The Outpatient Psychiatry Division of Rady Children's Hospital is located one mile from the central campus of Rady Children's Hospital. The Division also operates satellite clinics in Oceanside and Escondido (20 miles from Rady Children’s Hospital), as well as a host of school-based programs throughout San Diego County. The clinic averages 60 new intakes per month with an ongoing case load of 800 patients, accounting for approximately 1,400 visits per month.
All traditional track residents have a required part-time rotation in the Outpatient Psychiatry Division. This rotation takes place at the main San Diego clinic. A majority of patients are between 5 and 15 years of age but patients between 3 and 18 are served. Patients from all diagnostic categories are represented, including developmental, mood, anxiety, psychotic, eating, disruptive, and elimination disorders. Most referrals are for externalizing disorders (ADHD, Oppositional Disorders and Conduct Problems), many of whom also have academic or learning problems. The population consists of a diverse ethnic mixture with 98% public funded and 2% private insurance and self-pay patients. Second year fellows on the traditional track spend three days per week at Rady's Outpatient Psychiatry at the Central clinic near Rady Children's Hospital or in one of the satellite clinics in Oceanside or Escondido (one day per week).
The San Diego Clinic is organized clinically and administratively into 3 multidisciplinary teams. Each team is comprised of senior staff and trainees from the disciplines of psychiatry, psychology, social work, and marriage and family therapy. Teams meet weekly for 1.5 hours. All new cases that have been evaluated in the preceding week are discussed. Diagnostic considerations and treatment issues are reviewed with the goal of developing a team-oriented intervention plan. Challenging clinical cases in ongoing treatment as well as administrative questions are also routinely discussed.
Treatment approaches are varied but include individual, family, group, pharmacotherapy, behavior therapy and parent training techniques. The case load for 1st Year residents is approximately 10-12 patients and for 2nd Year residents is 40-50 patients total, including 6-8 long-term psychotherapy cases, 1 diagnostic every other week, and medication evaluations. Residents have 3 hours of individual supervision weekly. The faculty includes 3child psychiatrists, 3 psychologists, 5 psychiatric social workers, and 7 marriage and family therapists. The Outpatient Clinics are also a training site for the disciplines of psychology, social work, and marriage and family therapy. Trainees rotate on a yearly basis.