Child and Adolescent Psychiatry Fellowship

Our Child and Adolescent Psychiatry Fellowship Program is a two-year program intended to follow completion of three or four years of General Psychiatry residency. We offer two positions each year. Our goal is to train competent, caring child and adolescent psychiatrists prepared to practice in a variety of settings in this regional and national subspecialty shortage area.

The hallmark of our training program is the nationally recognized managed care clinic in which our child and adolescent psychiatry fellows see the majority of their outpatients over the two-year period. In this setting, fellows learn to manage resources while providing their patients with optimal care, including assessment, medication management, and psychodynamic, cognitive-behavioral, family, or group therapy. The patient population in the Scott & White system is culturally diverse and socioeconomically varied, with a rich variety of disorders and symptom severity as well as the gamut of payment sources. Resident caseloads are monitored to ensure a representative sampling of this population.

Supervision is provided regularly. Each trainee meets weekly with an outpatient therapy supervisor as well as a medication supervisor. In addition, each rotation is individually supervised weekly by the on-site attending faculty responsible for the rotation. Additional individual supervision is provided for cases requiring specific therapeutic techniques, such as cognitive-behavioral therapy and family therapy. Faculty members are also available for immediate supervision.

During the first year of the program, residents devoted their time primarily to conducting inpatient and partial hospital care at the Metroplex Pavilion Hospital in nearby Killeen, and studying child neurology, child development and genetics in Scott & White and school clinics. A school consultation experience is also provided at the elementary and middle school levels in both mainstream and alternative learning settings in the Temple Independent School District.

In the second year, fellows concentrate on outpatient care at the Scott & White Clinic. This is supplemented with work in forensic psychiatry in a private clinic and the Bell County Juvenile Justice Department, administrative psychiatry in the Scott & White system as well as in community settings, and school consultation in the outstanding Therapeutic Learning Centers in the Killeen Independent School District. Second-year electives in research, consultation or clinical areas, in community, school, clinic or hospital settings allow fellows to obtain further training in areas of interest. An interest in research is encouraged and supported by a seminar in epidemiology and research methodology and a well-developed Research and Biostatistics Department at Scott & White. Interested fellows may work to obtain a masters degree in Rural Public Health from our School of Rural Public Health, part of the Texas A&M  Health Science Center.

Throughout both years, fellows provide consultation to our well-established primary care programs. More than 60 clinics in a 29,000-square-mile service area across Central Texas refer many of our patients, providing intensive interaction with family practice and pediatrics. Scott & White also has an active telepsychiatry program, allowing fellows to follow out-of-town patients in their home clinic and gain experience using this valuable technology. In addition, inpatient consultation is provided to pediatrics, orthopedic surgery, trauma and hematology-oncology services in the 486-bed Scott & White Hospital.

Didactics are provided on a two-year cyclical basis so that no matter when a fellow starts the program, exposure to all the seminars is ensured. The two-year Integrated Child and Adolescent Psychopathology and Psychopharmacology; Developmental Theory, Issues, and Practicum; and Theories and Therapies series form the backbone of the seminar plan and are complemented by specialty series given every other year.

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