Child and Adolescent Psychiatry Fellowship
We would like to introduce our Maricopa Integrated Health System (MIHS) Child and Adolescent Psychiatry (CAP) Fellowship Training Program to you. The MIHS CAP Fellowship is committed to developing future child psychiatrists who are knowledgeable, empathic and able to provide leadership in the care of diverse children. At MIHS Desert Vista Hospital, fellows are part of the treatment team on an innovative inpatient adolescent unit based on a Collaborative and Proactive Solutions model developed by Dr. Ross Greene. Fellows staff the MIHS Desert Vista Behavioral Outpatient Clinic, providing comprehensive assessment and psychiatric care including medication, psychotherapy, and parent guidance for children and families in need. Fellows also provide inpatient and outpatient pediatric consultation at the main hospital for MIHS, Maricopa Medical Center.
As a community program, our child/adolescent psychiatry fellows also have access to a variety of exceptional and unique training experiences outside of MIHS. Fellows are trained in acute care, psychopharmacology, and neurology at Phoenix Children’s Hospital, one of the 10 largest children’s hospitals in the nation and the principal pediatric affiliate of the University of Arizona College of Medicine. Rotations at Childhelp Children’s Advocacy Center of Arizona (an integrated investigation and treatment center that focuses on addressing child maltreatment), Southwest Human Development (a non-profit agency specializing in treating children from birth to five years of age), and Hu Hu Kam Memorial Hospital (a health care setting within the Gila River Indian Community) offer experiences with specialized populations.
While offering diverse training opportunities, we pride ourselves on providing fellows with a warm, supportive, family-friendly environment where they can acquire current and critical knowledge and develop professionally as psychiatrists. Our program’s relatively small size (three fellows per year) allows us to be very responsive to fellows’ needs and interests. Fellows routinely create electives based on special interests.
Training is balanced, with an understanding that familial, social, cultural, and spiritual factors all affect family presentation. Intensive supervision and didactic experiences are provided throughout both years of training. Seminars in psychopharmacology, child psychiatry, and psychotherapy occur year-round. Fellows gain experience in research, producing a senior research project that is submitted for publication.
Our child fellows are a diverse, welcoming, collegial group. With protected didactic and administrative blocks of time, they have time to focus on academics as well as excellent patient care. We appreciate your interest in the program in which we are so invested. Please contact us for further information and consider a visit to discover firsthand the desert beauty of the Phoenix area and the many benefits of training in child psychiatry at MIHS.
Our Graduates 2005-2017
- Our 31 graduates have worked at over 25 separate sites serving children.
- While Arizona is the most common area for practice, our graduates also include child psychiatrists in California, Colorado, Missouri and West Virginia.
- Their work has included acting as medical directors, founding private practices, teaching in training programs, working in residential and inpatient treatment settings, and working within the public sector in state hospital/juvenile justice/community mental health settings.
The MIHS Child and Adolescent Psychiatry Fellowship Training Program is fully accredited by the ACGME. The main campus is located at Desert Vista Behavioral Health Center, 570 West Brown Road, Mesa, AZ 85201. This two-year training program enrolled its first fellows in July 2003. Currently, the program includes six positions, three per training year.
The program offers comprehensive training in child and adolescent psychiatry with rotations in a variety of settings, providing a balanced clinical training experience. Rotations include inpatient, residential treatment, outpatient, specialty clinics and consultation. During the fellowship, call is from home rather than on-site and moonlighting opportunities are available. Supervision is emphasized and trainees receive a minimum of two hours of weekly ongoing individual supervision in addition to rotation-specific supervision.
MIHS will accept J-1 visas for qualified residents accepted into an MIHS program, but MIHS does not sponsor residents on J-1 visas. MIHS does not accept or sponsor any other visas for its GME program residents. Applicants must be authorized to work in the United States.
The didactic curriculum is scheduled throughout the two years of training. First- and second-year fellows attend classes together twice a week, for a total of eight hours of didactics per week, including child psychiatry grand rounds. Time to attend classes is protected. The curriculum is designed to ensure a comprehensive training experience, exposure to the major theories of child development and psychiatry and integration of different models of care in an evidence-based framework.
This series covers child development from conception to early adulthood. Topics include physical development, CNS development, cognitive development, and gender differences. Classic papers are presented. Theories of personality, social, and intrapsychic development are discussed. Common childhood problems are addressed (e.g., fears, sleep, parental divorce and death, sibling relationships, peer relationships, eating problems, etc.). This course is held weekly over a 6-month period each year.
This seminar covers the range of childhood psychiatric disorders as well as contextual presentations of child patients (i.e., family interaction challenges, school difficulties). Skills in evaluating children and adolescents at different developmental stages are taught, with an emphasis on learning board-style presentation skills. Assessment and treatment planning, as well as legal issues and ethics, are discussed. This seminar is held weekly over the course of two years.
This seminar teaches fellows about psychopharmacologic management of symptoms of child and adolescent psychiatric disorders using case-based, evidence-based, and problem-solving approaches. This seminar is held weekly over two years.
Initially, a review of different types of treatment and psychotherapy techniques is conducted. Related reading is assigned, including presentations on different methods of psychotherapy. Readings and video presentations are supplemented with discussion of specific cases. Utilization of webcam recordings of therapy sessions helps fellows to refine therapy skills. Models discussed in conference include psychodynamic, play therapy, cognitive-behavioral, family therapy, parent guidance, supportive therapy, group therapy, interpersonal process, and behavioral approaches. This seminar is held weekly over two years and led by an attending psychiatrist and a clinical psychologist.
During each clinical case conference, one case is reviewed with a focus on diagnoses, formulation, data gathering, and therapeutic recommendations. Fellows and staff present the cases, with discussion among faculty and fellows. Legal and ethical issues are discussed when pertinent. Psychological evaluations and school observations may also be reviewed. Conferences generally occur weekly.
Current articles in child and adolescent psychiatry are assigned. Fellows present on varied topics with discussion by fellows and faculty. Critical evaluations of papers, studies, and research are conducted. Evidence-based practice is emphasized. This seminar occurs monthly.
- Administrative Psychiatry
- Child Neuropsychiatry and Neurodevelopment
- Consultation-Liaison Psychiatry
- Cross-Cultural Child Psychiatry
- Ethics in Child and Adolescent Psychiatry
- Forensic Child Psychiatry
- Psychiatric Advocacy
- Systems-Based Practice
During the first year, emphasis is placed on mastering clinical care in the inpatient setting. Inpatient rotations where fellows are exposed to acute care include the Adolescent Psychiatry unit at Desert Vista Hospital as well as a Child Psychiatry unit and a child neurology rotation at Phoenix Children's Hospital. Fellows also participate in a residential treatment center program at Devereux Arizona. The outpatient experience begins in the first year as well at the Desert Vista outpatient clinic where the aim is to provide a longer-term treatment experience with a variety of patients, exposing fellows to the evolution of therapeutic progress in their patients.
During the second year, fellows master outpatient treatment and consultation in various settings. The outpatient experience started in the first year expands at Desert Vista during the second year. Fellows also rotate through several offsite settings for a wide range of clinical experiences. Off-site rotations include time at Childhelp Children’s Advocacy Center of Arizona (an integrated investigation and treatment center addressing child maltreatment), Southwest Human Development (a non-profit agency specializing in treating children from birth to five years of age), Hu Hu Kam Memorial Hospital (a health care setting within the Gila River Indian Community), and Children’s Rehabilitative Services (a state-sponsored program providing services for children with identified chronic or disabling medical conditions). Consultation experiences occur at both Phoenix Children’s Hospital and at the main campus of Maricopa Medical Center. Fellows are trained and supervised in a variety of treatment modalities, including individual child psychotherapy (psychodynamic, cognitive-behavioral, supportive, and play therapy), parent guidance, crisis intervention, and pharmacological treatments. Outpatient clinical work allows fellows to work with children of all ages, backgrounds, and diagnoses in a range of settings.
Year 1 Educational Experiences
|Didactic and Case conferences||12 months||8 hours/week|
|Supervised Outpatient Continuity Clinic||12 months||8 hours/week|
|Long-term Inpatient/Residential||2.5 months||3 days/week|
|Acute Adolescent Inpatient||3 months||3 days/week|
|Acute Child Inpatient||2.5 months||3 days/week|
|Child Neurology||1.5 months||3 days/week|
|Emergency and Inpatient Consultation Liaison||2 months||3 days/week|
|Investigations Project||2 weeks||3 days/week|
Year 2 Educational Experiences
|Didactic and Case Conferences||12 months||8 hours/week|
|Supervised Outpatient Continuity Clinic||12 months||12 hours/week|
|Infant and Preschool Age Clinic||4 months||8 hours/week|
|Outpatient Pediatric Consultation Liaison and Collaborative Care||6 months||4 hours/week|
|Developmental and Medical Disorders Clinic||4 months||4 hours/week|
|School/Systems Consultation Liaison||2 months||1 day/week|
|Child Maltreatment||1 month||1 day/week|
|Investigations Project||6 months||4 hours/week|
Phoenix Children's Hospital
This affiliate of the University of Arizona College of Medicine, is one of the 10 largest children’s hospitals in the country. As a free-standing entity, it provides comprehensive medical and psychiatric services to children representative of the diverse populations living in Maricopa County. Fellows gain experience in the provision of acute inpatient care to children with serious mental illness. In addition to interactions with psychiatric supervisors, nurses, and behavioral health staff, fellows have the opportunity to interact with social workers, family therapists, psychologists, special education teachers, and recreational therapists in this setting. Fellows attend daily staffings and educational conferences. Fellows gain experience in pediatric neurology at the renowned Barrow Neurological Institute at Phoenix Children’s Hospital. Fellows rotate through inpatient unit and outpatient clinics, where they participate in teaching rounds and case discussions with faculty and with adult and child neurology fellows. While at PCH, fellows also participate in child psychiatry consultation to inpatient pediatric services. Additionally, fellows have the opportunity to participate in multidisciplinary clinics specializing in medically complex children with conditions including fragile X, neurofibromatosis, tuberous sclerosis, and 22q deletion.
At this residential treatment center fellows provide care to children and adolescents with severe mental illness, as well as those requiring substance abuse treatment. Many of the patients have a history of abuse/trauma including some who have been victims of child sex trafficking, requiring specialized treatment services. Devereux also has an on-site school for residential children with special needs. During their inpatient rotation, fellows are supervised by medical director Robert Shuch, DO. Fellows provide individual psychotherapy and pharmacotherapy interventions to patients as well as participating in team treatment planning, family therapy, group therapy, behavioral therapy, and other interventions. Fellows have the unique opportunity to participate in adolescent group dialectic behavioral therapy. In addition, fellows are trained in the responsibilities of the medical director through modeling and supervision with administrative experiences.
Southwest Human Development Good FIT (Families, Infants and Toddlers) Center
The mission of this community provider is to serve very young children and their families and to assist in their development. Fellows evaluate and treat toddlers and preschool-age children under the supervision of and accompanied by Erum Ali, MD. Fellows gain experience in the specialized assessment and diagnosis of young children, including the use of the Diagnostic Classification 0-3 developed by the National Center for Infants, Toddlers, and Families. Specific family and child treatment modalities found to be effective in this population are observed. Fellows are involved in psychiatric and developmental evaluations, outpatient treatment, observation and consultation in preschools, collaboration with infant mental health professionals, and exposure to home-based behavioral health services.
Hu Hu Kam Memorial Hospital
This hospital is located within the Gila River Indian Community. Fellows are supervised by Lisa Cobourn, MD, gaining practical experience in school and systems consultation-liaison. Fellows have the unique opportunity to work with Head Start and the local schools in this Indian Community setting, and gain cultural knowledge and understanding. The Native American Community Outpatient elective also trains fellows to provide culturally sensitive and effective care to children and families.
Children's Rehabilitative Services (CRS)
CRS is part of a statewide program that provides comprehensive rehabilitative services to children and their families. The Phoenix Clinic is affiliated with providers at Maricopa Medical Center. Child psychiatry fellows work with attending child psychiatrists and staff psychologists in providing care to children with developmental, neuropsychiatric, and chronic medical illnesses including intellectual disabilities, autism spectrum disorders, seizure disorders, neurofibromatosis, cerebral palsy, static encephalopathy, asthma, osteogenesis imperfecta, sickle cell anemia, and diabetes, among others.
Childhelp Children's Advocacy Center of Arizona
The Child Maltreatment Rotation provides the opportunity to work with a multi-agency child maltreatment team. Pediatricians, social workers, police officers and caseworkers from the Department of Child Safety all participate at the Childhelp Children’s Advocacy Center of Arizona. This teaching and observing rotation educates fellows about abuse, neglect, domestic violence, forensic interviewing and court testimony. Fellows do not carry independent cases or provide direct treatment. On any given day, fellows may observe a forensic interview conducted by a criminologist and physical examinations conducted by pediatricians to evaluate the potential of abuse; be involved with medical chart reviews for possible abuse and neglect; participate in formal case conferences and informal case discussions; or observe court testimony.
Paid Time Off - Fellows are given:
- Vacation - 20 days/4 weeks
- Sick - 8 days
- Education - 5 days
- Federal Holidays - 10 days
- Parental Leave - 6 weeks (including initial week of PTO)
- Education fund - $1,000 provided annually
- Travel allowance for 2nd year fellows to attend American Academy of Child and Adolescent Psychiatry Annual Meeting
Fellows, particularly in year 2, are given many opportunities to develop their teaching skills. Second year fellows teach identified classes in child development and child psychiatry to their fellow adult residents. There are also opportunities to teach other staff during consultation-liaison months. Chief fellow responsibilities alternate between year 2 fellows, encouraging growth in administrative and teaching skills. Past fellows have also completed teaching electives.
Helping all fellows to become comfortable with the process of research is a high priority within the fellowship. To facilitate this development, all fellows are given dedicated research time and mentorship in both year 1 and year 2. Fellows present their literature reviews at Child Psychiatry Grand Rounds during year 1 and present their research results at this same venue during year 2. Senior research projects are submitted for publication or presentation and several fellows have had posters selected for presentation at the American Academy of Child and Adolescent Psychiatry Annual Meeting.