Clinical Rotations

Residency Training - Child and Adolescent Psychiatry

Overview of First Year Clinical Rotations

4 Months at Weill Cornell Medical Center

Adolescent Partial Hospital Program - 3 months
Pediatric Consultation Liaison Service, Neurology and Neonatal Follow-Up Clinics - 1 month
Family Therapy Supervision - part time over 4 months

4 Months at the Westchester Division

Children’s Inpatient Unit (Nichol's Cottage) - 2 months
Adolescent Inpatient Unit (7 North) - 1 month
Adolescent Eating Disorder Unit (Outlook) - 1 month
Social Skills Group Therapy (Outpatient Dept) - part time for 4 months

4 Months at NewYork-Presbyterian Hospital Morgan Stanley Children's Hospital

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

Description of First Year Clinical Rotations

Adolescent Partial Hospital Program (Weill Cornell Medical Center): Beginning in the fall of 2012, residents will treat patients in the first Adolescent Partial Hospital Program in Manhattan. This program will provide five day intensive psychiatric services to adolescent patients as well as enhanced emergency services to children and teens.

Pediatric Consultation Liaison Service (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. Resident gain experience teaching pediatric residents both informally on the inpatient services and formally during the pediatric morning report. While on the this rotation, residents gain additional experience in the pediatric neurology and neonatal follow up clinics outlined below.

Pediatric Neurology Clinic (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 Payne Whitney Manhattan. 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 (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 Infancy Seminar. The Neonatal Follow-Up Clinic evaluates all infants discharged from the Neonatal Intensive Care Unit (NICU). A multidisciplinary team of pediatricians, a physical therapist, and a nutritionist completes developmental assessments at regular intervals up to age 3 years of age. The Pediatric Psychiatry Consult resident observes and participates in these assessments.

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

Children's Inpatient Unit (Nichols Cottage, NYP Westchester Division): Nichols Cottage is a 17-bed acute inpatient unit for children age 4 to 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 (7 North, NYP Westchester Division): The adolescent inpatient unit is an 18-bed acute inpatient unit for adolescents age 13 to 17 years old, with a length of stay averaging two weeks. Residents care for patients with a wide range of psychopathologies and discharge needs. Residents function as a 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 disorder service is a 6-bed acute inpatient unit for adolescents, 13 to 17 years of age, with a principle diagnosis of an eating disorder, although co-occurring conditions are common. The average length of stay is 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 wide range of evidence based treatments that are provided for patients.

Social Skills Group Therapy (NYP Westchester Division): Residents participate in a social skills group therapy program on a weekly basis, under supervision, throughout their four-month rotation at The Westchester Division. These groups vary with regard to age range and diagnosis, but all provide the residents with valuable exposure to the principles and practice of social skills training.

Pediatric Consultation and Emergency Services (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 (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 NewYork-Presbyterian 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 disorder, or psychiatric factors complicating a neurological condition.

Pain Clinic (Morgan Stanley Children's Hospital of New York): Each child psychiatry fellow rotates for four weeks in the outpatient Pediatric Pain Management Center at NewYork-Presbyterian Morgan Stanley Children's Hospital. The fellow participates in the evaluation of children and adolescents with diagnoses such as functional abdominal pain, chronic daily headache, complex regional pain syndrome type I (reflex sympathetic dystrophy), and chronic pain associated with life-threatening illness.

Overview of Second Year Rotations

2 days a week at NewYork-Presbyterian Hospital Morgan Stanley Children's Hospital

Outpatient Evaluation Clinic - 4 months
Outpatient Sub-Specialty Clinics - 12 months
School Consultation - 1.5 months
Early Childhood Nursery Observation - 3 months
CARING @ Columbia - 3 months
Psychotherapy Technique Supervision

2 days a week at Payne Whitney Manhattan or Payne Whitney Westchester

Outpatient Evaluation Clinic - 12 months
Outpatient Sub-Specialty Clinics - 12 months
School Consultation - 1.5 months
Psychotherapy Technique Supervision

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

Descriptions of Second Year Clinical Rotations

Weill Cornell Psychiatry Manhattan and Westchester Campuses

Outpatient Evaluation Clinic: Residents perform psychiatric evaluations of children and adolescents under direct supervision. Evaluations include interview with the child, as well as 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: Resident gain experience in the treatment of patients in a variety of clinics which are organized by disorder (eg. Anxiety Disorder Clinic) or treatment modality (eg. Psychopharmacology Clinic). Faculty with particular expertise in specific psychopathology and treatment modalities provide ongoing supervision to the residents.

Psychotherapy Technique Supervision: Each resident receives ongoing supervision in the implementation of psychodynamic psychotherapy and of specific Cognitive Behavioral, Parent Training and Family Therapy techniques.

School Consultation: This rotation provides an experience in a mainstream education setting at PS 183 School in Manhattan and in White Plains Middle School in Westchester. Residents observe children in the classroom, consult with teachers about normal vs. deviant development and behavioral management, and in some instances participate in the committee on special education assessments.

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 evaluation clinic.

Outpatient Sub-Specialty Treatment Clinics: The Pediatric Psychiatry outpatient clinics at NewYork-Presbyterian Morgan Stanley Children's Hospital are organized around specific diagnoses. Residents rotate through the several of these subspecialty clinics, including the Children's Anxiety & 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.

School Consultation (Robert F. Kennedy School): The resident gain experience in specialized educations programs for youngsters with serious psychiatric disturbance. This experience is supplemented by didactic lectures and case conferences.

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 is available.

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