Child & Adolescent Psychiatry Fellowship

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, including:

  • 1988 - the Victims of Violence Program at CHA received the Gold Award from the American Psychiatric Association (APA) for innovative hospital and community service
  • 1993 - CHA was honored with the Foster G. McGraw Prize for service to the community
  • 2001 - CHA received three Safety Net awards for Open Access Patient Scheduling, Domestic Violence Programming, and Cultural and Linguistic Competency
  • 2001 - the Robert Wood Johnson Foundation selected CHA as one of seven healthcare systems for a “Pursuing Perfection” grant to transform healthcare delivery
  • 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
  • 2007 - the National Association of Public Hospitals and Health Systems presented the Chair Award to CHA for its integrated medical student clerkship program
  • 2009 - CHA was selected as a national best practice site for team development by the Commonwealth Fund Safety Net Medical Home transformation initiative.

In 2006, after Massachusetts passed health care reform legislation, CHA formed an Accountable Care Organization (ACO) and has been working to transition away from a fee-for-service payment model towards a global payment model in order to provide comprehensive and high quality care to our community of patients. To this end, CHA quickly began transforming its primary care centers into patient-centered medical homes, and as of December 2016, all 12 CHA primary care practices have been designated as Level III Patient-Centered Medical Homes by the National Committee for Quality Assurance (NCQA) and have received the MA Health Policy Commission's Patient Centered Medical Home PRIME Certification for behavioral health integration. Additionally, in 2014, CHA developed an affiliation with the Beth Israel Deaconess Care Organization (BIDCO). In 2017, CHA was selected by the Massachusetts Health Policy Commission (HPC) to create a Massachusetts Medicaid, MassHealth, ACO Partnership called Tufts Health Together with CHA. CHA’s MassHealth ACO launched in 2018, and has opened many doors for new value-based approaches to helping children and families. As these efforts continue to progress, and include pediatric integrated care models, CHA will be better able to focus on preventative care and population health for the children and families we serve.

Training in Child and Adolescent Psychiatry

CHA Child & Adolescent Psychiatry Fellowship Program Aim Statement:

"To develop clinical, academic, and innovation leaders in community child and adolescent psychiatry within a supportive learning environment that embraces health equity, diversity, and a compassionate, family-centered, evidence-based approach to caring for children and families."

Training and education are key elements of CHA's mission. The CHA child psychiatry fellowship training program has its roots in psychodynamic therapies and public sector, multicultural, community-based care. While continuing to nurture this tradition, the program also trains fellows in other evidence-based treatment modalities in the service of a comprehensive bio-psycho-social-cultural model. We are committed to training highly ethical, independent and responsible physicians to provide excellent psychiatric care to children and families of all backgrounds, using an integrative and collaborative approach. We aim to develop leaders in community child and adolescent psychiatry who will embody these core clinical values, and work to improve the systems, science, and practices supporting children and families in need.

The two-year training experience is designed upon a strong foundation of adult learning principles, and includes a combination of interactive didactics, longitudinal and rotation-based clinical practice, individual and group supervision, and independent and group projects and scholarship. Fellows develop proficiency in performing bio-psycho-social-cultural evaluations of children and families of diverse backgrounds in a variety of treatment settings. Fellows are taught to engage families in shared decision making around the most evidence-based, cost-effective, and appropriate treatment plans for each family’s unique set of preferences, beliefs, and strengths. Fellows develop a deep understanding of the systems of care that can be rallied to support children and families, and have extensive opportunities to participate in these collaborations throughout fellowship. Fellows will become proficient in the judicious use of medication and other biological interventions in the treatment of psychiatric disorders in youth, and will develop a range of psychotherapy techniques, including: intensive psychodynamic individual psychotherapy, intensive family therapy, brief and focused individual and family therapies, supportive psychotherapy, cognitive behavioral psychotherapy, dialectical behavior therapy, motivational interviewing, psycho-educational interventions, and group therapy. Fellows will also develop their skills of leadership, scholarship, and improvement in community mental health care through experiential learning in such topics as: culture, race, and ethnicity, health equity and disparities, social determinants of health, structural competency, population health, and value-based care.

The first year is divided into five 10-week blocks that allow fellows to develop expertise in a variety of settings, including the Adolescent Inpatient Psychiatry Unit, Child Inpatient Psychiatry Unit, Psychiatric Emergency Service, community service agency, residential psychiatric facility, and inpatient and outpatient pediatric medical settings. In addition, briefer rotations within each block focus on issues such as developmental disorders, pediatric neurology, preschool-age development and consultation, early intervention observation, wrap-around care, interdisciplinary outpatient diagnostic evaluations, pediatric primary care-mental health integration, consultation to state agencies, and elective time. Also in the first year, trainees begin their longitudinal outpatient experience in both psychotherapy and psychopharmacology, and begin a longitudinal group quality and process improvement project.

The second year is focused on seeing a diverse outpatient population for a full range of outpatient treatments. In addition, second-year fellows learn about forensic psychiatry in the juvenile court clinic and through evaluations of children seeking asylum. They learn about school consultation through a year-long school placement and supervised risk assessments. Eight 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 via ERAS by October 1, 2019. Interviews will be offered in September through November. The match list is submitted in mid-December and match results are announced in January for the following training year. We accept fellows only after their PGY-III year of training (or beyond) who have passed USMLE III, completed required Clinical Skills Evaluations (CSEs), and met all ACGME requirements for general psychiatry. 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 are dedicated to providing services for our diverse patient population.