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SUNY Downstate Health Sciences University

Department of Psychiatry & Behavioral Sciences

Rotations

Months 1 2 3 4 5 6 7 8 9 10 11 12
Institution KCHC KCHC KCHC SUNY Downstate NYCCC, Brooklyn Campus
Rotation Name Inpatient Adolescent Inpatient Early Onset Psychosis CPEP-CL Development: Infant Child Learning Center, Pediatric Neurology Day Treatment Program, Intensive Day Treatment Program
% Outpatient 0 0 0 100% 100%
% Research Scholarly 0 0 0 20% 10%

 

 

Child and Adolescent Inpatient Psychiatric Service

The Child and Adolescent Psychiatric Inpatient Service (CAPIS) of KCHC, is certified by the New York State Office of Mental Health (OMH) to provide care for up to 45 children and adolescents. In order to offer developmentally appropriate programming, the service is divided into two self-standing units: 1) adolescent 12 to 17 years old and 2) adolescents and young adults age 16 to 23 years old suffering with first episode or early psychosis. Patients are admitted from KCHC CPEP or from pediatrics.  Our programming includes a Department of Education approved school, psychotherapy, group therapy, family therapy and psychoeducation. We also have a behavioral support team to advice staff on behavioral, milieu treatments, psychopharmacology, and psychotherapy management techniques. The fellow will be able to see various psychiatric disorders in an inpatient setting. They will be participating in various group activities and participate in treatment plan meetings. They will conduct family meetings. They will also learn about various legal proceedings in an inpatient setting.  They will learn about the inpatient milieu of a child and adolescent psychiatry unit including our CBT informed Early Onset Psychosis unit.  They will participate in various group activities and treatment plan meetings.  They will conduct family meetings.  They will also learn about various legal proceedings in an inpatient setting.

Child Psychiatry Consultation Liaison Service

The Child and Adolescent Consultation-Liaison Service is a subspecialty consultation service available to hospital pediatric and medical services for patients under 16 years of age presenting with psychiatric symptoms. Its services include psychiatric evaluation, psychiatric treatment during medical hospitalization, assistance with disposition and discharge planning for patients with psychiatric co morbidities. The fellows will be seeing a variety of psychosomatic conditions.  The fellows will be able to see patients in a variety of settings such as the medical unit inpatient and outpatient setting in the medical emergency room and labor and delivery.

Comprehensive Psychiatric Emergency Program (CPEP)

The KCHC CPEP is the largest psychiatric emergency room in Brooklyn. An interdisciplinary team of subspecialty-trained clinicians is available to provide evaluation and emergency care for children and families in need. The services provided include crisis-oriented evaluations, interventions and referral, psychopharmacological management, supportive therapy, family therapy and referrals for psychosocial support services. The fellows are part of the child team and    see children and adolescents under the supervision of child and adolescent psychiatry attending in an emergency setting. They will be able to treat evaluate and diagnose patients acutely. They will also be working together with a multidisciplinary team, which includes nurses, other doctors and social workers.

Day Treatment Program (NYCCC)

The first year Child and Adolescent Psychiatry Fellows rotate through NYCCC-Brooklyn Campus for the Day Treatment Program rotation. This Board of Education school provides an environment where children and adolescents receive education along with clinical care. The fellows will observe classroom functioning, work closely with a multidisciplinary staff to assess and treat children who have been admitted to the Day Treatment Program. They also learn about systems of care in the public sector by visiting other state funded side child and adolescent psychiatry services that are on the same campus. 

Development Rotation

During their Development Rotation fellows spend time in the Infant Child Learning Center (ICLC), the Children’s Mental Health Center (CMHC), Pediatric Neurology and have protected time for their scholarly project. The Infant Child Learning Center is located at SUNY Downstate. It provides a comprehensive service program to children from birth to five years of age who are challenged with a disability stemming from a variety of medical conditions including: premature birth, neurological impairment, congenital anomalies, orthopedic impairment, and HIV infection. These services are provided at no direct cost to the parents. The program is open to eligible children and their families who can benefit from skilled interdisciplinary services, including Early Intervention Preschool Education Services. Fellows have the unique opportunity to observe a day care setting where typically developing children interact with those with special needs. The CMHC provides strong support for parents in advocating for school services.  When first year Child and Adolescent Psychiatry trainees rotate through ICLC, they learn to do a comprehensive psychosocial and developmental history, learn about multidisciplinary assessment of infants and toddlers with developmental problems, including Occupational Therapy, Speech Therapy and Physical Therapy. Fellows also will develop the understanding of parental issues surrounding having a child with developmental disabilities, how families learn to navigate through the Department of Education process to obtain services, as well as learning to do crisis counseling.

Intensive Day Treatment Program (IDT) Program (NYCCC)

This is a 30-45-day program serving children between the ages of 8 and 17 years with acute psychiatric disorders in a school-based setting.  The IDT Program serves as a short-term assessment and treatment program for children who are challenged, in crisis and are currently unable to sustain being in the community school setting and/or treatment milieu.  Patient receives comprehensive assessment and are stabilize so that they can return to their community school.  Patients engage in academics, supervised by the Department of Education teachers in order for keep up with their school work.  They also participate in recreational programming.  Fellows learn about comprehensive assessment, various modalities of treatment including individual therapy, group therapy, DBT and psychopharmacological management and systems of care.

Neurology Clinic

The Pediatric Neurology Outpatient Clinic is located in the KCHC E building, where children with a wide array of neurological disorders are evaluated up until 21 years of age. Child and Adolescent Psychiatry second year trainees are exposed to such conditions such as seizure disorders, developmental delay, neurological tumors and infections, neurodegenerative disorders and neurological manifestations of system disorders. The fellows learn to do basic neurological exams of children and adolescents, learn of common neurological disorders in this population, co-morbid psychiatric conditions and to set up differential diagnoses of such illnesses.

 

CPEP - Comprehensive Psychiatric Emergency Program

DTP - Day Treatment Program

IDT - Intensive Day Treatment

CL - Consultation Liaison

CMHC - Children Mental Health Center

ICLC - Infant Child Learning Center

KCHC - Kings County Hospital Center

NYCCC - New York City Children's Center, Brooklyn Campus

SUNY - State University of New York

Months 1 2 3 4 5 6 7 8 9 10 11 12
Institution KCHC, NYCCC Brooklyn Campus, SUNY Downstate
Major Rotation DEC OPD Evaluations and Collaborative Care OPD Evaluations and Scholarly Elective
Minor Rotation Foren-sics   School Consultation   IBR Scholarly Elective
Outpatient Ongoing Psychopharmacology and Psychotherapy cases at KCHC with one afternoon at NYCCC-Brooklyn Campus or SUNY Downstate
% Outpatient 90% 90% 80%
% Research/ Scholarly Elective 10% 10% 20%

 

CPEP - Comprehensive Psychiatric Emergency Program
CL - Consultation Liaison
DEC - Developmental Evaluation Clinic
DTP - Day Treatment Program
IBR - Institute for Basic Research
IDT - Intensive Day Program
ICLC - Infant Child Learning Center
KCHC – Kings County Hospital Center
NYCCC - New York City Children's Center, Brooklyn Campus
OPD - Outpatient Department
SUNY - State University of New York

 

Developmental Evaluation Clinic (DEC)

The Developmental Evaluation Clinic is located at Kings County Hospital Center. CAP fellows will assess children who are between the ages of birth and 17 years, who exhibit developmental, language or motor delays, mental retardation, autism spectrum disorders or other neurological problems. Children are provided with multidisciplinary evaluations, including speech, psychological, psychiatric, neurological, early intervention and neuropsychological assessments as needed. Among other services are case management services for short-term counseling, early intervention services, speech therapy and parent counseling.  The Child and Adolescent Psychiatry fellows will rotate through DEC during their second year, conducting and observing evaluations, treating patients with ongoing psychotherapy and medication management.

Forensics

Child and Adolescent Psychiatry fellows observe forensic evaluations and learn about the court system as it pertains to mental health issues, such as family court and custody hearings. They will also conduct a forensic evaluation in the New York Family Court System.

Institute of Basic Research (IBR)

IBR is a two month rotation where the fellows rotate four times for 2 months. The fellows will be working with patients with developmental disabilities. The fellows will be able to learn about the causes of mental retardation and the characteristics of autism. They will be able to learn about various genetic illnesses which contribute to developmental disabilities. They will also meet with a genetic counselor to discuss about disease conditions. The facility is state governed.

Kings County Hospital Center Outpatient Clinic (OPD)

The OPD is a multidisciplinary diagnostic and therapeutic clinic serving children and adolescents living in the borough of Brooklyn who are younger than 18 years old. We work with children and adolescents who present with a range of emotional, behavioral, social, and school problems, with the exception of some developmental delays and substance abuse. Our services include walk-in evaluations and ongoing outpatient treatment, including individual, group, and family psychotherapy, and medication treatment. Evaluations take place in the mornings. Clinic treatment appointment hours are Monday-Friday from 8:00 am to 8:00 pm. The fellows do assessments, and provide psychopharmacologic and psychotherapeutic treatment including CBT, supportive therapy, play therapy, family therapy and exploratory therapy.

NYCCC Outpatient Clinic

The second year Child and Adolescent Psychiatry Fellows rotate through NYCCC-Brooklyn Campus Outpatient Clinic on a weekly basis. Fellows’ responsibilities and experiences will include being the primary clinician on their assigned cases. This entails providing medication management, individual psychotherapy, as well as case management. They will also co-lead a DBT group.

School Consultation

The school consultation rotation takes place in conjunction with the seminar and trainees from the Department of Psychology. Second year Child and Adolescent Psychiatry fellows participate in consultation at a local Brooklyn Elementary school (PS 235) to observe typical child behavior at different developmental levels at school. Fellows have the opportunity to interact with teachers and students to learn how children’s behaviors are affected by the classroom milieu. Fellows will gain exposure to varied academic strategies that foster learning, understand the NYC school system and the role of staff members, and closely interact with school teachers to discuss classroom dynamics.

Research Selective / Scholarly Activity

All second-year residents engage in research or scholarly activity of their choosing with the support of a senior faculty mentor. The formal proposal for research/scholarly activity is due in August.

Goals and Objectives:

  1. Exploration of an area of interest in a fashion that advances the resident's knowledge of basic principles of research, including:
    • Transforming an idea into a research question
    • Conducting a literature review
    • Choosing an appropriate study design
    • Determining appropriate methods and instruments
    • Collecting, managing, and analyzing data
    • Preparing and submitting a protocol to the Institutional Review Board
    • Writing up a case with an accompanying literature review for submission to a journal
  2. Consolidating the process and findings of the research/scholarly activity in a Grand Rounds presentation (and, in some cases, a paper). Preparing and presenting at Grand Rounds is a program requirement.

 

DEC - Developmental Evaluation Clinic

IBR -  Institute for Basic Research

KCHC - Kings County Hospital Center

NYCCC - New York City Children’s Center, Brooklyn Campus

OPD - Outpatient Department

SUNY - State University of New York