Education

Child and Adolescent Psychiatry Fellowship

Welcome to the Child and Adolescent Psychiatry training program at the University of Chicago and thank you for your interest in our fellowship program. 

This is an exceptional time to consider fellowship training in Child and Adolescent Psychiatry. The burgeoning developments in neurogenetics, neuroimaging, psychopharmacology, evidence-based psychotherapies, and rehabilitative strategies have significantly expanded the therapeutic armamentarium that psychiatrists have to offer their patients. The University of Chicago has a longstanding devotion to academic scholarship and rigorous thinking.  Our mission is to train fellows to become not only excellent clinicians, researchers, and teachers, but to foster an attitude of innovation and leadership as the basis for pioneering tomorrow’s state-of-the-art treatments in all the aforementioned disciplines. Our Program is accredited by the ACGME (Accreditation Council for Graduate Medical Education) which reflects our strong commitment to education and outstanding clinical training.

Every year we welcome a diverse body of fellows, as reflected by their unique academic backgrounds, talents, strengths, and viewpoints. We believe that it is through such diversity that our program is strengthened. We are also proud of the breadth and depth of opportunities that we can offer our fellows, specifically with a strong emphasis on clinical training. This is made possible by the strong dedication of our faculty and staff to an empirical inquisition. Most of our faculty members, in addition to being talented teachers, are also avid investigators of well-established research programs. This has traditionally provided our fellows with an unparalleled milieu of scholarly endeavor, curiosity, and mentorship necessary to help them become competent clinicians. We are also mindful of the fact that realizing one’s fullest potential is closely tied to personal growth. Towards this end, the department strives to develop close supervisory relationships and process groups with our fellows in order to support them in reaching their professional training goals.

The program is also buttressed by solid didactic components aimed at enriching our fellows’ basic fund of knowledge as a strong theoretical basis to all clinical care.  By becoming critical readers of psychiatric literature, fellows gradually step into more sophisticated roles of educators of other health professionals and trainees all while initiating and pursuing their own research and clinical interests. Our section maintains close and collaborative ties with both the adult psychiatry and clinical neuropsychology program. This has traditionally provided rich opportunities for didactics and research.

We are also excited to add that, in 2016, the family of Dr. Harold Plotzky, MD generously established a permanently endowed fund to enrich the educational experience of the Child and Adolescent Psychiatry fellowship. This fund is earmarked for the support of educational and professional opportunities, (including research, conference fees, and associated travel, and other educational materials).

Our fellows, upon completion of their training, gain the competence of functioning both independently and as consultants to pediatricians, neurologists, school systems, community-based agencies, and the court system. Our program, with its strong emphasis on leadership, research, clinical care, and didactics equips the new graduate with the necessary parameters to secure full-time positions in prestigious academic institutions, national psychiatric organizations as well as establish a successful private practice.

As program director, I invite you to become acquainted with the different rotations, offered by our program, as well as the academic and clinical interests of our talented faculty and staff here at the section of child and adolescent psychiatry.  On behalf of the entire program, we wish you success in making an important career training decision and look forward to hearing from you. 

Karam Radwan

Associate Professor of Psychiatry and Behavioral Neuroscience

 

2019-2020 Resident Stipends

PGY-1: $60,000
PGY-2: $63,800
PGY-3: $66,000
PGY-4: $69,000
PGY-5: $72,000
PGY-6: $73,500

Vacation

All residents receive four weeks of paid vacation leave per year to be scheduled by mutual agreement between the resident, chief resident, service chief, and the Program Director.

Sick Leave

Five days of paid sick leave is granted to residents who are absent from work and unable to perform their assigned duties due to illness.

Offices

All residents have individual offices to see patients and accomplish other duties in a professional manner.  All offices are furnished with a computer.

Computer Access

Universal Workstations are located throughout the Hospitals, through which residents can access labs, patient information, word processing, the Internet, as well as Medline and other medical information databases.

Call Frequency

There isn't any in-house call.  In the first year of the child residency program, there is phone back up when rotating on the inpatient service at UChicago Medicine Ingalls Memorial once a week (Monday, Tuesday, Thursday, Friday only).

Medical Leave

Residents are provided a four-week paid leave for maternity-related purposes or other required medical care.

Other Leaves of Absence

Residents may request a personal Leave of Absence from the Program Director who grants such leave in cooperation with Office of Housestaff Affairs. Such a request should be predicated on some unusual and substantial personal situation. In all but rare cases, a leave of absence should not exceed twelve weeks. We also have policies on bereavement and civil leaves.

Educational Meetings

Residents may attend educational meetings at the discretion of the Program Director and relevant service chief. The dates of such meetings must not interfere with good patient care. Excused absence for attending such meetings should not extend beyond the dates of the educational meeting and necessary travel time. Additional days will be considered vacation time and also should be scheduled with the permission of the Program Director.

Benefits

University of Chicago Hospitals house officers are eligible for a benefits package that includes dental coverage, flexible spending accounts, health insurance coverage, life insurance, long term disability, personal accident insurance, tuition remission for spouses and children, supplemental retirement annuities, and workers' compensation.

Professional Liability Coverage

The Hospital provides medical malpractice liability coverage for all residents for activities performed in connection with assigned duties as a resident at the University of Chicago Hospitals and at off-site rotations with prior written approval. The coverage is a composite of self-retained coverage funded by a composite of self-retained coverage funded by a trust fund and purchased excess commercial insurance.

Library Facilities

Residents are granted borrowing privileges at the University of Chicago Libraries, one of the largest libraries in the country with over 10 million volumes. Residents have 24-hour access to The John Crerar Library, the major research library for medicine and the biological sciences on the University campus, containing 570,000 titles, and located across the street from the Hospitals.

Be Captivated by AACAP

 

Graduate Medical Education (GME) Website

First Year:

UChicago Medicine Ingalls Memorial Inpatient Rotation:

In the first year, clinical rotations are offered in inpatient child and adolescent psychiatry, emergency services, forensic and consultation/liaison psychiatry. In addition, fellows begin their longitudinal outpatient experience. The rotation at UChicago Medicine Ingalls Memorial provides a rich and diverse inpatient clinical experience and a chance to work with multidisciplinary staff in a team format. Fellows gain experience working with outside systems of care and presenting evaluations in teaching rounds. The population ranges in age from 3 to 17 years. The patients represent a diverse ethnic and cultural mix.

In addition, residents have opportunities to participate in teaching and evaluating medical students on both rotations and electives during clinical rounds and during formal presentations. Dr. Peter Nierman, , coordinates our inpatient rotation for the residents at UChicago Medicine Ingalls Memorial.

Forensic Rotation:

This rotation is a subcomponent of the inpatient experience. Fellows work with Dr. Nierman in his role as a Forensic Psychiatrist Dr. Nierman, a forensic expert, plays an integral role in the didactics component of the forensic rotation. Residents can choose to be involved in cases, and participate in the formulation of reports for civil, family, mental health or criminal court cases. The resident’s role is to participate in the evaluation of the patient, acquisition of collateral information, review of records and assist in the preparation of a formal written forensic report. Residents accompany Dr. Nierman to all conferences, depositions and courtroom testimony. They learn the art of forensic interviewing, report preparation, and courtroom testimony.

ER Rotation:

The ER Residents evaluate patients and their families presenting to UChicago Medicine Ingalls Memorial Intake Unit and to the Comer and Mitchell Emergency Departments in order to determine the appropriate level of care needed. There is an opportunity to do multidisciplinary work with social workers and community agencies such as SASS, schools, and law enforcement.

The pediatric consult-liaison:

The pediatric consult-liaison service is a 4-month rotation for 1st year trainees in the child & adolescent psychiatry training program. Dr. Khalid Afzal is the Director of the Consult-Liaison Service. The experience involves a range of consultation opportunities to the general pediatrics and pediatric sub-specialty teams at Comer Children’s Hospital. Trainees also have opportunities to assess patients in the emergency room at Comer.

Trainees work closely with the attending faculty, Dr. Afzal and frequently do walking rounds through the hospital. Opportunities exist to do brief individual and family therapy, medication management of a variety of C/L presentations. Numerous educational opportunities exist on this rotation. Trainees work closely with the supervising faculty on a daily basis. In addition, there is weekly child C/L case rounds, a combined adult-child C/L case conference, and bedside teaching while seeing cases at Comer. Research electives are available for those who are interested.

Highland Park Hospital:

This rotation was created following a collaborative merging between NorthShore Health System and the University of Chicago. It provides fellows with the unique opportunity to work with a suburban patient population and to acquire the necessary skills for their diverse needs. Fellows become part of a multidisciplinary milieu during which they gain experience working with outside systems of care. They rotate with two to three different experienced child and adolescent psychiatrists. Fellows become acquainted with the administrative aspects of private practice, Partial Hospitalization, Intensive Outpatient, and in an inpatient setting working with adolescents.

Second year rotations:

Neurodevelopmental Clinic:

This rotation involves a one half day per week commitment week for 4 months. The neurodevelopmental clinic serves preschoolers, children, adolescents with suspected pervasive developmental disorders as well as a variety of associated comorbid conditions. Fellows work closely with Dr. Radwan, the current section chief and training director, and a multidisciplinary team of professionals including psychologists, developmental pediatricians, speech and language pathologists and neurologists who specialize in pervasive development disorders.

Pediatric Neurology Clinic:

Fellows rotate through the outpatient pediatric neurology service one-half day per week for four months and work with Dr. Marcuccilli. They attend neurology outpatient clinic and participate in the evaluations of new and follow-up patients. Fellows initially see the patient, present the case to the attending and see the patient with the attending who reviews the critical aspects of the examination. The neurology clinics at the University of Chicago see a broad range of neurological problems, including seizure disorders, trauma, perinatal injuries, CNS malformations, metabolic disorders, tumors, developmental delays, neurological manifestations of autoimmune disease and other systemic illnesses.

Mood and Anxiety Clinic:

This rotation spans 12 months during which fellows spend one half day per week. Run by Dr. Karam Radwan, this clinic offers fellows the unique opportunity of working from a broad range of therapeutic orientations, including cognitive behavioral, client-centered, dialectical behavior therapy, time-limited psychodynamic, solution-oriented, play, and systemic psychotherapy.

Eating Disorders and Family Based Psychotherapy Clinic:

This rotation runs for 4 months and involves one half day per week. In the Eating Disorders Clinic fellows master the use of standardized evaluations (the Eating Disorders Examination, EDE) with patients presenting with various eating disorders, including anorexia nervosa, bulimia nervosa, obesity, binge-eating disorder, and unspecified eating disorders. The treatment approach adopted by the clinic is based on a manualized family therapy model, the Maudsley approach, as developed by former faculty Dr. LeGrange. The clinic also serves as a vehicle to conduct clinical research investigating effective treatments of these disorders. The clinic has been operating for over 10 years serving patients from surrounding communities and across the country. Fellows are supervised by Dr. Seeba Anam MD and Dr. Jennifer Wildes PhD; in addition they work in a multi-disciplinary team with psychology trainees.

Neuropsychology Clinic:

This rotation entails one half day per week for 4 weeks. Fellows work with Dr. Scott Hunter PhD, the head of Pediatric Neuropsychology. During this rotation, fellows learn how to select appropriate neuropsychological assessment tools, score tests and clinically interpret them. Emphasis is placed on advancing knowledge in the interpretation and understanding of findings (both quantitative and qualitative) gleaned from neuropsychological assessment.

Community / School Consultation:

This rotation entails one half day per week for 4 months duration. This rotation comprises exposure at the Hyde Park Career Academy (High School- 9th-12th grade). In addition there are community consultations with the Child Protective Services Team (CPS) at The University of Chicago Hospitals (UCH). Fellows provide consultation services to the school system, and to individual teachers/ staff and parents. Trainees participate in psychoeducational sessions, such as conducting on- site teaching/ education sessions in the classroom setting. Residents also have “drop-in hours” where teachers, students, and parents are encouraged to ask individual consultation questions.

Electives:

During the second year fellows are given additional time to pursue a variety of electives available both within the University of Chicago Hospitals and outside if desired.  Fellows are able to choose between clinical and educational electives pending approval from the Program Director, and this can be tailored to fit the unique educational interests of each individual fellow.  Past examples include reading electives, outside clinical experiences, additional time spent in pre-exisiting clinics, and administrative electives.

Research:

This is an individually tailored rotation, where fellows have the choice to delve into a broad range of research areas ranging from clinical to basic research. Fellows join an established research group at The University of Chicago, develop their own project or participate in an ongoing research project, and present their data and conclusions to the department section by the end of their second year of training. Fellows can spend additional elective time should they choose to.

Administrative Duties:

Fellows attend QA meetings and regular meetings with Dr. Radwan to become familiar with the functioning of the clinical services. Fellows assist in the administrative aspect by reviewing referrals and intakes, referring cases to the appropriate clinics and participating in supervision of residents in the Adult track conjointly with the attending psychiatrist.

The below schedule is for Monday, Tuesday, Thursday, and Fridays.  Wednesdays all fellows are on-site for didactics all day.

UC = University of Chicago
ING = UChicago Medicine Ingalls Memorial
HPH = Highland Park Hospital
HPA = Hyde Park Career Academy (School)
PRE = Paul Revere Elementary
COMM = Various Locations

First Year Fellows

4 Months

4 Months

4 Months

Inpatient and partial hospitalization 90% HPH Inpatient 90% ING ER & C/L 80% UC
Psychotherapy ½ day a week 10% UC Psychotherapy ½ day a week 10% UC Outpatient 10% UC:
Psychosomatic Medicine Clinic ½ day a week
    Outpatient 10% UC
Psychotherapy ½ day a week

Second Year Fellows

4 Months

4 Months

4 Months

Outpatient 60% UC       Mood/ Anxiety Psychotherapy             General Psychopharm Clinic(at Northshore) Outpatient 60% UC     Mood/ Anxiety Psychotherapy           Eating Disorders       General Psychopharm Clinic(at Northshore) Outpatient 60% UC          Mood/ Anxiety Psychotherapy                        General Psychopharm Clinic(at Northshore)
Elective/ Research 20% UC Elective/ Research 20% UC Elective/ Research 20% UC
Admin Duties 10% UC
(Includes Admin Clinic)
Admin Duties 10% UC
(Includes Admin Clinic)
Admin Duties 10% UC
(Includes Admin Clinic)
Community/School 10%
HPA/ PRE/ COMM
Neurology 10% UC Neurodevelopmental Clinic UC 10%

 

The ability to comprehensively assess, discuss, document, and intervene in situations concerning patients who have psychiatric illness interfering with medical or surgical illness, or who have psychiatric illness presenting with physical symptoms, e.g. somatoform illness. The resident will be able to:

  • Evaluate procedures including review of physical and neurologic findings, laboratory and radiologic findings, medications and treatments.
  • Manage crisis/ emergencies of acutely disturbed children and adolescents with medical or surgical illness from outpatient practice.
  • Discuss consultation liaison treatment standards, procedures, psychopharmacolgy and the differences from outpatient
  • Effectively intervene to implement methods to minimize risk of harm to self or others including psychopharmacolgic and mechanical restraints
  • Choose the most appropriate psychotherapeutic treatment for different each consultation.

MEDICAL KNOWLEDGE

Residents will demonstrate a solid understanding and grasp of core concepts and knowledge in the following areas:

  1. Understanding of the psychological impact of, and adjustment to, acute and chronic illness in children and their families
  2. Understanding how developmental level affects response to treatment and treatment approaches.
  3. Define the consult process (calling a consult, defining the consult question, evaluation the child and family, working with the medical team.)
  4. Understand the role of the Consult-liaison psychiatist in the medical/ surgical team
  5. Define differences in presentation of common pyschiatric disorders in the medical/ surgical setting.
  6. Describe developmentally appropriate understanding of and responses to death in both children and adolescents, and describe how to identify when supportive or treatment interventions are needed.

INTERPERSONAL AND COMMUNICATION SKILLS

Upon completion of the CL rotation, residents will be able to demonstrate the following interpersonal and communication skills:

  1. Help the referring physician articulate and define a practical, useful and answerable consult question.
  2. Help children/ adolescents communicate in developmentally appropriate ways.
  3. Communicate effectively with every member of the family bot individually and in groups to form an effective working alliance.
  4. Form effective working relationships with the entire pediatric treatment team, including generalists and specialists, physicians, nurses, social workers, nutritionists, psychologists, physical/occupational therapists, etc.
  5. Be able to deliver "bad news" effectively, compassionately, and therapeutically; and model this for other members of the team.
  6. The ability to work effectively within a multidisciplinary team structure as a team member and consultant. Be able to lead the team when called for.

PROFESSIONALISM

Residents will be sensitive to the sociocultural, socioeconomic, educational issues that arise in the therapeutic relationship. In addition:

  1. Residents will evaluate children and families with sensitivity, empathy and clinical acumen, while being sensitive to feelings of anger, guilt, anxiety and hopelessness, or to denial of feeling .
  2. Residents will use developmentally appropriate, comprehensible language in communicating with children and families with physical illness and comorbid psychiatric illness.
  3. Use culturally and socially appropriate language in communicating with children and families.
  4. Wear appropriate professional attire on the C/L service, including an understanding of how the consultant's attire may affect children based on their trauma and medical histories and past experience with medical care.

PRACTICE-BASED LEARNING AND IMPROVEMENT

The resident will evaluate caseload and practice experience in a systematic manner. Daily rounds are held to review the patient's treatment and informal feedback is given. Residents will identify areas of strengths and weakness, and work with the attending to make a performance improvement plan.

In addition, the resident will:

  1. Know when to update knowledge of pediatric illnesses and treatment.
  2. Identify when to seek additional supervision.
  3. Be able to discuss transference and countertransference with patients and families and identify when this is interfering with treatment.

SYSTEMS-BASED PRACTICE

The resident will:

  1. Learn how to advocate for optimal patient care within the limits of the health care delivery system by understanding the resources available for increased outpatient services or residential care including community and school based resources.
  2. Learn how to consult with emergency doctors and other specialist including state agencies around inpatient admissions
  3. Learn how to be the leader in a psychiatric emergency, keeping the patient and staff safety as priority
  4. Review cases with supervisors and other staff in ER/ C-L Rounds, and when appropriate, in quality improvement rounds (M&M)
  5. Understand the different levels of care in acute inpatient, partial hospitalization, intensive outpatient, 23-hour crisis evaluation and management units and be able to define the typical symptomatology that can be best managed in each treatment environment.
  6. Understand what is meant by "systems of care" and use a system of care approach in addressing the comprehensive bio-psycho-social and spiritual needs of physically ill children with psychiatric needs.
  7. Be able to work effectively with all of the relevant care-providers involved in a given case, potentially including pediatricians, nurses, OT/PT, nutritionist, educators, child life specialists, psychologists, patient advocates and others.

PATIENT CARE

Residents will demonstrate the ability to comprehensively assess, discuss, document, and intervene in situations concerning patients' potential for self-harm or harm to others.

This will include:

  • assessment of risk based on known risk factors
  • knowledge of inpatient treatment standards and procedures
  • effective intervention to minimize risk
  • Implement prevention methods for self-harm and harm to others.

MEDICAL KNOWLEDGE

Residents will demonstrate knowledge of emergency psychiatry. This includes:

  • suicide
  • crisis interventions
  • differential diagnosis in emergency situations
  • treatment methods in emergency situations
  • violent behaviors

INTERPERSONAL AND COMMUNICATION SKILLS

Residents will demonstrate:

  • the ability to work effectively within multidisciplinary team structures as member, consultant, and leader.
  • the ability to form relationships with patients and professionals in a emergency setting.
  • The ability to exhibit professional, ethically sound behavior and attitude in all patient and professional interactions
  • Residents demonstrate the ability to obtain, interpret and evaluate emergency consultations. This will include formulating and clearly communicating consultation questions
  • discussing consultation findings with the consultant in the ER
  • evaluating consultation findings and making recommendations.

PROFESSIONALISM

Residents will be empathic, respectful, curious, open, nonjudgmental, collaborative, able to tolerate ambiguity and demonstrate confidence in the efficacy of supportive therapy.

Residents will be sensitive to the sociocultural, socioeconomic, educational issues that arise in the therapeutic relationship.

PRACTICE-BASED LEARNING AND IMPROVEMENT

The resident will evaluate caseload and practice experience in a systematic manner. The residents will bring certain cases to be discussed in supervision, rounds and M & M meetings.

SYSTEMS-BASED PRACTICE

The resident will:

  1. Learn how to advocate for optimal patient care within the limits of the health care delivery system.
  2. Learn how to consult with emergency doctors and other specialist including state agencies around inpatient admissions
  3. Learn how to be the leader in a psychiatric emergency, keeping the patient and staff safety as priority
  4. Review cases with supervisors and other staff in ER/ C-L Rounds, and when appropriate, in quality improvement rounds (M&M)

PATIENT CARE

Forensic evaluation of a variety of patients of both genders, including adolescent, who represent a broad range of mental disorders and circumstances, in both civil and criminal contexts.

MEDICAL KNOWLEDGE

The resident will participate in consultation to general psychiatric services on issues related to the legal psychiatric practice, such as civil commitment, confidentiality, refusal of treatment, decision-making competence, custody evaluation and guardianship.

The resident will acquire:

  • Knowledge of child custody laws.
  • Evaluation methodology to perform custody evaluation.
  • Evaluation of adolescents for custody.

INTERPERSONAL AND COMMUNICATION SKILLS

The resident will learn to observe evaluations done by experienced professionals in court and the homes of families with regards to custody disputes and visitation rights. Interpersonal skills are defined as the specific techniques and methods, which facilitate effective and empathetic communication between the resident, patients, colleagues, staff, and system.

PROFESSIONALISM

The resident will demonstrate respect for patients and colleagues, and respect their age, culture, disabilities, ethnicity, gender, and sexual orientation. The resident will interact professionally with the legal system.

PRACTICE-BASED LEARNING AND IMPROVEMENT

The resident will be able to articulate the basic concepts of forensic child and adolescent psychiatry and how it is used in the legal system. The resident should have a working knowledge of the diverse systems involved in treating children, and adolescents, and understand how to use the systems as part of a comprehensive system of care, in general, and as part of a comprehensive, individualized plan.

SYSTEMS-BASED PRACTICE

The resident will be able to:

  1. Work with various members of the hospital, clinical and legal teams including but not limited to lawyers, child protective services, and inpatient unit physicians.
  2. Work to identify system errors, and accurately identify what happened to cause the errors and what outcome the error has caused.

PATIENT CARE

Residents will demonstrate the ability to comprehensively assess, discuss, document, and intervene in situations concerning patients' potential for self-harm or harm to others.

This will include:

  • Knowledge of admission procedures including involuntary admissions and admission orders
  • Crisis/ emergency management of acutely disturbed children and adolescents including assessment of risk based on known risk factors
  • Knowledge of inpatient treatment standards, procedures, and psychopharmacolgy and the differences from outpatient
  • Effective intervention to minimize risk inclding psychopharmacolgic and mechanical restraints
  • Implement prevention methods for self-harm and harm to others.

MEDICAL KNOWLEDGE

Residents will demonstrate knowledge of treatment in acutely disturbed children and adolescents, and recognize the differences from an outpatient practice This includes evaluation and treatment of:

  • Patients with suicidal or homicidal ideation
  • Patients with psychotic disorders
  • Crisis interventions
  • Differential diagnosis in emergency situations, with special emphasis on neurologic and medical presentations mimicking psychiatric illness
  • Treatment methods in emergency situations
  • Patients with violent behaviors

Residents will also demonstrate knowledge of medical legal and risk management issues pertinent to the practice of inpaqtient child and adolescent psychiatry, including issues surrounding criteria for involuntary admission, right to consent for treatment and various confidentiality issues.

INTERPERSONAL AND COMMUNICATION SKILLS

Residents will demonstrate:

  • The ability to work effectively within a multidisciplinary team structure as a member, consultant and leader
  • The ability to form relationships with patients and professionals in an acute care setting.
  • Knowledge of liaison techniques related to coordination of care with outpatient mental health professionals, community ased agencies, schools, residential treatment programs, and the Department of Children and Family Services.
  • The ability to exhibit professional, ethically sound behavior and attitude in all patient and professional interactions

PROFESSIONALISM

Residents will be empathic, respectful, curious, open, nonjudgmental, collaborative, able to tolerate ambiguity and demonstrate confidence in the efficacy of supportive therapy.

Residents will be sensitive to the sociocultural, socioeconomic, educational issues that arise in the therapeutic relationship.

PRACTICE-BASED LEARNING AND IMPROVEMENT

The resident will evaluate caseload and practice experience in a systematic manner. Daily rounds are held to review the patient's treatment and informal feedback is given. Residents will identify areas of strengths and weakness, and work with the attending to make a performance improvement plan.

SYSTEMS-BASED PRACTICE

The resident will:

  1. Learn how to advocate for optimal patient care within the limits of the health care delivery system by understanding the resources available for increased outpatient services or residential care including community and school based resources.
  2. Learn how to consult with emergency doctors and other specialist including state agencies around inpatient admissions
  3. Learn how to be the leader in a psychiatric emergency, keeping the patient and staff safety as priority
  4. Review cases with supervisors and other staff in ER/ C-L Rounds, and when appropriate, in quality improvement rounds (M&M)
  5. Understand the different levels of care in acute inpatient, partial hospitalization, intensive outpatient, 23-hour crisis evaluation and management units and be able to define the typical symptomatology that can be best managed in each treatment environment.

PATIENT CARE

  1. 1.  For residents participating in clinical research projects, the resident will demonstrate the ability to perform a comprehensive psychiatric history utilizing appropriate research evaluations such as the K-SADS and ADOS and/ or standardized rating instrument.  The resident will be able to document this assessment and present in consensus meeting:
    • Psychiatric symptoms and history
    • Social and educational history
    • Family history
    • Substance abuse history
    • Medical history and review of systems
    • Physical and neurological examination, as deemed necessary
    • Developmental history
    • Mental status examination including assessment of cognitive functioning
  2. Residents will learn to differentiate patient care in a research study from those in clinical care, and know when to terminate a research project to pursue clinical care.
  3. Residents will learn to work with clinical and research staff and balance the competing demands of each. 

MEDICAL KNOWLEDGE

  1. The resident will learn the proper techniques of research, including the NIH regulations and ethical guidelines concerning research. 
  2. Residents will learn how to use the medical literature to develop their project and to prepare background for a presentation before the section or the department. 
  3. The resident will learn how to find and utilize resources for research at The University of Chicago such as the Institute or Mind and Body, and the Translational & Molecular Neuroscience research center of our department.
  4. The resident will further their medical knowledge base about their research project. 

INTERPERSONAL AND COMMUNICATION SKILLS

  1. Residents will work collaboratively with mentors, other researchers, and other support services. 
  2. Residents will demonstrate the ability to communicate effectively with granting agencies, research subjects their families in both written and oral formats. 
  3. Residents will work with their research mentor to develop a presentation to clearly and simply present the work they have been doing. 

PROFESSIONALISM:

  1. The resident will demonstrate respect for patients and colleagues, and respect their age, culture, disabilities, ethnicity, gender, and sexual orientation.
  2. The resident will interact professionally with the research staff, IRB and Office of Research Support.
  3. The resident will demonstrate a collaborative and nonjudgmental attitude characterized by empathy, curiosity, respect and openness.  Residents also demonstrate the ability to tolerate ambiguity and show confidence in the research process.

PRACTICE-BASED LEARNING AND IMPROVEMENT

  1. The resident will be able to evaluate and incorporate the basic principles underlying clinical, translational, and/or basic science research into their own research and clinical work with patients. 
  2. The resident should be able to identify their personal limitations in research, but also develop a sense of understanding and of their strengths in the contributions they make and continue to make to moving the field forward in research that can continue once they leave training. 
  3. This rotation will support a more in-depth use of the electronic resources and help the resident adopt a system of life-long learning. 
  4. Teaching abilities will be evaluated as the resident works with their mentor on presentation skills, and be students, peers and faculty at their presentation. 

SYSTEMS-BASED PRACTICE:

  1. Each resident must recognize and accept limitations in his/her knowledge base and clinical skills, and understand the need for life-long learning.
  2. Residents will possess research appropriate skills and demonstrate the ability to obtain current scientific research and clinical practice guidelines to assist in promoting high quality patient care. This will include, but not be limited to:
    • use of medical libraries
    • use of information technology, including Internet-based searches and research databases (e.g., MedLine)
    • use of drug information databases
  3. Residents will evaluate caseloads and practice experience in a systematic manner. This may include:
    • maintenance of patient logs
    • review of patient records and outcomes
    • obtaining appropriate supervision
    • residents will understand how their patient care affects and is affected by other health care providers

MEDICAL KNOWLEDGE

  • observe normal development in a classroom setting and learn to differentiate variations of normal development from psychopathology across all ages of development
  • learn to understand, define and clarify consultation problems or questions by using clear, and respectful language with school staff,
  • learn to understand the roles played by various mental health and medical professionals in the school, and how to consult with each, respectively
  • learn how to help school personnel plan the most effective, and efficient course of evaluation, especially in emergency situations
  • observe and participate in the IEP process
  • observe a regular classroom setting and develop skill in differentiating typical from atypical development from preschool to high school.

INTERPERSONAL AND COMMUNICATION SKILLS

  • learn how to provide feedback and recommendations at the time of the consultation
  • learn how to work effectively with community organizations such as DCFS, CMHC, and SASS
  • residents will advocate for quality mental health and help with referrals.

PROFESSIONALISM

  • Residents will demonstrate sensitivity and responsiveness to school rules, and demonstrate professionalism in dealing with school personals.
  • Residents will be sensitive to the socio-cultural, socioeconomic, educational issues that arise in the rotation.
  • Residents will be empathic, respectful, curious, open, nonjudgmental, collaborative.

SYSTEMS-BASED PRACTICE

Demonstrate knowledge of community systems of care and assist students and their respective families to access appropriate psychiatric care and other mental health support services. This requires knowledge of psychiatric treatment settings in the community, which includes ambulatory, consulting, inpatient, partial hospital, substance abuse.  Work with reporting agencies to ensure patient safety.  Work with the UCH child protective team to protect children and still advocate for the family unit when possible.  Realize how health care disparities play a role in injury and psychiatric illness. 

The resident will demonstrate knowledge of the organization of care in each relevant delivery setting.

PATIENT CARE:

The clinic director supervises the chief resident to learn how to run the clinic, manage patients load, and help junior resident in their direct patient care. The chief resident is also responsible on reviewing intake request and deciding the appropriate level of care.

The clinic serves patients with a broad age range, including a significant number of pre-school patients, as well as the more typical school-aged and adolescent patients. 

The chief resident is involved in the supervision of patient evaluations (preschool, school aged, and adolescent); Review of diagnoses of disorders diagnosed in toddlers, childhood and adolescence disorders.

MEDICAL KNOWLEDGE

The resident will demonstrate knowledge in administrative psychiatry and in systems of health care delivery.

INTERPERSONAL AND COMMUNICATION SKILLS

Interpersonal skills are defined as the specific techniques and methods, which facilitate effective and empathetic communication between the psychiatrist, patients, colleagues, staff, and system.

PROFESSIONALISM:

The chief  resident insures continuity of care for patients and ensure that the clinic and the staff members respect the rules of the University of Chicago and the Principles of Medical Ethics with Special Annotations for Psychiatry (APA) and the ethics code of the American Academy of Child and Adolescent Psychiatry.

PRACTICE-BASED LEARNING AND IMPROVEMENT

The chief resident acts as the liaison between the residents and the Training Director, runs the weekly resident meeting, and oversees the case loads of the residents, acts as the section liaison to the QA committee. The chief resident attends QA meetings with the vice Chair of the department and weekly meetings with the CAP director to learn about merging challenges from the system and address them appropriately.

SYSTEMS-BASED PRACTICE

The chief resident sits on the QA committee for the section and reports back to the section the current projects.  The chief resident represents the residents in the faculty meetings and in the residency education meeting.  They coordinate the resident meetings. 

PATIENT CARE

The resident works with approximately 2-4 hours of long-term individual and family based outpatient cases per week during the first year of training and approximately 8-12 hours per week in the second year of training.  Residents manage their own clinical schedules with the supervision of the faculty. Residents become skilled in evaluation and treatment planning for children, adolescents and their families.

MEDICAL KNOWLEDGE:

The resident will demonstrate the ability to conduct a range of individual, and family therapies using standard, accepted models that are evidence-based, and integrate these psychotherapies and psychopharmacologic interventions in their daily clinic activities.

INTERPERSONAL AND COMMUNICATION SKILLS

The resident will demonstrate the ability to effectively communicate with the patient and their family (while respecting confidentiality):

  • the results of the assessment
  • the risks and benefits of the proposed treatment plan, including possible side-effects of psychotropic medications
  • alternatives (if any) to the proposed treatment plan
  • education concerning the disorder, its prognosis, and prevention strategies

PROFESSIONALISM

The resident will demonstrate responsibility for their patients’ care. This includes:

  • responding to patient communications
  • use of the medical record for appropriate documentation of the course of illness and its treatment
  • providing coverage if unavailable, e.g., out of town, on vacation
  • coordinating care with other members of the medical and/or multidisciplinary team
  • providing for appropriate transfer or referral if this is necessary

PRACTICE-BASED LEARNING AND IMPROVEMENT

The resident will demonstrate an ability to critically evaluate the psychiatric literature. This may include:

  • using knowledge of common methodologies employed in psychiatric research to evaluate studies, particularly drug treatment trials
  • conducting and presenting reviews of current research in such formats as journal clubs, grand rounds, and/ or original publications
  • researching and summarizing a particular problem that derives from the resident’s case load

SYSTEMS-BASED PRACTICE

The resident will learn to access systems of care when ongoing therapy cases need more intensive services, and will be able to work with insurance companies and state funding agencies to obtain needed services for their patients. 

PATIENT CARE

The resident works with approximately 2-4 hours of long-term individual and family based outpatient cases per week during the first year of training and approximately 8-12 hours per week in the second year of training.  Residents manage their own clinical schedules with the supervision of the faculty. In the second year of training, the resident takes on increasingly more complex cases and expands the types of treatment modalities used.  Residents become skilled in evaluation and treatment planning for children, adolescents and their families.

MEDICAL KNOWLEDGE

The resident will demonstrate the ability to conduct a range of individual, and family therapies using standard, accepted models that are evidence-based, and integrate these psychotherapies and psychopharmacologic interventions in their daily clinic activities.

INTERPERSONAL AND COMMUNICATION SKILLS

The resident will demonstrate the ability to effectively communicate with the patient and their family (while respecting confidentiality):

  • the results of the assessment
  • the risks and benefits of the proposed treatment plan, including possible side-effects of psychotropic medications
  • alternatives (if any) to the proposed treatment plan
  • education concerning the disorder, its prognosis, and prevention strategies

PROFESSIONALISM

The resident will demonstrate responsibility for their patients’ care. This includes:

  • responding to patient communications
  • use of the medical record for appropriate documentation of the course of illness and its treatment
  • providing coverage if unavailable, e.g., out of town, on vacation
  • coordinating care with other members of the medical and/or multidisciplinary team
  • providing for appropriate transfer or referral if this is necessary

PRACTICE-BASED LEARNING AND IMPROVEMENT

The resident will demonstrate an ability to critically evaluate the psychiatric literature. This may include:

  • using knowledge of common methodologies employed in psychiatric research to evaluate studies, particularly drug treatment trials
  • conducting and presenting reviews of current research in such formats as journal clubs, grand rounds, and/ or original publications
  • researching and summarizing a particular problem that derives from the resident’s case load

SYSTEMS-BASED PRACTICE

The resident will learn to access systems of care when ongoing therapy cases need more intensive services, and will be able to work with insurance companies and state funding agencies to obtain needed services for their patients. 

PATIENT CARE

  1. Residents will demonstrate the ability to perform and document a comprehensive psychiatric history and examination
    • a complete present and past psychiatric history
    • a social and educational history a family historya substance abuse history
    • a medical history and review of systems
    • a physical and neurological examination if necessary
    • a comprehensive mental status examination including the assessment of cognitive functioning
    • a developmental history

The resident will demonstrate the ability to conduct therapeutic interviews, e.g. enhance the ability to collect and use clinically relevant material through the conduct of supportive interventions, and exploratory interventions and
clarifications.

The resident will demonstrate the ability to conduct a range of individual, and family therapies using standard, accepted models that are evidence-based, and integrate these psychotherapies.

MEDICAL KNOWLEDGE

Residents will demonstrate knowledge of psychosocial therapies used in the treatment of mood and anxiety disorders in children and adolescents.

Residents will demonstrate knowledge of psychopharmacological  therapies used in the treatment of mood and anxiety disorders in children and adolescents.

Residents will demonstrate knowledge of patient evaluation and treatment selection.

This will include:

  • psychological testing
  • laboratory methods
  • mental status evaluation
  • diagnostic interviewing
  • treatment comparison and selection

Residents will demonstrate knowledge of outpatient psychiatric treatment. This
will  include:

  • specific syndromes, e.g., stress reactions, PTSD, panic disorder, OCD,  Depression,   bipolar Disorder, generalized anxiety disorder , and other mood and  anxiety disorders
  • psychiatric aspects of non-psychiatric illness
  • psychosomatic disorders and other manifestations in children nonetheless.

INTERPERSONAL AND COMMUNICATION SKILLS

  1. Interpersonal skills refer to the ability of the resident to develop and maintain therapeutic relationships with patients and their respective families.
  2. Residents will demonstrate willingness to continuously self-observe and confront their    own respective biases and transferences.
  3. Residents will demonstrate techniques and methods, which facilitate effective and empathetic communication between residents, patients, colleagues, staff, and system.
  4. Residents will demonstrate the following skills:
    • ability to listen to and understand patients
    • ability to communicate effectively with patients, using verbal, nonverbal, and writing skills, as appropriate
    • ability to foster a therapeutic alliance with patients, as indicated by instilling feelings of trust, openness, rapport, and comfort in the relationship with the   physician
    • ability to use negotiation skills to develop an agreed upon health care management plan with patients’ families.
    • ability to transmit information to patients in a clear and meaningful manner
    • ability to provide explanations of psychiatric disorders and treatment (both verbally and in written form) that are geared to the educational/ intellectual level of the   patients and their families

PROFESSIONALISM

Residents will demonstrate responsibility for their patients’ care.

This includes:

  • use of the medical record for appropriate documentation of the course of illness and its treatment
  • providing coverage if unavailable, e.g., out of town, on vacation
  • coordinating care with other members of the medical and/or multidisciplinary team
  • providing appropriate transfer or referral if this is necessary
  • The resident will demonstrate ethical behavior, as defined in the Principles of
    Medical Ethics with Special Annotations for child and adolescent psychiatry.
  • Residents will be empathic, respectful, curious, open, nonjudgmental, and collaborative.

PRACTICE-BASED LEARNING AND IMPROVEMENT

  1. Resident must recognize and accept limitations in their knowledge base and clinical skills, and appreciate the need for life-long learning
  2. The resident will have appropriate skills and demonstrate the ability to obtain current information from scientific and practice literature and other sources to assist in providing high quality patient care.
  3. The resident will demonstrate an ability to critically evaluate the psychiatric
    literature regarding the treatment of mood and anxiety disorders in children and adolescent.

SYSTEMS-BASED PRACTICE

The resident will learn to work with primary care providers and their offices to augment the treatment done at UCH with supportive care/ monitoring for other disease processes and reporting back of vital signs and labs as appropriate.  This is especially important for those patients who can not come in weekly due to distance traveled, problems with transportation. 

PATIENT CARE

Patients with pervasive developmental disorders can have complex presentations, including mental retardation.  These patients can present with disruptive or dangerous behaviors requiring intervention.  Residents are educated about the major modalities of treatment in autistic disorder and other PDDs including psychopharmacology, educational intervention, behavioral treatment, family support and psychotherapy.

MEDICAL KNOWLEDGE

Required educational experiences include:

  1. Patient evaluations (preschool, school aged, adolescent); 
  2. Diagnosis of toddlers, children and adolescents suffering from mood disorders, anxiety disorders, adjustment disorders, ADHD, disruptive disorders, psychotic, and sleep disorders;
  3. Treatments of preschool, school age, and adolescent patients and supportive care of their respective, paying particular attention to cultural and SES diversity
  4. Treatment modalities including crisis intervention, supportive, and pharmacologic therapies;
  5. Collaboration with other mental health providers, pediatricians and pediatric specialists and school professionals;
  6. Other experiences on this rotation include psychological testing, pediatric neurology, psychiatric emergencies, acute and seriously emotionally disturbed children and adolescents.
  7. Consultations with pediatricians, the legal system, school system and community organizations. 

INTERPERSONAL AND COMMUNICATION SKILLS:

Residents are able to demonstrate the following skills:

  • ability to listen to and understand patients
  • ability to communicate effectively with patients and their respctive families, using verbal, nonverbal, and writing skills, as appropriate
  • ability to foster a therapeutic alliance with the family, as indicated by instilling feelings of trust, openness, rapport, and comfort in the relationship with the physician

PROFESSIONALISM

  1. Residents ensure continuity of patient care, ad when appropriate, terminate treatment in a manner that doesn’t leave patients feeling ‘abandoned’.
  2. Residents respond to communications from patients and health professionals in a timely manner. If unavailable, residents negotiate and communicate back-up arrangements. Residents communicate clearly to patients’ families about how to seek emergency care when necessary.
  3. The resident will demonstrate ethical behavior, as defined in the Principles of Medical Ethics.
  4. The resident will demonstrate respect for patients and colleagues as persons, regardless of age, culture, disabilities, ethnicity, gender, and sexual orientation.

PRACTICE-BASED LEARNING AND IMPROVEMENT

Residents will be able to articulate the basic concepts of systems theory and how it is used in child and adolescent psychiatry.

Residents demonstrate a working knowledge of the diverse systems involved in treating children with development disorders.

Residents demonstrate understanding of use of systems as part of a comprehensive system of care.

SYSTEMS-BASED PRACTICE

The resident will interact with multiple specialities including Occupational therapy, Physical therapy, speech and language, neuropsychology, pediatrics, genetics, and neurology.  Residents will learn how to write a formal report that can be used to advocate for services/ placement.  

PATIENT CARE

Resident will observe patient evaluations, and attend the feedback session with the parents.

MEDICAL KNOWLEDGE

Residents will learn how to appreciate neuropsychological and adaptive function measures by direct supervision in the cases observed.  They will also be supported in learning how to score and then interpret simple measures.  Emphasis is placed on advancing knowledge in the interpretation and understanding of findings.

INTERPERSONAL AND COMMUNICATION SKILLS

Interpersonal skills require an underlying attitude of respect for others, especially with differing points of view or from different backgrounds.

The resident will show:

  • A desire to gain understanding of another’s position and reasoning
  • A belief in the intrinsic worth of other opinion
  • A desire to build collaboration
  • A will to share information in a consultative fashion

PROFESSIONALISM

The resident will respond to communications from patients and health professionals in a timely manner. The resident will demonstrate respect for patients and colleagues.

PRACTICE-BASED LEARNING AND IMPROVEMENT

The resident will demonstrate an ability to critically evaluate the psychiatric literature. This may include:

  • using knowledge of common methodologies employed in psychiatric research to evaluate studies, particularly drug treatment trials
  • conducting and presenting reviews of current research in such formats as journal clubs, grand rounds, and/ or original publications
  • researching and summarizing a particular problem that derives from the resident’s case load

SYSTEMS-BASED PRACTICE

The resident will be learn to work in an interprofessional team, and will learn to use scarce resources in the school and other settings to maximize supports for children tested as they sit in on feed-back sessions. 

PATIENT CARE

The resident will demonstrate the ability to:

  1. Complete an in-depth psychopharmacologic assessment to determine the diagnosis of an eating disordered patient including:
    • A Psychiatric history
    • A Social and educational history
    • A Family history
    • A Substance abuse history
    • A Medical history and review of systems
    • A Physical and neurological examination, as deemed necessary
    • A Developmental history
    • Mental status examination including assessment of cognitive functioning
    • Laboratory, radiologic, and ECG studies
  2. Identify comorbid diagnoses commonly occurring with eating disorders
  3. Provide on-going medication follow-up
  4. Residents serve as psychiatric consultants for medication evaluations for non-MD clinicians in the clinic.

MEDICAL KNOWLEDGE

  1. The Residents will demonstrate knowledge of psychotropic medications, including antidepressants, antipsychotics, anxiolytics, mood-stabilizers, hypnotics, and stimulants commonly used in the treatment of eating disorders or in their comorbid conditions. This knowledge will be comprised of the following:
    • pharmacological action
    • clinical indications
    • side effects
    • drug interactions
    • toxicity
    • appropriate prescribing practices
  2. Knowledge of the associated medical complications of eating disorders, as well as other co-morbid psychiatric diagnoses
  3. Knowledge of the roles the the multimodal treatment team plays in the treatment of many patients with eating disorders.

INTERPERSONAL AND COMMUNICATION SKILLS

The resident will develop skills during this time to:

  1. Educate patients and families regarding eating disorders including the risk of morbidity and mortality, and treatment options
  2. Collaborate effectively with other members of the team, primary care physicians and other therapists
  3. Maintain a therapeutic relationship with the patient and their parents/ primary caregivers
  4. Learn to work collaboratively with supervisors and other care providers.
  5. Communicate psychopharmacologic information in a timely, clear and meaningful manner taking into account the developmental and educational level of each family member
  6. Residents will demonstrate the ability to communicate effectively with allied healthcare professionals

PROFESSIONALISM

The residents will demonstrate a collaborative and nonjudgmental attitude characterized by empathy, respect, curiosity, and openness. Residents will also demonstrate the ability to tolerate ambiguity and show confidence in the efficacy of supportive therapy.

Residents will be sensitive to the sociocultural, socioeconomic, and educational issues that arise within the therapeutic relationship as demonstrated by:

  1. Respect for the patient's and the family's stress during evaluation and treatment
  2. Willingness to seek supervision for all treatments, especially those which engender strong countertransference responses
  3. Respect for the members of the treatment team and their differing roles

PRACTICE-BASED LEARNING AND IMPROVEMENT

  1. The resident will learn how to educate families with eating disordered children and teenagers.
  2. The resident will receive feedback from the supervising attending, and incorporate suggestions in the clinical care of patients.
  3. The resident will identify their own strength and weaknesses in dealing with this clinical population, and work with the clinic supervisor to develop a plan of care to work on these issues.

SYSTEMS-BASED PRACTICE

  1. Each residents must recognize and accept limitations in his/her knowledge base and clinical skills, and understand the need for life-long learning.
  2. Residents will possess research appropriate skills and demonstrate the ability to obtain current scientific research and clinical practice guidelines to assist in promoting high quality patient care. This will include, but not be limited to:
    • use of medical libraries
    • use of information technology, including Internet-based searches and research databases (e.g., MedLine)
    • use of drug information databases
  3. Residents will understand how their patient care affects and is affected by other health care providers.
  4. Residents will understand the regulation of outpatient psychiatric treatment including patient confidentiality, HIPAA, state regulations regarding drug prescription and scheduled medications.

KNOWLEDGE

  1.  Familiarity with the common neurological disorders of infants and children in an outpatient, university –based practice setting
  2. Knowledge of the pediatric neurological examination, presentation style and differential diagnoses.
  3. Knowledge of the indications for requesting specific diagnostic services and consultation with other services.
  4. Knowledge of interventions, indication and contraindications of treatments for common neurological disorders in children and adolescent.
  5. Knowledge of community services, including social, educational, respite, intervention, and rehabilitation for infants and children with neurological disabilities and their families.

SKILLS

  1. Ability to take an accurate history and perform a neurological examination of a child and an adolescent
  2. Ability to integrate clinical findings with other investigations to make a differential diagnosis and formulate a treatment plan
  3. Ability to write a concise chart note regarding the neurological evaluation of the infant or child.
  4. Ability to participate in the parent and child discussions, giving appropriate education regarding the illness, treatment plan, possible course and prognosis.

ATTITUDES:

  1. Empathy for patients and their families with neurological disabilities.
  2. Desire to work collaboratively with families, other physicians, other medical staff, as well as community services.