Our mission is to train child and adolescent psychiatrists that will positively impact the health of youth and their families through excellence in direct clinical care and in clinical consultation to the community. Our fellows will be capable of practicing in a variety of settings, with an emphasis on caring for the underserved. In addition, our program seeks to foster each fellow’s career development through individual mentorship as well as personalized longitudinal elective experiences. The program’s focus on serving the underserved aligns with the larger mission of the University of Florida College of Medicine – Jacksonville.

Program Aims

• To produce excellent, independent child and adolescent psychiatrists who can practice evidence-based psychiatry in outpatient, inpatient, residential and integrated primary care settings
• To train the next generation of child and adolescent psychiatrists to impact the care of children, adolescents and their families on a public health scale by serving as consultants to other health care professionals, to the juvenile justice system, to the school system and to the community
• To foster the development of individualized clinical, research and educational interests within the field of child and adolescent psychiatry

Goals and Objectives

The overall goal of the program is to educate child and adolescents psychiatrists who will be competent to practice independently in the competency areas outlined below.

Patient Care

Fellows will be able to provide patient care that is compassionate, appropriate and effective for the treatment of mental health problems and the promotion of overall health. Fellows must be able to provide such care for patients from diverse cultural backgrounds and varied socioeconomic levels.

Fellows will develop skills in the evaluation and treatment of patients representing the full spectrum of psychiatric illness in children and adolescents, including developmental and substance use disorder. Specifically, they will become competent in interviewing and assessing skills; developing rapport with children, adolescents and families; performing and documenting all aspects of an evaluation, including eliciting a clear and accurate history; performing a mental status examination; performing physical and neurological examinations when appropriate; and integrating supplementary medical and psychological data into a formulation, differential diagnosis and comprehensive treatment plan.

Fellows will be competent in formulating a diagnosis based on the data they have obtained, including evaluation of past records. They will develop skills to make a thorough differential diagnosis and be able to plan further steps to clarify the diagnoses.

Fellows will develop competency in creating an appropriate and comprehensive treatment plan for children and adolescents with diagnoses in the current diagnostic manual in brief and long-term individual therapy, family therapy, group therapy, crisis intervention, supportive therapy, psychodynamic and cognitive-behavioral psychotherapies.

Fellows will also:

• Participate in psychiatric administration to include leadership of interdisciplinary teams
• Provide psychiatric consultation in multiple different settings (i.e. pediatric inpatient and outpatient teams, school systems, legal systems)
• Provide psychiatric treatment while collaborating and coordinating treatment with non-medical therapists
• Use pharmacological regimens, including the concurrent use of medications and psychotherapy

Medical Knowledge

Fellows must demonstrate knowledge of established and evolving biomedical, clinical, epidemiological and social-behavioral sciences, as well as the application of this knowledge to patient care.

Fellows must demonstrate knowledge in specific areas, such as:

• Basic neurobiological, psychological and clinical sciences relevant to psychiatry and the application of developmental, psychological and sociocultural theories relevant to the understanding of psychopathology
• Cultural issues pertinent to children, adolescents and their families
• Recognition and management of domestic and community violence, including physical and sexual abuse, as well as neglect, as it affects children and adolescents
• The appropriate uses and limitations of psychological tests
• The full range of psychopathology in children and adolescents, including the etiology, epidemiology, diagnosis, treatment and prevention of the major psychiatric conditions that affect children and adolescents
• The ability to critically appraise and understand the relevant research literature and to apply research findings appropriately to clinical practice, including the concepts and process of evidenced-based clinical practice:
  • Fellows and faculty will participate in journal club, research conferences, didactics and/or other activities that address critical appraisal of the literature and understanding of the research process
  • Fellows will have research opportunities and the opportunity for development of research skills for fellows interested in conducting research in psychiatry or related fields

Practice-based Learning and Improvement

Fellows must demonstrate the ability to investigate and evaluate their care of patients, appraise and assimilate scientific evidence and continuously improve patient care based on constant self-evaluation and life-long learning. Fellows are expected to develop skills and habits to be able to meet the following goals:

• Identify and perform appropriate learning activities
• Identify strengths, deficiencies and limits in one's knowledge and expertise
• Incorporate formative evaluation feedback into daily practice
• Locate, appraise and assimilate evidence from scientific studies related to their patients' health problems
• Participate in the education of patients, families, students, fellows and other health professionals
• Take primary responsibility for lifelong learning to improve knowledge, skills and practice performance
• Set learning and improvement goals
• Systematically analyze practice using quality improvement methods and implement changes with the goal of practice improvement
• Use information technology to optimize learning

Interpersonal and Communication Skills

Fellows must demonstrate interpersonal and communication skills that result in the effective exchange of information and collaboration with patients, their families and health professionals. Fellows are expected to:

• Act in a consultative role to other physicians and health professionals
• Communicate effectively with patients, families and the public, as appropriate, across a broad range of socioeconomic and cultural backgrounds
• Communicate effectively with physicians, other health professionals and health related agencies
• Collaborate with other professional mental health personnel, pediatricians, teachers and other school personnel in the evaluation and treatment of patients
• Maintain comprehensive, timely and legible medical records
• Work effectively as a member or leader of a health care team or other professional group

Professionalism

Fellows must demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles. Fellows are expected to demonstrate:

• Accountability to patients, society and the profession
• Compassion, integrity and respect for others
• Responsiveness to patient needs that supersedes self-interest
• Respect for patient privacy and autonomy
• Sensitivity and responsiveness to a diverse patient population, including but not limited to diversity in gender, age, culture, race, religion, disabilities and sexual orientation
• The ability to maintain appropriate professional boundaries, including those specific to psychiatric practice based on the American Psychiatric Association's The Principles of Medical Ethics with Annotations Especially Applicable to Psychiatry

Systems-based Practice

Fellows must demonstrate an awareness of and responsiveness to the larger context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care. Fellows are expected to:

• Advocate for quality patient care and assist patients in dealing with system complexities, including disparities in mental health care for children and adolescents
• Advocate for quality patient care and optimal patient care systems
• Coordinate patient care within the health care system relevant to their clinical specialty
• Incorporate considerations of cost awareness and risk-benefit analysis in patient and/or population-based care as appropriate
• Know how to advocate for the promotion of health and the prevention of disease and injury in populations
• Participate in identifying system errors and implementing potential systems solutions
• Participate in the practices of utilization review, quality assurance and performance improvement
• Understand how types of medical practice and delivery systems differ from one another, including methods of controlling health care cost, assuring quality and allocating resources
• Work effectively in various health care delivery settings and systems relevant to their clinical specialty
• Work in inter-professional teams to enhance patient safety and improve patient care quality