5 Year Overview
Residents spend the first year of their training in pediatrics, providing both inpatient and outpatient care. In the second year, residents spend 6 months in pediatrics as an upper level resident and 6 months in general/adult psychiatry, combining inpatient experience with neurology. The third year provides an introduction to acute child and adolescent psychiatry (CAP) and opportunity to consolidate the pediatric skills as an upper level resident. In the fourth year, residents provide outpatient general/adult psychiatry services to a diverse group of patients and develop skills in psychotherapy and psychopharmacological interventions, as well as consultations and substance use treatments. The fifth year focuses on outpatient CAP, with opportunities to provide clinical care for children and adolescent with a range of psychopathology in a wide variety of community and hospital-based settings.
Residents have pediatric continuity clinic for five years. They see their pediatric continuity patients in the “Triple Board Clinic” where they are supervised by Triple Board and categorical pediatric faculty. The clinic focuses on primary care, but provides residents an opportunity to evaluate and treat a number of patients with primary-care level mental health concerns.
Residents attend discipline-specific didactics throughout the five years. They run a Triple Board–specific journal club and meet regularly with the Training Director and team for lunch meetings that allow all time for socializing as well as discussion of the program. Residents also meet annually with the Training Directors of all 3 programs and the Chairs of Pediatrics and Psychiatry to provide more formal feedback about the strengths and needs of the program.
Residents begin their training with immersion in the foundations of pediatric medicine. They provide treatment in two New Orleans hospitals as well as a range of community based outpatient clinics that provide a diversity of patient populations and exposure to a range of faculty. Residents have close supervision and support as they begin their residency. Highlights include family centered rounds on the Ochsner inpatient hospital wards and an innovative case-focused team based learning experience.
Residents become supervising residents in pediatrics in the second year and develop a higher level of autonomy, though still with faculty teaching and clinical back-up. Inpatient general psychiatry provides the first transition out of pediatrics and residents serve patients from throughout the Gulf Coast.
In the third year, residents solidify their pediatric skills as senior residents. Third year also provides the first introduction to CAP. During the CAP block, residents begin to learn child psychotherapy with close in-person and video supervision. They may continue to see the same patients throughout the remainder of residency if needed. Intensive didactics help residents to develop a strong base in CAP clinical skills and evidence based practice.
In the fourth year, residents focus on outpatient general/adult psychiatry. During most of the year, residents have opportunities to see their own outpatients in the Tulane Behavioral Clinic, where a priority is placed upon developing therapy skills as well as establishing a strong clinical knowledge of psychopharmacological treatment. Psychotherapy training at the Psychoanalytic Institute and Tulane provide a range of psychotherapy didactics and individual supervision gives residents opportunities to discuss the implementation of these and other therapeutic approaches in their own outpatients. Residents continue to see a small number of child psychiatry outpatients as well, with supervision by child psychiatry faculty.
The fifth year provides the opportunity for residents to consolidate their child psychiatry skills as well as to prepare for their post-residency professional life. Tulane CAP training focuses on outpatient, community based treatment, with many opportunities to work with traditionally underserved patients from birth through adolescence. At this stage of training, residents are given opportunities for independent work as well as substantial supervision time and on-site clinical supervision with a faculty member. We believe it is important for residents to be proficient in psychopharmacological treatment and to master a range of psychotherapy modalities with children and their families. Residents have the opportunity to learn cutting-edge evidence based therapies such as preschool cognitive behavioral therapy and parent-child interaction therapy, as well as family therapy and psychodynamically informed therapeutic approaches. The Tulane CAP Division includes internationally known infant mental health faculty members and residents have opportunities to develop competence in working with very young children. Fridays are academic days - weekly grand rounds and interdisciplinary didactics provide foundations for clinical learning in CAP. Didactics include a clinical case conference organized around principles of object relations, case based learning of psychopharmacology and psychopathology, developmental psychopathology, neurobiology, ethics, and forensic child psychiatry, as well as a clinical issues course and intensive individual supervision that often includes video review of therapy.