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| The Child and Adolescent Psychiatry Residency Program is an integral part of the University Texas Southwestern Medical School, Parkland Memorial Hospital, Children’s Medical Center of Dallas, and the Dallas psychiatric community. The mission of our program is to develop child and adolescent psychiatrists with broad clinical and professional competence. We place great emphasize on developmental, biopsychosocial, psychodynamic, cross-cultural, family systems and behavioral concepts. This includes knowledge of normal and pathological development, developmental neuroscience, developmental delays, and deviations due to environmental stressors, cultural differences, and psychopathology. The Child and Adolescent Psychiatry training objectives include: • Fellows will have the ability to carry out evaluations. The program offers extensive didactic and clinical training in psychodynamics. We are one of a small number of sites able to offer cognitive and behavioral therapy research support. The division of Child and Adolescent Psychiatry has recently been awarded one of eight NIMH funded sites in the U.S. These Research Units for Pediatric Psychopharmacology and Psychosocial Interventions reflect the field's recognition of our faculty as world leaders in psychopharmacology and psychosocial interventions. The program offers extensive didactic and clinical training in psychodynamics. We are one of a small number of sites able to offer cognitive and behavioral therapy research support. The division of Child and Adolescent Psychiatry has recently been awarded one of eight NIMH funded sites in the U.S. These Research Units for Pediatric Psychopharmacology and Psychosocial Interventions reflect the field's recognition of our faculty as world leaders in psychopharmacology and psychosocial interventions. Research interests include mood disorders, anxiety disorders, psychotic disorders, sleep disorders, neuro-imaging, ADHD, eating disorders, and developmental disorders. Research opportunities in clinical and basic science are available for Trainees. UT Southwestern has long been recognized as a leading psychopharmacology clinical trial center. There are a large number of ongoing and planned NIMH, foundation and industry sponsored clinical trials. Fellows are encouraged to participate in these trials or develop research of their own. Active areas of research include depression, bipolar disorder, anxiety disorders, psychotic disorders, eating disorders, addiction and substance abuse, and ADHD. Child and Adolescent Psychiatry residency subspecialty training requires two years beyond the general psychiatry residency. However, beginning the child and adolescent psychiatry residency in the fourth postgraduate year can shorten the total length of training. The first year of the fellowship training also counts as the last year of general psychiatry. If pursuing this track should ensure ahead of that the first three years of their general psychiatry residency cover certain essentials mandated by the RRC and the American Board of Psychiatry and Neurology for Adult Psychiatry. There is easy access to the University of Texas Southwestern Medical School library on campus and off through the library’s website with online availability to MedLine, PsychLit and other electronic journals. Graduates of the University of Texas Southwestern Child and Adolescent Psychiatry program have entered private practice, research, and faculty positions, inpatient and outpatient medical directorships (in both the public and private sector), Psychoanalytic Training, and practice. The faculty consists of ten full-time child and adolescent psychiatrists, who teach and direct a clinical service within the division, have clinical practices and are involved in research as well as numerous voluntary clinical faculty. Full-time clinical psychologists and social workers play important teaching roles in psychological testing, cognitive behavioral therapy, hypnosis, group, and family therapy. General psychiatry, pediatric residents, medical students, psychology interns, and social work students also rotate through the Division’ training sites, ensuring a rich, multi-disciplinary training experience. The faculty continues to publish in a wide variety of refereed journals as well as present at national and regional conferences. Part-time and clinical faculty has significant roles in teaching, advising, and supervising fellows. Many of the faculty are both psychoanalysts as well as child and adolescent psychiatrists Fellowship Program Faculty DidacticsThe Child and Adolescent fellows attend lectures weekly on Tuesdays, 8:00am-4:30pm. Faculty, clinical faculty, social workers, psychologists and other members of the university psychiatric team present lectures.
EvaluationsFellows are evaluated by supervising faculty, the Training Director, and the Education Committee. The Education Committee consists of the Child and Adolescent Psychiatry Faculty as well as the Chief Resident. Evaluations are completed in accordance to the ACGME training program requirements. All evaluations are discussed on an individual basis with each fellow and the evaluating. Semi-annual evaluations with the Training Director are held in December and May. All evaluations are reviewed and the fellow's training progress discussed. Evaluations of fellows for didactics are completed by the lecturer semi-annually. Peer and self-evaluations are completed semi-annually. Fellows evaluate the training program anonymously twice during the academic year, including each rotation, selected didactics and individual site supervisors The results are compiled anonymously and discussed as part of the annual Program Review. First Year Rotations Children’s Medical Center, Inpatient Service *Each Fellow is required to have 1-2 individual therapy patients weekly by September of the first year. Second Year Rotations Community Consultation through Dallas ISD’s Youth and Family Center * Each Fellow is required to have 5-7 therapy hours per week, one of which should be a family therapy case. Child Psychiatry R-25 Research Track The Department of Psychiatry and the Division of Child and Adolescent Psychiatry are committed to prepare interested residents and child fellows to become independent clinical researchers in Child and Adolescent Psychiatry. The child and adolescent fellowship training program at UTSW supports research training of interested child fellows during their two-year fellowship. During the two years of fellowship training, the research fellow will complete all clinical requirements. In addition, he/she will have 45% and 50% protected time during their first and second years in fellowship, respectively to engage in research activities. The research fellow will work with mentors on developing his or her own research while actively participating in on-going research projects in the division. The fellow will attend didactics and seminars available through the research track of the department of psychiatry. Currently, we have research programs in pediatric bipolar disorders, major depressive disorders, ADHD, eating disorders, substance abuse, chronic medical illness and oncology. Not only we have on-going treatment studies (both medication and psychotherapy), we also have on-going neuroimaging and genetic studies that fellows can readily participate. We continue to expand our research efforts in other areas of child psychiatry, including developmental disorders. The fellow will be expected to complete a research project and a report for publication at the end of his or her training. The research training is supported by an NIH funded R-25 training grant awarded to the child division. Description of Inpatient Service: The psychiatric inpatient unit at Children's Medical Center of Dallas has 12 beds and admits children and adolescents between the ages of 2-18 years. Approximately 180 patients are admitted to this unit each year. Residents function as team leaders of a multidisciplinary treatment team and provide evaluation, integrated multimodal treatment plans for individual, group, family therapies and psychopharmacology for hospitalized children and adolescents. Description of Day Treatment Service: Residents are supervised daily in a report by the medical director; participate in educational discussion with multidisciplinary team centered on daily review of patients including treatment planning and crisis intervention; participate in frequent scheduled focus meetings structured by patient needs, which provide clinical material for education; examples include focused behavioral programming meeting and educational consultation. The presentations are multimodal and multidisciplinary. Residents receive group therapy education / supervision with a co-therapist. Formal individual teaching/supervision sessions are held at least 2 - 3 hours per week. Description of Consult / Liaison Service: The Psychiatric Consultation/Liaison Service is a multidisciplinary team that evaluates and treats the emotional, behavioral, and cognitive needs of pediatric patients receiving care in the medical setting. As a member of this team, the Fellow provides consultation for Children's Medical Center of Dallas. Patients with co-morbid medical and psychiatric illnesses are seen in the general hospital, emergency room, first care, and outpatient clinics. Patients seen for consultation can be followed-up in the weekly psychiatric Consult Clinic. The average inpatient consultation caseload for the consulting resident is 5 new consults a week, plus appropriate follow-up of cases in the hospital or in clinics. Inpatients are seen immediately or within 24 hours. Interventions are then formulated to support the patient, their family, and/or the clinical team. Residents often facilitate the transfer of patients to the inpatient psychiatric unit and day treatment. During the C/L rotation, residents learn the basic principles of psychiatric consultation. Residents work with complex pediatric systems and provide the full range of interventions. Description of Second Year Rotations: The CMC Outpatient Clinic provides a site for ongoing care of patients who are discharged from the psychiatric inpatient and day treatment services, and to provide diagnostic evaluations and treatment for outpatients. Residents conduct evaluations and treatment with a wide range of children and adolescents. CMC Outpatient Clinic is a required 12-month rotation 4 days per week for second year residents. Two hours per week are spent in individual supervision with full time and clinical faculty in addition to morning didactics and teaching rounds. Additional supervision is provided in a group format for family therapy, and psychopharmacology. Second year residents see approximately 2-3 new cases each week, and have 4-5 follow-ups per day. Cases are carried throughout the 12-month rotation, and an appropriate disposition is made at the conclusion of the 12-month rotation. First year fellows carry long-term patients into their second year of training. Faculty consists of three full-time child psychiatrists, one part time child psychiatrist, two full-time child psychologists, one full time social worker, a registered nutritionist (for eating disorders) one mental health nurse practitioner and several mental health ancillary staff. The Outpatient Clinic also hosts several specialty clinics for the following areas: Autism, Bipolar Disorder, Depression and ADHD. Behavioral and Psychiatric Services (BPS) through Dallas Metrocare Fellows will participate in a four-hour-per-week rotation through a dual diagnosis (mental health and mental retardation) public sector clinic. The Fellow will perform psychiatric assessments and make treatment recommendations. The Fellow will follow patients previously evaluated for medication maintenance. Supervision provided by a Board-certified child/adolescent psychiatrist. Exposure to the special diagnostic and treatment problems of children and adolescents with both mental retardation and disruptive behaviors or sever psychiatric symptoms. DISD Youth and Family Centers has had a long-standing relationship with UT Southwestern as an opportunity for community members to receive quality mental health care. Fellows will treat patients one half day per week for 8 weeks. The Episcopal School of Dallas is a private college preparatory school with approximately 1200 students from beginner to 12th grade. As part of your experience at the school, you will be working with 3 clinical psychologists from Children’s Medical Center and one intern from UT Southwestern. They work with parents, teachers, and administrators to help identify students in need of services for learning, emotional, social or behavioral difficulties. You will attend meetings with the psychologists and school personnel in which concerns about students are discussed and appropriate recommendations are made. You may also have the opportunity to conduct classroom observation with elementary age children. Classroom observation is an excellent way to gather information useful in making helpful recommendations to the school. Forensic Psychiatry, Dallas County Juvenile Detention Center performs psychiatric evaluations on children and adolescents ages 10-17 that are either referred by a psychologist, a probation officer or a judge. During this rotation, Fellows will see patients from 1-5pm on Friday afternoons. The Low Birth Weight Clinic (LBWC) at Children’s Medical Center serves 0-3 year old children born premature and under 2500 grams. These children and their families represent several race/ethnic groups. The clinic provides primary care for infants and has one pediatrician, one physician assistant, two pediatric nurse practitioners, a nutrition specialist, a child life specialist, and a social worker. Low Birth Weight Follow-up Clinic is an outpatient clinic designed to meet the special post-discharge needs of high-risk infants cared for in the Parkland Memorial Hospital’s Special Care Nursery. The clinic is also involved in a spectrum of national research studies. The Pediatric Neurology Clinic at Children's Medical Center sees the overlap of pediatric neurology and psychiatry, adding greater understanding of developmental disabilities, genetic and seizure disorders. This is a required rotation occurring in the second year at Children's Medical Center. Residents see 2-5 cases per morning. They work closely with one of the five full-time pediatric neurology attendings. Cases are discussed in a group conference at the end of each clinic. The clinic population ranges in age from birth to 18 years. Common diagnoses include seizure disorders, headaches, post-traumatic, head injuries, developmental delays, and genetic syndromes. They have the opportunity to develop a greater understanding of developmental disorders, mental retardation and genetic disorders. The Salesmanship Club of Dallas, Inc. (SCD) is a not-for-profit civic service organization of business professionals dedicated to improving the future of children and their families. SCD raises funds to support the charitable work of the Salesmanship Club Youth and Family Centers, Inc., an independent, not-for-profit human service agency with a community school and a family center. The goals of our training program are: To broaden the resident’s knowledge of family therapy models based on systemic and interaction concepts; To promote reflective habits that enable residents to evaluate how their own assumptions influence their actions; To sensitize and enhance the resident's knowledge and skills in working with clients of diverse SES, racial, and cultural backgrounds. The mission of the Solutions Outpatient Services rotation for residents in child and adolescent psychiatry is to assure that the psychiatrist treating substance abuse disorders demonstrates basic competency in assessment, treatment, pharmacology, relapse prevention, and continuing care of adolescents with substance abuse problems. SOS is a privately owned addiction treatment center renowned for its innovative approach to the intensive outpatient treatment of adolescents. Description of Research Requirement: In the second year of the fellowship, the fellows are required to participate in a current research study. Second year fellows also attend the weekly Friday Research Meetings and are required to complete an individual research project to be presented in the spring. Functional Magnetic Resonance Imaging Study: (fMRI study): The purpose of the study is to evaluate fMRI findings in adolescents with major depressive disorder before and after treatment with an SSRI medication. Subjects must have a primary diagnosis of major depressive disorder for at least four weeks and must be about to initiate treatment with an SSRI medication for their depression. Subjects should be outpatients between the ages of 11-18 years of age, in good general medical health and of normal intelligence. Subjects may have comorbid psychiatric diagnosis as long as they are psychotropic free for 4 weeks prior to the initial fMRI. Subject's will participate in three scans (pre-treatment, week 1 after treatment with a SSRI and week 8 after treatment with a SSRI) If the subject does not want to participate in the week 1 scan, that is acceptable as well. PI: Dr. RongRong Tao Stanley Bipolar Study: Ziprasidone in Pediatric Bipolar Disorder: The purpose of this study is to evaluate the safety, effectiveness and dosing of Ziprasidone in treating pediatric bipolar disorder. Subjects must be between the ages of 10 - 17 years of age and be diagnosed with bipolar I, II, or NOS disorder. The study consists of a two week screening and evaluation period followed by 6 weeks of treatment with Ziprasidone in either rapid titration or slow dose titration. Lab work is assessed at the beginning and the end of the study and ECG's at the beginning, two weeks after initiating treatment and at the end of the study. Subjects must be willing to be off other medications for bipolar disorder, however the use of stimulants to treat comorbid ADHD is allowed. PI: Dr. Kirti Saxena Exercise Treatment in Adolescents with Depressive Symptoms: The purpose of this study is to evaluate whether an exercise treatment program is effective for the treatment of depressive symptoms in adolescents. Subjects must be between the ages of 10 - 18 years of age, must have depressive symptoms, and must be willing and able to participate in routine exercise sessions for 12 weeks. Subjects may be either treated or untreated with psychotropic medication for their depression. Exercise sessions will be conducted at the Shelton School of Dallas for the first two - four weeks and then will be continued at home with a once a week session at the Shelton school for the next 8 - 10 weeks. PI: Dr. Carroll Hughes CMC Stipends (2007-2008):PGY (level) Stipend (Please note that there will be no taxes withheld from the educational stipend. Fellows are to discuss individual taxes with their CPA and/or tax attorney.) • Applicants are required to participate in the NRMP Match.
• After review of the completed application packet by the Education Committee, the applicant may then be invited for an in-person interview with the Child Faculty. Contact Information:Maryam Rezai, M.D. Child & Adolescent Psychiatry (214) 648-5302
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Copyright 2008. The University of Texas Southwestern Medical Center at Dallas 5323 Harry Hines Boulevard, Dallas, Texas 75390. Telephone 214-648-3111 |
