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Residency Training - Child and Adolescent Psychiatry

Clinical Rotations

Child and Adolescent Psychiatry Clinical Rotations

Overview of the First Year Clinical Rotations

4 Months at NYP Weill Cornell Medical Center

  • Adolescent Partial Hospital Program -- 3 months
  • Pediatric Consultation-Liaison Service, Neurology, and Neonatal Follow-Up Clinic -- 1 month
  • Family Therapy Supervision -- part-time over 3 months

4 Months at Weill Cornell Psychiatry Westchester Division

  • Children's Inpatient Unit (Nichols Cottage) -- 2 months
  • Adolescent Inpatient Unit (2 North) -- 1 month
  • Adolescent Eating Disorder Unit (2 South) -- 1 month
  • Center for Autism and the Developing Brain (Outpatient Department) -- part-time over 4 months

4 Months at NYP Morgan Stanley Children's Hospital of New York

  • Pediatric Consultation and Emergency Service -- 4 months
  • Neurology Clinic -- part-time over 4 months

Description of First Year Clinical Rotations

Adolescent Partial Hospital Program (NYP Weill Cornell Medical Center): Residents evaluate and treat adolescent with acute psychiatric illness in an intensive, five day a week program which serves as a diversion from an inpatient level of care for some teens or as a step down from inpatient care for others. This is the first program of its kind in Manhattan. Residents will also participate in enhances outpatient emergency services provided to patients seen in the emergency department and will gain experience with a full complement of services available to acutely disturbed children of all ages.

Pediatric Consultation-Liaison Service (NYP Weill Cornell Medical Center): Residents consult to pediatric inpatient services, including the Hearst Burn Unit as well as the Pediatric Emergency Department. Each consultation is reviewed by a supervising attending child psychiatrist. Residents gain experience teaching pediatric residents both informally on the inpatient services and formally during the pediatric morning report. While on this rotation, residents gain additional experience in the pediatric neurology and neonatal follow-up clinics outlined below.

Pediatric Neurology Clinic (NYP Weill Cornell Medical Center): Residents rotate through the Pediatric Neurology Clinic under the direction of the Pediatric Neurology Service while on the Pediatric Consultation-Liaison Service at NYP-Weill Cornell Medical Center. The clinic population is culturally diverse, with a variety of neurological disorders, including neuromuscular disorders, seizure disorders, tumors, movement disorders, degenerative neurological diseases, strokes, and other neurological syndromes. Many disorders are complicated by neuropsychiatric problems or include a differential diagnosis of a conversion disorder, somatization disorder, or psychiatric factors complicating a neurological condition.

0-3 Infant Psychiatry Experience (NYP Weill Cornell Medical Center): The 0-3 Infant Psychiatry Experience includes a one-month observation in the Neonatal Follow-Up Clinic and participation in the Sackler Infancy Seminar. The Neonatal Follow-Up Clinic evaluates all infants discharged from the Neonatal Intensive Care Unit (NICU). A multi-disciplinary team of pediatricians, a physical therapist, and a nutritionist completes developmental assessments at regular intervals up to 3 years of age. Residents observe and participate in these assessments while on the Pediatric Consultation-Liaison Service at NYP-Weill Cornell Medical Center.

Family Therapy Supervision (NYP Weill Cornell Medical Center): Residents receive ongoing family therapy instruction and supervision addressing the needs of families and acutely ill youth.

Children's Inpatient Unit (Nichols Cottage, NYP Westchester Division): Nichols Cottage is a 17-bed acute inpatient unit for children ages 4-12 years old with an average length of stay of 30 days. Residents care for patients with a wide range of psychopathologies. Residents function as part of a multidisciplinary team, working alongside psychiatrists, social workers, and nursing staff. They are involved in formulating treatment and discharge plans as well as managing psychiatric emergencies.

Adolescent Inpatient Unit (2 North, NYP Westchester Division): The adolescent inpatient unit is an 21-bed acute inpatient unit for adolescents ages 13-17 years old with an average length of stay of 2 weeks. Residents care for patients with a wide range of psychopathologies and discharge needs. Residents function as part of a multidisciplinary team, working closely with psychiatrists, social workers, and nursing staff. They are involved in formulating treatment and discharge plans as well as managing psychiatric emergencies.

Adolescent Eating Disorders Service (The Outlook, NYP Westchester Division): The adolescent eating disorders service is a 6-bed acute inpatient unit for adolescents ages 13-17 years old. Patients have a principle diagnosis of an eating disorder, although co-occurring conditions are common, and they have an average length of stay of 2-3 weeks. The unit provides comprehensive assessment and treatment for a variety of eating disorders including Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder. The unit utilizes a multidisciplinary approach which includes individual, group, and family therapy. Residents will have direct patient care responsibilities which will include the comprehensive assessment, oversight of medical issues, individual and group-based treatment, and participation in discharge planning. In addition, they will have opportunities to observe and participate in a wide range of evidence-based treatments for patients.

Center for Autism and the Developing Brain (NYP Westchester Division): Residents will spend one afternoon a week for 4 months participating in outpatient assessments of youngsters with developmental disorders at the Center for Autism and the Developing Brain. They will gain experience taking a developmental history, performing comprehensive developmental assessments with a multi-disciplinary team and assessing co-occurring psychiatric disorders. Residents will learn about the services that are available to this population and how comprehensive education and treatments plans are made.

Pediatric Consultation and Emergency Service (NYP Morgan Stanley Children's Hospital of New York): The Pediatric Consultation and Emergency Service has two major components: first, residents provide consultation to hospitalized children and adolescents and liaison services to selected subspecialty teams including cardiac transplant, ICU, pain management, hematology/oncology, neurology and renal. Second, residents provide consultation to the emergency room and brief outpatient treatment to children and adolescents in crisis.

Neurology Clinic (NYP Morgan Stanley Children's Hospital of New York): Residents rotate through the Pediatric Neurology Clinic, under the direction of the Pediatric Neurology Service, while on the Pediatric Consultation Liaison Service at NYP Morgan Stanley Children's Hospital. The clinic population is culturally diverse with a variety of neurological disorders including neuromuscular disorders, seizure disorders, tumors, movement disorders, degenerative neurological diseases, strokes, and other neurological syndromes. Many disorders are complicated by neuropsychiatric problems or include a differential diagnosis of a conversion disorder, somatization disorders, or psychiatric factors complicating a neurological diagnosis.

Overview of Second Year Rotations

Two Days per Week at NYP Morgan Stanley Children's Hospital of New York

  • Outpatient Evaluation Services -- 4 months
  • Outpatient Sub-Specialty Clinics - 12 months
  • Early Childhood Nursery Observation -- 1.5 months
  • CARING @ Columbia -- 1.5 months
  • Psychotherapy Technique Supervision

Two Days per Week at NYP Weill Cornell Psychiatry - Payne Whitney Clinic and Westchester Division

  • Outpatient Evaluation Clinic -- 12 months
  • Outpatient Sub-Specialty Clinics -- 12 months
  • School Consultation -- 3 months
  • Psychotherapy Technique Supervision

Research/Scholarly Activity -- 12 months: Every resident has the equivalent of two half-days per week to pursue research and scholarly activity under direct mentorship by a faculty of their choosing. This is scheduled into the day at either the Columbia or Weill Cornell sites.

Description of Second Year Rotations

Weill Cornell Psychiatry - Payne Whitney Clinic and Westchester Division

Outpatient Evaluation Clinic: Residents perform psychiatric evaluations of children and adolescents under direct supervision. Evaluations include interview with the child, interview with parents/caretakers, and acquisition of collateral history. Differential diagnosis, risk assessment, and disposition of patients are done with a supervisor.

Outpatient Sub-Specialty Treatment Clinics: Residents gain experience in the treatment of patients in a variety of clinics which are organized by disorder (e.g., Anxiety Disorders Clinic) or treatment modality (e.g., Psychopharmacology Clinic). Faculty with particular expertise in specific psychopathology and treatment modalities provide ongoing supervision to the residents.

Psychotherapy Technique Supervision: Residents receive ongoing individual supervision in the implantation of psychodynamic psychotherapy and/or specific Cognitive Behavioral, Parent Training, and Family Therapy techniques.

School Consultation: Each resident will spend one morning per week for 3 months in school consultation experiences while they are at either Weill Cornell Medical Center in Manhattan or Weill Cornell Westchester Division. At each site, they will be exposed to a variety of school consultation experiences which will give them opportunities to serve as a consultant to schools, to practice classroom observation, and to become familiar with the variety of specialized educational programs for children with medical and psychiatric challenges.

Columbia University Medical Center -- Morgan Stanley Children's Hospital of New York (CHONY)

Outpatient Evaluation Clinic: Residents receive training in K-SADS and employ the semi-structured interview instrument in the evaluation clinic.

Outpatient Sub-Specialty Treatment Clinics: The Pediatric Psychiatry outpatient clinics at NYP Morgan Stanley Children's Hospital are organized around specific diagnoses. Residents rotate through several of these subspecialty clinics, including the Children's Anxiety and Depression Clinic (CADC) and the Disruptive Behavior Disorders Clinic (DBDC) or the Neuropsychiatry Clinic (NPC). Each resident receives individual supervision for their respective subspecialty clinic patients. The combination of individual supervision and small group technique supervision teach the resident how to employ a wide range of treatments including individual psychodynamic or play therapy, behavior therapy, interpersonal therapy, family therapy, social skills group therapy and psychopharmacology.

Early Childhood Nursery Observation (Columbia University Medical Center Nursery School): Residents observe children in routine nursery school programs under supervision. Time is provided for discussion of child observations.

CARING @ Columbia: A program initiated almost 25 years ago, CARING @ Columbia brings the arts to children at risk for psychopathology. The target population consists of community children living in the Washington Heights area of upper Manhattan and adolescents attending the Children's Day Unit. Residents participate in group interventions alongside faculty and art therapists.

Psychotherapy Technique Supervision: Each resident receives ongoing supervision in the implementation of psychodynamic psychotherapy as well as specific cognitive behavioral, parent training and family therapy techniques. Additional case specific supervision in Dialectic Behavior Therapy, Interpersonal Therapy and Motivational Interviewing are available.

Research/Scholarly Activity: Every resident has one half day per week to pursue a research project or scholarly activity under direct mentorship by a faculty member of their choosing.

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