Core Clinical Rotations

First Year

The 1st year of the 2-year Child and Adolescent Psychiatry Residency is divided into four blocks, each of 3 months duration. For a full description of the Seattle Children’s Hospital and CSTC, including individual departments, units and specialty services, please refer to our Training Sites page.

The F1 rotations are as follows:

• Seattle Children’s (SCH) Psychiatry and Behavioral Medicine Unit (PBMU), our Inpatient Psychiatric Unit

• Fellows work on a team with an attending psychiatrist, mental health therapist, case manager and often psychiatry/psychology residents and rotating medical students. Fellows work from Monday through Friday, with a continuity clinic half-day on Wednesday afternoon and protected time for didactics on Friday morning. Fellows work with youth from ages 3 to 17, dealing with a wide range of acute psychiatric disorders or behavioral problems. With some variation, fellows can usually expect a caseload of 4-6 patients, with supervision provided by an attending child and adolescent psychiatrist. Fellows gain experience in short-term psychotherapy, medication management, facilitating family meetings, acute behavioral management, safety planning, and working on a multidisciplinary team. Fellows participate in safety huddles, multidisciplinary didactics and case conferences.

• SCH Consult/Liaison Service

• The child psychiatry consult service is composed of a multidisciplinary team of psychologists, psychiatrists, trainees (psychology residents and CAP fellows) consulting to various medical services within SCH. Fellows rotate for a full day on Monday, Tuesday, Thursday, and Friday (afternoon only). Common referrals include patients with challenges in coping with chronic illnesses or long-term hospitalization, mood and anxiety disorders associated with medical illnesses, eating disorders, conversion disorders, delirium, iatrogenic reactions such as medication-induced mood disorders, safety evaluations following suicidal behaviors or significant noncompliance, and consultation to our emergency room mental health staff. Fellows also work with youth exhibiting lack of adherence to their medical care, aggression, and other behavioral issues on medical and surgical units.

• Child Study and Treatment Center (CSTC)

• Fellows rotate on Mondays, Tuesdays, and Thursdays. On Wednesday fellows will be in the SCH Continuity Clinic (see below). Friday mornings are protected for Didactics with Friday afternoons reserved for scholarly inquiry projects. Fellows work on Ketron Cottage at CSTC, which serves youth generally between the ages of 11 and 15. As a WA State long term/residential psychiatric hospital, CSTC treats children who have persistent and severe medical and psychosocial treatment needs. Patients are referred through the DSHS Children's Long-term Inpatient Placement (CLIP) committee. They may also be placed at CSTC via the Involuntary Treatment Act (ITA). Fellows gain experience in milieu and group (including dialectical behavioral and adventure-based) therapies, as well as individual therapies such as narrative, motivational, and trauma-focused cognitive behavioral therapy. This training site provides a unique opportunity for "in-vivo" appreciation of the lives, challenges, and developmental pathways of youth with very complex biopsychosocial challenges.

• SCH Outpatient Rotation

• Monday:
• Eating Disorders Clinic: Fellows perform initial evaluations for children and adolescents with eating disorders. Fellows also participate in various treatment modalities for eating disorder including meal support classes, family based treatment and CBT interventions.
• Tuesday:
• Mornings are spent in the Typical Development rotation: Fellows attend a daycare center doing observation of normative development. Typical developmental milestones are reviewed with a supervisor.
• Afternoons are spent in Anxiety Training Clinic. Fellows participate in intakes for anxiety clinic, participate in individual CBT/exposure therapy sessions and co-lead anxiety groups for youth and parents.
• Thursday:
• Autism Center: Fellows work in the medication management, biobehavioral/RUBI (parent training) and diagnostic testing (ADOS) clinics within the Autism Center. Fellows also participate in weekly teaching rounds with Dr. Soo Kim at the Autism Center.
• Friday:
• Afternoon Pediatric Neurology Clinic: Fellows train in the SCH general pediatric neurology clinic. Common presenting concerns include seizure disorders, movement disorders, metabolic diseases affecting the nervous system, congenital anomalies of the brain and spinal cord and neuro-oncologic problems. Fellows refine their neurologic evaluation and examination skills in the pediatric population.

• SCH Outpatient Psychiatry Clinic

  Fellows have their continuity training clinics on Wednesdays throughout both years of training. During their PBMU rotation, fellows participate in a clinic half-day on Wednesday afternoons (mornings are spent on the PBMU). This clinic offers fellows a chance to experience long-term continuity care with both weekly therapy patients and medication management cases that are seen less frequently. Fellows also have 1 hour of medication management supervision and 1 hour of CBT psychotherapy supervision each Wednesday built into their clinic schedules

        

F1 Rotation Schedule 2020-2021