Clinical Opportunities

UCSD CHILD AND ADOLESCENT PSYCHIATRY SERVICES
Residents have a required sixty-six percent time rotation of twelve months duration in the first year of training at this JCAHO accredited facility. UCSD Child and Adolescent Psychiatry Services is a twenty-eight bed inpatient service that was transferred under contract to UCSD from the County of San Diego. This modern hospital includes a twelve to fourteen bed acute care facility for adolescents and a twelve to fourteen bed short-term facility for children. It is located fifteen minutes from the primary site of training.

Inpatient diagnoses are varied, including approximately ten percent psychotic disorders, twenty percent disruptive behavior disorders, fifty percent mood disorders and twenty percent others; and treatment approaches include individual and group psychotherapy, behavior modification, therapeutic community, psychopharmacology and family therapy.

Residents are responsible for running two treatment teams with an average case load of fewer than six patients. Residents direct the overall care for the patients, including assessment, management and discharge planning. The inpatient residents receive a minimum of one hour of individual supervision weekly from their unit medical director.

The inpatient unit faculty consists of three full-time board certified child psychiatrists, one full-time licensed clinical psychologist and two full-time licensed social workers.

The Department of Psychiatry at UCSD is proud to announce plans for an Inpatient Eating Disorder Program which will be located near CAPS and is planned to open sometime in the spring of 2004.

CHILDREN'S HOSPITAL AND HEALTH CENTER
Children's Hospital is the leading tertiary care center for children in San Diego County and is affiliated with the University of California, San Diego.

Children's Hospital is a two hundred-bed pediatric hospital with outstanding programs in Neonatal Intensive Care, General Pediatrics, Pediatric Surgery, Pediatric Hematology-Oncology, Pediatric Neurology, Muscular Dystrophy, Cardiopulmonary Medicine, Pediatric Rehabilitation and including thirty-seven specialty outpatient clinics for treatment. The Patient Care Pavilion opened in January 1993 and provides the region's first and only Pediatric Emergency Room and Trauma Center.

Residents have a required twenty percent time rotation in Consultation-Liaison at Children's Hospital and Health Center. They also cover emergency room call on a 24-hour basis during the first and second year of residency. Residents provide consultation and provide psychotherapy and pharmacotherapy as well as performing liaison activities. They attend seminars at Children's Hospital and Health Center twice a week. They also participate in various hospital clinics including the developmental evaluation clinic and the pediatric neurology clinic.

CHILDREN'S OUTPATIENT PSYCHIATRY
The Outpatient Psychiatry Division of Children's Hospital is located one mile from the main campus of Children's Hospital and operates several clinics in North San Diego County. The clinic averages 60 new intakes per month with an ongoing caseload of 800 patients, accounting for approximately 1,400 visits per month.

Residents have a required part-time rotation in the Outpatient Psychiatry Division during the first and second years of training. A majority of patients are between five and fifteen years of age but patients up to age eighteen are served. Sixty percent of referrals are for externalizing disorders (ADHD, Oppositional Disorders and Conduct Problems), many of whom also have academic or learning problems. The population is sixty-six percent male with a diverse ethnic mixture.

Treatment approaches are varied but include individual, family, group, pharmacotherapy, behavior therapy and parent training techniques. The caseload is approximately six to eight patients and one diagnostic per week for first year residents, (including two long-term psychotherapy cases), and ten to twelve patients and one evaluation per week for second year residents. Residents have three hours of individual supervision weekly. The faculty consists of two full-time child psychiatrists, one full-time psychologist, one half-time psychologist, one full-time psychologist, and four full-time psychiatric social workers and four marriage and family therapists.

SCHOOL CONSULTATION
All second year child and adolescent psychiatry residents participate in a school consultation rotation that runs concurrently with the public school year. The schools selected represent a cross-section of the San Diego Public Schools including both inner city schools and those on the periphery of the inner city. Emphasis is placed on systems consultation to the faculty, staff and administration of the school. In-class observations are a regular component of the consultation experience. Individual resident supervision occurs weekly throughout the school year.

FORENSIC CONSULTATION
Second year residents receive experience in consultation to the Dependency Court and Juvenile Court. Residents perform court-ordered psychiatric assessments and provide court testimony under the direct supervision of a forensic child and adolescent psychiatrist. Residents also participate in a forensic seminar throughout the two years of training.

CHILD PROTECTION
Second year residents receive experience in consultation with children who have experienced physical and sexual abuse and neglect at the Children's Hospital Chadwick Center for Children and Families on a two-month rotation under direct supervision of a board certified child and adolescent psychiatrist.

PEDIATRIC NEUROLOGY AT CHILDREN'S HOSPITAL
Residents attend pediatric neurology clinic at Children's Hospital on a two-month rotation under the supervision of six full-time board certified child neurologists. Residents gain experience with a variety of neurological conditions including seizures, headaches, movement disorders, tics and Tourettes syndrome, developmental delay, cerebral palsy and neurocutaneous disorders, as well as traumatic brain injury.

CHILD DEVELOPMENT
All second year child and adolescent psychiatry residents receive experience in child development through the Children's Hospital Developmental Evaluation Clinic, Toddler School, Autism Intervention Center and Behavioral Pediatrics Clinic. Residents learn developmental evaluation techniques and treatment techniques for patients with developmental disabilities.

COMMUNITY PSYCHIATRY
All residents receive experience in consultation to community systems of care, providing consultation under direct supervision from a board certified child and adolescent psychiatrist.