Child and Adolescent Psychiatry Fellowship 

The Child and Adolescent Psychiatry Fellowship is a two-year, ACGME-approved fellowship program with six fellowship spots per training year. Our fellowship program provides rigorous training in the treatment of children, adolescents, and families with a wide variety of psychiatric illnesses. When you finish your training, we want you to feel confident that you can manage any clinical challenge that might come your way because you’ve seen it here first and because you had first-class supervisors who guided you through the approach to complex psychiatric illness in children and adolescents.

Our first year curriculum is remarkable for including a range of high-acuity services: an adolescent inpatient psychiatric ward, the psychosomatic medicine service of a tertiary care pediatric hospital, and dedicated pediatric neurology rotation. Our second year curriculum contains an exceptional psychotherapy training program embedded in two separate outpatient clinics, where fellows are able to learn and practice in a manner that is evidence-based, but where they also enjoy and benefit from substantial independence. Indeed, our graduates report feeling well-trained and prepared for independent practice in all the settings in which they choose to work: large medical centers, the public sector, academics, and private practice.

While exposing you to a diverse set of clinical rotations, we also provide forums for you to develop your own interests and passions during your training. Fellows can participate in research and healthcare systems projects in both years of training. In the second year, fellows have 10% time protected for an elective experience. Past electives have included participating in coursework at a psychoanalytic institute, studying the effects of atypical antipsychotics on cardiac conduction of children in the ICU, and developing a presentation on how music affects emotions and learning. Our faculty consists of expert clinicians, neuroscientists, psychoanalysts, and community psychiatrists who will mentor you during your time with us.

We place a high value in recruiting genuine and collegial individuals. By doing so, we have built a culture in which fellows feel excited to perform clinical duties and learn, and in which faculty feel inspired and free to teach. Faculty model professional, ethical, and collegial behavior with one another and with fellows. We also put substantial weight on fellow well-being, including a support group for first year fellows and planned lunch meetings for both classes to meet and enjoy one another’s company. We are fortunate to have a concentration of faculty and fellows with substantial strength in the performing and visual arts and who are enthusiastic about incorporating their creative skills and capacity to play into their psychiatric practice with children and adults.

Finally, for all of the diversity of interests among our faculty, we are all rooted in our common desire to care for children and families who are disadvantaged, be it by poverty, immigration status, family dynamics, or medical illness. We commonly work with underprivileged families, and we have a passion for not allowing limited resources to affect the quality of care we provide to the children and families we serve.

Educational Goals and Objectives

Year 1

During year 1, fellows complete rotations as follows:

WARD F BHC
ALHAMBRA
LAC+USC CHLA CHLA
Adolescent Inpatient
4 months
Young Child
Inpatient /
Eating
Disorders
1 month
Child Crisis
Service
4 months
Pediatric
Neurology
1 month
Pediatric
Consultation
Liaison
2 months

Space is provided within 2 months of the Child Crisis rotation to pursue elective experiences.


Lectures and Seminars

  • Diagnostic Interviewing with Children and Adolescents
  • Biweekly seminar in Psychoanalytic Treatment of Children and Adolescents
  • Psychotherapeutic Skills with Children, Adolescents and Families
  • Typical Child Development
  • Psychopathology in Children and Adolescents
  • Introductory Psychopharmacology with Children and Adolescents
  • Quality Improvement in Child and Adolescent Psychiatry
  • Neurosciences in Child and Adolescent Psychiatry
  • Consultation in the Pediatric Medical Hospital
  • Field trips to Central Juvenile Hall, residential treatment center and residential substance abuse treatment center

Supervision

  • On-ward and on-service
  • Additional Individual tele-supervision available based on interest

Scholarly Experience

  • Journal club
  • Each first-year fellow gives an oral presentation to all fellows and faculty, based on a case presentation and a literature review.
  • Each fellow begins planning for his or her second-year scholarly elective.

On-Call

  • Adolescent Inpatient: Fellows rotating at Augustus Hawkins typically do in-house rounding on patients 2–4 weekend days per month. In house work can often be completed by early to mid-afternoon. They cover evening pages 10-15 nights per month by phone, but do not physically return to the hospital (for evening need of face-to-face evaluation/response, attending staff who are already in-house will lend support).
  • Child Crisis Service: Fellows are typically responsible for 4-6 weekend days of combined jeopardy (back-up) and in-house call coverage per month. In house call involves only rounding on pediatric patients who are on psychiatric holds and who are admitted to the hospital’s medical floors. This is usually limited to 2-3 patients per weekend day, while sometimes there are no patients (meaning the fellow does not go in). The jeopardy system has been needed extremely infrequently. There is no regular weekday or evening call.
  • CHLA consultation liaison: 10–15 nights of call by phone only (no reporting to the hospital)
  • CHLA Neurology and Young Child Inpatient: No call

*Our fellows’ on-call duties never exceed ACGME duty-hour standards.

Year 2

During year 2, fellows will complete rotations as follows:

  • LAC+USC Child Outpatient Clinic (67%)
  • CHLA UCEDD Outpatient Clinic (20%)
  • Scholarly elective (10%)
  • LAC+USC Early Childhood Clinic (2%)
  • LAUSD school consultation (1%)

Lectures and Seminars

  • Psychotherapy with Children, Adolescents, and Family Seminar:
    • Motivational Interviewing
    • Training in The Incredible Years and other EBP’s
    • Parent Training/Behavior Therapy
    • Cognitive Behavioral Therapy and Trauma-Focused CBT
    • Family Therapy
  • Advanced Psychopharmacology (case-based)
  • Child and Adolescent Psychiatry in the Schools
  • Forensic Child and Adolescent Psychiatry
  • Advanced Psychopathology in Children and Adolescents
  • Autism Spectrum Disorders
  • Ethics
  • Cultural Psychiatry
  • Field Trips to tour community resources

Supervision

  • In-clinic on-demand
  • One hour per week of individual supervision with a core faculty and one hour per week with an outside supervisor
  • Outside supervisors have expertise in psychodynamic psychotherapy, group therapy, establishing a private practice, Asian-American psychiatry, autism spectrum disorders, work-life balance and public-sector administration among others.
  • Outside supervisors are assigned to match fellows’ interests.
  • One hour per week group psychotherapy supervision

Scholarly Work

  • Each fellow has 10% time over the course of the year for a scholarly project, which typically involves learning and practicing an area of special interest that culminates in a scholarly product.
  • Monthly journal club

On Call

  • Second-year fellows have no on-call responsibilities.

Scholarly Development & Electives

Electives

Fellows dedicate 10 percent of time during the second fellowship year to a scholarly elective. While the elective may have a clinical treatment component, it must also culminate in a scholarly product, generally a poster or manuscript. Planning for this elective begins in winter of the first year of fellowship. Previous fellows’ electives have included:

  • Case series on NMDA-receptor encephalitis
  • Psychoanalytic psychotherapy with children and adolescents at the new center for psychoanalysis
  • Music therapy in child and adolescent psychiatry

Fellows have published in the Residents’ Journal of The American Journal of Psychiatry and in Academic Psychiatry, and have presented posters at the Academy of Psychosomatic Medicine, International OCD Foundation Conference, American Association of Directors of Psychiatry Residency Training and the American Psychological Association annual meeting.

Formal Scholarly Training

One resident or fellow from the Department of Psychiatry is chosen annually to spend a year collaboratively working with graduate students in law, philosophy, social work, neuroscience and psychology at the Saks Institute for Mental Health Law, Policy, and Ethics on an “Issue for Investigation,” typically leading to a manuscript and several presentations. The Saks Institute is part of the USC Gould School of Law.

Fellows and junior faculty have the opportunity to take Introduction to Clinical and Translational Research Study Design, one-half day per week for eight weeks, through the Southern California Clinical and Translational Science Institute, a multifaceted research center created by USC and Children’s Hospital Los Angeles to translate scientific discoveries into solutions for better health.

Both of these experiences can be integrated into the second year of fellowship and do not extend training.

Teaching Child and Adolescent Psychiatry

  • All second-year fellows must give at least one lecture for pediatrics residents or Psychiatry interns
  • Many voluntary teaching opportunities exist for formal teaching of medical students, parents and school teachers above and beyond the requirement

Extramural Fellowships

We accommodate travel and time away for service in fellowships sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA), American Psychological Association (APA), American Academy of Child and Adolescent Psychiatry (AACAP) and American Association of Directors of Psychiatric Residency Training (AADPRT).

Salaries and Benefits

Fellows are employees of Los Angeles County. Fellows’ salaries are determined in negotiations among the county’s legal bargaining unit, the Council of Interns and Residents, and the county’s Department of Health Services.

Salary as of July 1, 2017

PGY-4  $65,944.08
PGY-5  $70,565.61

Benefits

Bonus $2,000 for interns progressing to second residency year
Meals $10 per meal, $28 per day at LAC+USC Medical Center; meals are reimbursed during off-campus rotations at $25 per day
Parking Available at no cost at LAC+USC Medical Center
White coats Provided
Vacation Residents are entitled to 24 days paid vacation each year
Sick leave 8 days per year, of which 3 may be used for personal leave
Professional liability insurance Provided (Los Angeles County self-insures)
Maternity leave Available — most residents use sick leave, vacation time and limited unpaid leave
Parental leave Available as required by the Family and Medical Leave Act of 1993
Medical/dental benefits Choice of several offered plans; family coverage available at additional cost
Life insurance $2,000 term policy is provided; additional insurance may be purchased


Fellow Life

child-psych-well-being

Fellow Well-being

Fellows who feel a sense of purpose and satisfaction in their training learn better, treat their colleagues better, are more effective with patients. Such fellows are also best able to teach and learn from one another. For this reason, the program puts a high value on resident well-being and morale. Didactics are scheduled so as to allow residents from both classes to meet for lunch at least once/week. When possible, teaching modalities incorporate interactive activities to enrich the learning experience. There is a yearly retreat for fellows to work on team-building and their own professional identity. There are multiple formal and informal opportunities for fellows to give confidential feedback (to their chief fellows) about the program, giving fellows a high degree of input in the program. Fellows in the first year class also attend a 2x/month support group led by a social worker. Second year fellows have guided mindfulness sessions scheduled several times throughout the year.

Living in Los Angeles

LA

Few areas in the world rival southern California. The beautiful weather, cultural diversity, and easy access to beaches, desert, and mountains make Los Angeles one of the worlds’ most exciting cities.
The Los Angeles climate is warm and dry, with over 300 days of sunshine per year. The beaches—Malibu, Santa Monica, and Venice—are close and offer swimming, surfing, and sailing. The high desert (Joshua Tree Park) and Sierra Nevada mountains (Yosemite, Kings Canyon, and Sequoia National Parks) are easy drives from the city. In the winter, one can drive to the mountains and skiing areas in less than 2 hours.

Cultural and entertainment events include world-class concert halls, theaters and museums. Dodger stadium and the Hollywood sign are visible from the Medical Center, and one can drive to Disneyland in less than an hour. Farmers’ markets and world-class restaurants abound.

Within easy driving distance of the medical center are neighborhoods buzzing with young creative people (Hollywood, Silverlake, and Los Feliz) and also neighborhoods with excellent parks and schools perfect for young families (Pasadena, South Pasadena, and Alhambra). Nearly one third of California’s population lives in Los Angeles. Inhabitants include native Angelenos and immigrants from all over the world. One can easily walk from Thai Town Little Armenia. Los Angeles has a vibrant and diverse economy, featuring not only the entertainment industry, but multiple universities, large private corporations, and high-tech start-up businesses. This diversity provides residents and their families with rich work, educational, and recreational opportunities.

How to Apply

Application Deadline:

October 1st each year

Requirements:

By July of the year of fellowship entry, an applicant must:

  • Have completed at least three years of general psychiatry residency training
  • Have a California medical or osteopathic license. The process of obtaining a license in California takes approximately six months for graduates of American medical/osteopathic schools and can be substantially longer for international graduates. Please note: Our program cannot rank an applicant who is not well along in the application process for a license by the early December rank-order list submission date. In practical terms, applicants without a California license should begin the application process by September. For details regarding licensure in California, please refer to the Medical Board of California website or the Osteopathic Medical Board of California website.
  • Have passed at least one clinical skills evaluation (CSE) of the examination of an adult psychiatry patient. However, if you wish to be eligible to take the psychiatry boards at the beginning of PGY5, we recommend you pass three CSEs with adult patients, as you may not have passed any CSEs with child patients by that time.
  • Be a U.S. citizen or permanent resident, or have a J-1 visa. We cannot accept H1B visas.

Application Instructions:

Our program accepts applications only via the Electronic Residency Application Service (ERAS). You must submit the following documents through ERAS:

  • A letter of recommendation from your general psychiatry program director
  • Program Director’s Verification Form Attesting to Child and Adolescent Psychiatry Fellowship Eligibility (download in PDF or Word). This form can be submitted in one of the letter of recommendations slots in ERAS or be saved in one document along with your program director’s letter of recommendation and submitted in the same slot as the program director’s letter.
  • Medical School Performance Evaluation (MSPE/dean’s letter)
  • Two to three other letters of recommendation
  • Personal statement
  • Curriculum vitae that includes your date of birth and social security number
  • United States Medical Licensing Examination (USMLE) transcript or Comprehensive Osteopathic Medical Licensing Examination (COMLEX) transcript
  • Transcript of medical school grades
  • Photograph

We comply with the policies and procedures of the the National Resident Matching Program (NRMP) and all six slots are filled through this program. The due date to register with NRMP and to obtain a match number is in early December for training starting July 1 of the following year. You will be notified of NRMP results in early January.

Interview Day

Interviews are held in October and November for July start dates. In exceptional circumstances, we will arrange for an alternative interview date. Up to five applicants are interviewed on each designated interview day. All interview days begin at Children’s Hospital Los Angeles then move to the USC Health Sciences Campus and LAC+USC Medical Center. The day typically runs 8 am– 4:30 pm

We strongly advise you to arrive the night before your interview, especially since applicants generally meet fellows at a restaurant near LAC-USC Hospital the evening prior to the interview (food provided by the department). Please let us know if you need special accommodations to end your interview day a bit early (i.e., to make a plane).

Where to stay:
If you will need hotel accommodations in Los Angeles, it will be most convenient to stay in Pasadena. Downtown Los Angeles or near Children’s Hospital Los Angeles (Hollywood/Los Feliz area) are reasonable alternatives. We send interviewees a list of hotels that offer reduced rates for USC.

Transportation:
Most applicants rent a car and drive between sites, but it is possible to use public transportation between all interview sites. We send interviewees a list of links for public transportation.

What to Wear:
Comfortable shoes (and professional interview attire)

Contact

For more information or questions about our program, please contact:

Christopher Snowdy, MD
Associate Program Director
(323) 409-5342
Christopher.Snowdy@med.usc.edu