The Training Program in Child and Adolescent Psychiatry
Cambridge Health Alliance and Its Mission
Since 1964, the Cambridge Hospital (now Cambridge Health Alliance, or CHA) has provided a model of innovative community-oriented healthcare in which trainees from all psychiatric disciplines have developed their skills. The CHA mission is to improve the health of the Massachusetts communities we serve. As a safety-net healthcare system, CHA has been on the cutting edge of healthcare reform, and has received national recognition for its innovative work. In 1988, the Victims of Violence Program at CHA received the Gold Award from the American Psychiatric Association for innovative hospital and community service. In 1993, CHA was honored with the Foster G. McGraw Prize for service to the community. In 2001, CHA received three Safety Net awards for Open Access Patient Scheduling, Domestic Violence Programming, and Cultural and Linguistic Competency. In 2001, the Robert Woods Johnson Foundation selected CHA as one of seven healthcare systems for a “Pursuing Perfection” grant to transform healthcare delivery. In 2003, CHA was again honored with APA’s Gold Award, this time for its innovative work in providing a restraint-free environment on its child inpatient psychiatric unit. In 2007, the National Association of Public Hospitals and Health Systems presented the Chair Award to CHA for its integrated medical student clerkship program. And in 2009, CHA was selected as a national best practice site for team development by the Commonwealth Fund Safety Net Medical Home transformation initiative.
As part of its 2015 strategic planning process, CHA is poised to become an Accountable Care Organization. This “medical home” model would involve CHA receiving global insurance payments from private, state and federal insurers in exchange for providing integrated care to a community of patients. The planning and implementation for this model is actively underway with the initial focus occurring on the side of adult medical and mental health care; child services will be phased in over time. This model will enhance our ability to focus on preventative care and well as treatment, and offer earlier interventions for the children and families we serve.
Child Psychiatry at CHA
Child psychiatry services are delivered through CHA hospitals but also, very importantly, through our community- and school-based clinics. Our Child Psychiatry Faculty is devoted to helping children, adolescents and families from diverse and underserved populations and has expertise in psychotherapy and psychopharmacology, many different kinds of consultation, multicultural issues, and public sector systems of care. In addition to our wealth of current services, developing areas of clinical focus are: child psychiatry/pediatrics collaborative care; infancy and early relationship support; eating disorders; and preschool consultation.
CHA Training in Child Psychiatry
Training and education are key elements of CHA’s mission. The CHA child psychiatry fellowship training program has its roots in psychodynamic and psychoanalytic therapies, as well as multiculturalism and community-based care. It continuously incorporates new treatment modalities within our field into the training program within the frame of biopsychosocial treatment. Our values include training highly ethical, independent and responsible physicians who will give excellent psychiatric care to children and families using an integrative approach to child psychiatry that fits the needs of the individual patient and families.
The two-year training program includes a combination of didactics and clinical rotations. Currently, eight to ten hours a week are protected for didactic learning. Weekly seminars cover a variety of topics pertinent to our field. Clinical rotations occur throughout both years. The first year is divided into 5 approximately 10-week blocks with primary rotations in adolescent inpatient, child inpatient, psychiatric emergencies, consult-liaison, (which includes both inpatient and outpatient consultation) and elective. In addition, briefer rotations within each block focus on issues such as developmental disorders, eating disorders, neuropsychological testing and preschool-age development. Also in the first year, trainees begin their longitudinal outpatient experience in both psychotherapy and psychopharmacology. Finally, the first year fellows rotate through the outpatient diagnostic evaluation team to begin to learn the skills needed to conduct outpatient assessments.
The second year focuses on seeing a diverse outpatient population for a full range of outpatient treatments including individual therapy, family therapy, cognitive-based therapy, psychopharmacology and group therapy. In addition, second-year fellows have rotations in pediatric neurology, forensics, and school consultation in one of the Cambridge public schools. Seven hours a week throughout the second year is available for elective time and scholarly activity.All second-year fellows complete a Clinical Scholarship Project.
The Training Program in Child and Adolescent Psychiatry at Cambridge Health Alliance recruits five fellows per year. Interested applicants should submit an application in writing using the joint application form of the three Harvard Medical school affiliated training programs in child and adolescent psychiatry after July 15th. Interviews begin in September and run through the beginning of December. Decisions are made by mid-December for the following training year. We accept fellows only after their PGY-III year of training (or beyond) who have passed USMLE III. Our program participates in the NRMP match for fellows in Child and Adolescent Psychiatry. We are an equal opportunity employer and training program and seek to recruit minority trainees and faculty members who will assist us in providing services to minority groups in our community.