Psychiatry Consultation Service Global Partnerships for Psychiatry Observership Program

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Working Together to Promote Healthy Development Across the World

Sponsored by: Department of Psychiatry, Boston Children's Hospital

Introduction

The Boston Children's Hospital Global Partnerships for Psychiatry (CHGP) Observership Program is a cross-disciplinary program designed for physicians and psychologists residing outside the United States, who have an interest in child and adolescent mental health. The goal of this program is to provide exposure for a cadre of trained individuals from countries all over the world, who can then aid in the development of child mental health policy, foster child mental health clinical programming and otherwise serve as advocates for child mental health care in their respective countries of origin.

It must be emphasized that due to licensing and insurance requirements, direct clinical care is not a part of CHGP Observership Program. However, participation in clinical conferences, ward rounds and other clinically related activities is integral to the program. Therefore this program is not intended as a substitute for formal training in the clinical disciplines of child psychiatry or child psychology, and is strictly an observership in nature, with no substantive direct clinical experiences and no clinical certification of training provided.

The CHGP Observership Program has multiple components to allow visiting professionals to participate for varying periods of time extending from one to three months, in a variety of clinical settings. Conceptually, this program places the clinical, programmatic and advocacy efforts of the Boston Children's Hospital's Department of Psychiatry in a global context through readings and discussion of comparisons with other contexts.

Mission

Excellence and innovation in education, consultation, research, and advocacy for the mental health of children and families across the globe.

Integration Seminar Series

This seminar will aid the participant in understanding his/her clinical experience in a cross-cultural context. Participants will meet regularly with visiting professionals at scheduled times arranged during each rotation. The focus of these meetings will be on understanding the clinical experience at Boston Children's Hospital in an international, cross-cultural context. Clinical issues will be discussed and relevant literature reviewed. Special attention is paid to areas of clinical work that may form the basis for longer-term interest and/or clinical research collaborations. Global child mental health policy and service delivery will be discussed.

Boston Children's Hospital

CHGP Observership Rotations

OPTION 1: Psychiatry Consultation Service

OBJECTIVES: The unique objectives of the Psychiatry Consultation Service (PCS) elective are to provide opportunities to observe the evaluation and management of children and adolescents with psychiatric needs who present in medical settings.

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DESCRIPTION: The PCS, under the direction of Patricia Ibeziako, MD, provides psychiatric consultations to all inpatient medical and surgical units at Boston Children's Hospital. In providing these clinical services, the PCS targets the teaching of consultation-liaison psychiatry to trainees in child psychiatry and psychology, and aims to expand the academic knowledge base of pediatric psychosomatic medicine.

The PCS is comprised of attending psychiatrists, attending psychologists, child psychiatry fellows, post-doctoral psychology fellows, and pre-doctoral psychology interns. Subspecialty areas within the PCS include oncology, transplant, cystic fibrosis, and critical care services. One of the largest in the country, the PCS conducts about 1000 consultations a year.

ROTATION: Opportunities will be provided to observe consultations conducted by attendings and trainees on the inpatient medical and surgical floors, including interactions with patients and families, exposure to different behavioral interventions and collaborations with other multidisciplinary clinicians in the hospital. There will be case based teaching, discussions about diagnostic assessments, management and disposition planning. There will also be an expectation to participate in PCS rounds and seminars and all other residency training didactics outside PCS.

DURATION: 1-3 months

TIMES AVAILABLE: Throughout the year.

SUPERVISORS: Patricia Ibeziako, MD, Robert Li Kitts, MD, Simona Bujoreanu, PhD

SUPERVISION:

Individual - 1 hour per week "Off-Line", as well as "Live" bedside patient interviews supervision

Group - Rounds and case conference: Monday, Wednesday, and Friday mornings

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OPTION 2: Inpatient Psychiatry Service

OBJECTIVES: The unique objectives of the Inpatient Psychiatry Service (IPS) elective are to provide opportunities to observe the evaluation and management of children and adolescents who present with severe psychiatric illnesses, or co-morbid medical-psychiatric illnesses, requiring care in the more restrictive inpatient setting.

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DESCRIPTION: The IPS, under the direction of Gary Gosselin, MD, is a 16-bed secure unit that specializes in caring for children ages 8 to 18 years who struggle with anxiety, depression, psychosis, eating disorders, and disruptive behavior disorders. This unit also provides unique expertise in treating children with serious co-occurring physical illnesses that can often be vehicles through which emotional and behavioral problems are expressed; as well as the most severe forms of somatoform and eating disorders that require concomitant medical and psychiatric inpatient care.

The IPS is comprised of 3 attending psychiatrists, 1 psychologist, 3 social workers, 1-2 child psychiatry fellows, 2-3 general psychiatry residents (PGY-II), 2 pre-doctoral psychology interns, 3 social work interns, and 1 elective medical student. In addition there are 2 schoolteachers, a pediatric nurse practitioner, an occupational therapist, a nutritionist, a recreational therapist, a group therapist, and a full staff of nurses and milieu counselors.

ROTATION: Opportunities will be provided to observe initial evaluations, walk rounds, and follow-up sessions with the assigned attending, trainee or family therapist. The will also be opportunities to discuss changes in patient status and management plans, observe communications with the medical team, outpatient clinicians, schools, family, etc., as indicated, as well as in disposition planning. The observer is expected to participate in IPS rounds and all other residency training didactics outside IPS.

DURATION: 1-3 months

TIMES AVAILABLE: Throughout the year

SUPERVISOR: Gary Gosselin, MD

SUPERVISION:

Individual - 1 hour per week "Off-Line", as well as "Live" walk-rounds and patient interviews

Group - Daily rounds and team meetings

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OPTION 3: Outpatient and Community Programs

OBJECTIVES: The unique objectives of the Outpatient and Community Programs (OCP) elective are to expose visiting professionals to models for evaluating children and adolescents who present with a wide range of psychiatric needs in outpatient clinic and other community settings, including schools.

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DESCRIPTION: The Outpatient Psychiatry Service located at Boston Children's Hospital proper, offers comprehensive diagnostic and treatment services to children and their families. There are four distinct programs subsumed under this service: 1) Psychopharmacology Clinic, 2) Neuropsychology Program, 3) Emergency Psychiatry Service, and 4) Psychosocial Treatment Clinic (PSTC).

In addition, through longstanding collaborative relationships with the Department of Medicine at Boston Children's Hospital, residents may participate in multidisciplinary specialty clinics in addictions medicine (Adolescent Substance Abuse Program - ASAP), and developmental disabilities (Developmental Medicine Center - DMC).

The Children's Hospital Neighborhood Partnerships (CHNP) is an innovative community mental health program based in 16 schools, public and private, and three community health centers in Greater Boston. CHNP concentrates its efforts to provide mental health services to children and families living in those neighborhoods that have a high prevalence of risk factors such as single parent households, poverty, substandard housing, or community/domestic violence.

ROTATION: A blend of experiences will be formulated from the many possibilities offered in the OCP elective. With the permission of the attendings, patients and parent/guardians, there may be opportunities observe ongoing treatments.

DURATION: 1-3 months

TIMES AVAILABLE: Throughout the year. School programs are only available between September and June.

SUPERVISORS: Enrico Mezzacappa, MD, Stuart Goldman, MD, Eugene D'Angelo, PhD, Kerim Munir, MD, Kaizad Munshi, MD, Celiane Rey-Casserly, PhD

SUPERVISION: 1 hour per week "Off-Line", as well as "Live" supervision during all assessments and related discussions

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Application Guidelines

The CHGP Observership will accept a limited number of individuals for specified periods of time. The average length of stay for each visitor is 1-3 months with a one month minimum requirement. Each visitor may elect to spend at least one month at each of the above tracks or 2-3 full months at a track of their choice. A full application must be completed and approved.

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Clinician Selection Criteria

- Must be a Physician (medical school graduate) or Post-doctoral level Psychologist from outside the US. Undergraduates, medical students, or clinicians who plan to train or practice within the US are not eligible for this program.

- Proficiency in English-language is a requirement.

- Medical students interested in a child psychiatry rotation at Boston Children's Hospital must apply through the Harvard Medical School Registrar.

Selection Process

Applications must be sent in at least 3 months prior to expected rotations. Individuals who require a US visa should anticipate the duration for visa processing prior to applying. Upon review of applications, telephone interviews may be granted to selected applicants and approval would subsequently be determined based on eligibility of the applicant and available positions in the program.

Applications must be in English and must include:

- Application form (includes biosketch, personal statement and goals statement)

- Guarantee of health care costs

- Good health attestation

- Immunization records

- Letter of support from institution or provincial government where applicable (optional)

- US B1/B2 business visa if needed - letter of support may be provided by request.

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Travel and Accommodation

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Individuals will be responsible for all meals, travel and accommodation arrangements within the US.

- For information regarding public transportation in Boston, visit www.mbta.com

- For affordable accommodation, visit:

At Home in Boston (Ms. Joan Cohen) 617-277-6444 or http://www.athomeinboston.org/

Arrival at Boston Children's Hospital

- Introduction and intake interview with goals of rotation, confirmation of areas of interest, review of program structure and assignment to primary rotation tracks. These should have been initiated prior to arrival at Boston Children's Hospital.

- Orientation, meeting with human resources and health services, Boston Children's Hospital badge processing and email, Harvard Medical School Countway library account application.

- Provision of reading materials and standard hospitality packet (e.g., Maps, bus schedule, etc.)

End of Observership

- Complete program evaluation form

- Exit interview with a faculty mentor

- Meet with administrator for submission of ID, any hospital keys, borrowed texts

- Provide contact information for ongoing liaison

- At the end of the program, the directors will provide on request, a letter stipulating the observer's participation in the program including duration and features of the experience, but there will be no certification for the purposes of granting an advanced training certification in the participant's home program and/or country.

- Program participation and completion cannot be construed to represent what would be considered child psychiatry training for the purpose of providing clinical care in another setting.

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Application

View and download a program application

For more information

For more information, please contact:

Patricia Ibeziako, MD
Director, CHGP
Boston Children’s Hospital
Hunnewell Building, 1st Floor
300 Longwood Avenue
Boston, MA 02215
phone: 617-355-5418
fax: 617-730-0319
e-mail: patricia.ibeziako@childrens.harvard.edu

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