liaison service, seeing patients on medical floors with psychiatric issues, as well as on child and adolescent medical/psychiatric inpatient units and the Emergency Room and Crisis Stabilization Unit.  The first year fellow also completes a rotation at Family Health Centers of San Diego as well as a longitudinal experience at Children's Outpatient Psychiatry. The second year is more fully devoted to outpatient services at clinics around the county. Traditional track fellows spend time at Rady's Outpatient Psychiatry Central Clinic and North County Clinics in Oceanside and Escondido. Community track fellows spend time at Vista Hill Foundation and San Diego Center for Children. Traditional track fellows select individual elective experiences including research, administration, clinical electives as well as international electives during the second year of training. Community track fellows complete a community track didactic/selective in place of the standard elective experience.

Community Track

The partnership between the Community Track (CPP) of the UCSD Child and Adolescent Psychiatry Fellowship, Family Health Centers of San Diego (FHCSD), San Diego Center for Children (SDCC) and Vista Hill Foundation (VHF), will place Child and Adolescent Fellows at FHCSD, SDCC and VHF sites in addition to Rady and other selective sites. The first phase of the Community Track would start July 2018, with placement of five first-year fellows at FHCSD (Year 1 Curriculum). The second phase, beginning in July 2019, will continue the Year 1 Curriculum (with a new set of fellows), as well as initiate placement of one second year fellow at SDCC and VHF outpatient sites (Year 2 Curriculum).

During Year 1, each first-year fellow rotates through FHCSD, spending ~2.5 months on site, 6 half day sessions per week. The new child mental health clinic at FHCSD in Barrio Logan Area (FCC-2) will be the main clinic with dedicated exam rooms for the UCSD fellow and faculty. FHCSD will dedicate space at its pediatric clinic in either Logan Heights or Diamond Clinic for integrated care model of training. FHCSD will devote two child adolescent psychiatrists to be voluntary faculty with UCSD to help train CPP child adolescent track fellows. Patient volume per half-day will be capped at 3.5. One half-day will be reserved for CPP child/adolescent placement, one half-day will be for UCSD/Rady outpatient clinic, and 2 didactic blocks will be protected.

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During year 2, the dedicated second community track fellow will provide outpatient services at a range of clinical sites at SDCC and VHF. These may include Residential program at SDCC, managed MediCal FFS program at SDCC, Merit High School, Substance abuse treatment, Parent Care, or other sites.  The fellow will have 6 half day sessions of outpatient care. This will protect half-day of mandatory Child Adolescent selectives and CPP didactics.

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Fellow Expectations and Supervision

Child and adolescent psychiatry fellows have completed at least 3 years of psychiatry residency, which includes at least two months of approximately 4 days / week of direct patient care for children and adolescents (most commonly on an inpatient unit). First year fellows enter fellowship well versed in safety evaluations, basics of psychopharmacology, psychiatric emergencies, and have carried longitudinal psychotherapy patients.

First-year fellows’ responsibilities include communicating effectively with family and collateral supports, providing psychiatric assessment, diagnosis, treatment planning (including recommendations for medications and psychotherapy), managing psychopharmacology, monitoring medical conditions as appropriate, participating in multidisciplinary teams, and running psycho-educational / CBT/ DBT groups and family meetings.

First-year fellows will review cases on a daily basis with a Board Certified or Board Eligible child and adolescent psychiatrist, who may be a UCSD faculty supervisor, or a staff attending.  Each fellow will be assigned a UCSD faculty member as site caseload supervisor, who will review cases with the fellow at least once per week.

Second-year fellows are expected to carry approximately 40 outpatients.  Responsibilities include psychiatric assessment, diagnosis, treatment planning (including recommendations for medications and psychotherapy), managing psychopharmacology, monitoring medical conditions as appropriate, participating in multidisciplinary teams. The second-year outpatient caseload is expected to include patients’ facing a range of the most common psychiatric disorders among children and adolescents (anxiety disorders, affective disorders, psychosis, eating disorders, OCD, ADHD)