A core curriculum for child and adolescent psychiatry

 This paper suggests that it will be increasingly necessary to have a core curriculum for training in child and adolescent psychiatry. The reasons include the growth of knowledge, need for selection of information, the influence of evidence-based practice and accountability, and recognition of training across the European community. The principles for organising a curriculum are coherence, accessibility, and the context of professional development. Implementation of these principles is illustrated by the St Mary’s training programme in London. Important components are the reading seminars in developmental psychopathology and the psychological treatments course. Implementing a core curriculum nationally and internationally would have difficulties, which could be overcome by a compromise of central control and local interests and initiatives.     

Training general psychiatry residents in child and adolescent psychiatry

The authors describe the nature of current social and economic forces impacting on the education and future practice of general psychiatry residents in child and adolescent psychiatry. They review theoretical and practical reasons for training in child and adolescent psychiatry, analyze the form and content of what is currently taught based on a national survey of general training programs, and suggest guidelines for the training and postgraduate practice of general psychiatrists in evaluating and treating children and adolescents. The authors conclude that while social and economic changes necessitate general psychiatrists' clinical involvement with children and adolescents, insufficient general training may necessitate postgraduate education and supervision. They pose ethical and professional dilemmas for the field in meeting the national shortage of child and adolescent psychiatrists and propose strategies to enhance recruitment into child and adolescent residency training.     

A model curriculum for substance abuse education in child and adolescent psychiatry training programs

Child psychiatry training recognizes substance abuse as a problem requiring an educational effort to provide fellows with adequate clinical skills to manage these patients. The components of a substance abuse educational module which may be integrated into existing child psychiatry fellowships are presented, with a discussion of practical problems raised by the expansion of child psychiatry into this neglected area.     

Ethical principles governing research in child and adolescent psychiatry.

This paper examines the ethical principles governing research in child and adolescent psychiatry. The guidelines for protection of children and adolescents are research subjects are discussed. These include the principle of nonmaleficence and beneficence (the risk-benefit ratio), the principle of autonomy (informed consent and confidentiality), and the principle of justice (fair distribution of benefits and burdens of research). In the light of recent national efforts to help promote responsible research practice, the ethical standards relating to the protection of scientific integrity as well as research advocacy, training, and stewardship are also discussed.     

Specialty training in child and adolescent psychiatry in India

European Child & Adolescent Psychiatry - India has a considerable skilled manpower deficit in the area of child and adolescent mental health, given its population and their needs. To address...     

Adult neurology training during child neurology residency

As it is currently configured, completion of child neurology residency requires performance of 12 months of training in adult neurology. Exploration of whether or not this duration of training in adult neurology is appropriate for what child neurology is today must take into account the initial reasons for this requirement and the goals of adult neurology training during child neurology residency.     

An international perspective on training in child and adolescent psychiatry

European Child & Adolescent Psychiatry -     

A competency-based model for research training during psychiatry residency

The Institute of Medicine recently identified a critical shortage of psychiatrist-researchers and highlighted the need for competency-based curricula that promote research training during psychiatry residency as a way to address that shortage. In this article we review extant approaches to research training during psychiatry residency. We then identify five core elements necessary for promoting research training: (1) mentoring, (2) education, (3) experience, (4) time, and (5) support. We describe six interrelated domains of core research competencies that can be mastered gradually over the course of residency training: (1) research literacy, (2) content mastery of specific research topics, (3) principles of research design and methods, (4) principles of biostatistics, (5) presentation and writing skills, including grant writing, and (6) principles of responsible conduct of research. Finally, we propose a broadly applicable, developmental, competency-based framework for applying these core elements to research training during psychiatry residency.     

Preparation for practice: child and adolescent psychiatry graduates' assessment of training experiences

OBJECTIVE: To assess the perceived effectiveness of child and adolescent psychiatry residency training in preparing recent graduates for practice in diverse work settings. METHOD: Analysis of survey data of 392/797 (49.2%) of all U.S. child and adolescent psychiatrists graduating from training in 1996-1998 and on the mailing list of the American Academy of Child and Adolescent Psychiatry. RESULTS: Overall, respondents reported high-quality training. They felt least prepared by training for their present practice in the areas of administration and leadership skills, medical economics and business skills, complex psychopharmacology, treatment of children with complicated developmental disabilities, and cognitive-behavioral therapy. They felt overtrained in consultation-liaison to pediatrics and inpatient work. Clinical experiences, supervisors/mentors and a well-rounded program were cited as most crucial to training. Suggestions for improvement included more "real-world" administration and leadership exposure, enhanced supervision, and improved didactics. Most felt training prepared them for their specialty board examinations. CONCLUSIONS: Recruitment and training of highly skilled child and adolescent psychiatrists is a national priority. The present database assessment of efficacy in preparing graduates for diverse career practices may inform training programs and policy. An enhanced training curriculum in leadership and administrative skills and medical economics is recommended.     

Recruitment and training of child and adolescent psychiatry residents from pediatrics.

This article describes a 21-year experience of recruiting and training child and adolescent psychiatry residents with pediatric backgrounds. Three grounds of physicians are compared: those with previous training in general psychiatry alone, those with previous training in both general psychiatry and pediatrics, and those with previous training in pediatrics alone. Residents with pediatric backgrounds compared favorably with those with general psychiatry training. Those with only pediatric training were not only able to successfully complete the residency, but also the majority entered the field of child psychiatry. The findings support accepting residents directly from pediatrics as a viable pathway into child psychiatry.     

An approach to teaching ethics in child and adolescent psychiatry.

Examples of ethical dilemmas, emerging in the context of a resident case-centered seminar, are used to illustrate a proposed approach to instruction in ethics for child and adolescent psychiatry residents. In addition to a rudimentary formal didactic curriculum, a teaching methodology is outlined that intentionally focuses on ethical problems, approaches to analyses, proposed courses of action, and attempts at resolution. Four representative issues are utilized: confidentiality, treatment refusal, treatment termination, and the interface of individual and family therapies. Educational objectives include the increased recognition by child and adolescent psychiatry trainees of potential ethical conflicts, of the utility of ethical analyses to inform choices of clinical interventions, and of the desirability of forestalling premature action before attempts at thoughtful resolution.     

The child and adolescent psychiatry: study of training in Europe (CAP-STATE)

European Child & Adolescent Psychiatry - There is great cultural diversity across Europe. This is reflected in the organisation of child and adolescent mental health (CAMH) services and the...