PEDIATRIC CHILD PSYCHIATRY

What does a Child and Adolescent Psychiatrist do?
What are the career opportunities?
What Board certifies a Child and Adolescent Psychiatrist?
What is the lifestyle of a Child and Adolescent Psychiatrist?
What is the compensation of a Child and Adolescent Psychiatrist?
How do I become a Child and Adolescent Psychiatrist?
Where do I find out about available programs?
When do I apply?
Why should I become a Child and Adolescent Psychiatrist?

What does a Child and Adolescent Psychiatrist do?
The discipline of child and adolescent psychiatry encompasses disorders of emotion and behavior that have their origins in neurophysiology, genetics, and in environmental factors that affect the child's growth and development. Patients seen by the child and adolescent psychiatrist vary from those with common problems including attention deficit hyperactivity disorder and generalized anxiety disorder, to more complicated conditions such as conversion or autistic disorders. Diagnostic evaluations give attention to the physical, genetic, developmental, emotional, cognitive, educational, family, peer, and social components. An integrated approach may involve individual, group, or family psychotherapy; medication; and/or consultation with other physicians or professionals from schools, juvenile courts, social agencies, or other community organizations. In addition, the child psychiatrist is prepared and expected to act as an advocate for the best interests of children and adolescents. The variety of diagnoses and the multiple etiologies that accompany these clinical presentations allow the child and adolescent psychiatrist to focus their patient-care and academic efforts on a broad range of problems.

What are the career opportunities?
Child and adolescent psychiatrists have multiple opportunities to build careers in private practice as well as in academics. As with other pediatric mental health professionals, there is a tremendous shortage of child and adolescent psychiatrists across the United States. There are approximately 7,400 practicing child and adolescent psychiatrists in the U.S., and a report by the U.S. Bureau of Health Professions (2000) estimated a need for 13,000 child and adolescent psychiatrists by the year 2020 with an anticipated supply of 8,300. In addition, only 20% of children with emotional or behavioral problems receive any mental health treatment. The demand for child and adolescent psychiatric services will, therefore, increase dramatically in the next 10 to 20 years.

Child and adolescent psychiatrists provide clinical service in solo or group private practice settings, in managed care or government settings, or as a supervisor or administrator. They can work at any point in the continuity of care, including inpatient, residential, day hospital, or outpatient programs. Consultation opportunities exist in schools, hospital, or courts; and to a variety of agencies and professionals. The demand for academic psychiatrists remains high both as clinician-educators and as researchers, with an ever increasing need for new knowledge and treatments. Most physicians cover a broad range of disorders, but there are physicians in academic medical centers and specialty hospitals who focus their work on specific diagnoses, including mood disorders, autism, disruptive behavioral disorders, and chemical dependency.

What Board certifies a Child and Adolescent Psychiatrist?
Physicians must complete four years of post-graduate training in order to Board Eligible in general psychiatry. One year of this can be spent in the first year of child and adolescent psychiatry residency. Board eligibility in child and adolescent psychiatry requires two years of child and adolescent psychiatry training as well as board certification in general psychiatry. The certification examination is given by the American Board of Psychiatry and Neurology (APBN).

What is the lifestyle of a Child and Adolescent Psychiatrist?
The job opportunities and lifestyle of the child and adolescent psychiatrist are excellent. Child and adolescent psychiatry also provided a broad range of practice options, work-life balance, and flexibility. There are ample jobs that allow a call-free life style. In addition, being On-Call usually generates additional compensation. As there is a scarcity of child psychiatrists and significant need for mental health care, this specialty allows the physician to be in strong negotiating position to develop a job description tailored to their desires and gives the individual the capability of achieving an excellent work-life balance. What is the compensation of a Child and Adolescent Psychiatrist?
Because of the demand for child and adolescent psychiatry, practitioners can select from multiple career paths and decide how many hours they want to devote to their careers. According to a survey of all graduating resident and fellows in California and New York in 2000, Child and adolescent psychiatrists ranked first of 27 medical specialties in California and second of 28 specialties in New York on the average number of job offers per resident. For information about salary, click here or here.

How do I become a Child and Adolescent Psychiatrist?
Child and adolescent psychiatric training requires at least three years of approved residency training in medicine, neurology, and general psychiatry with adults, and two years of additional specialized training in psychiatric work with children, adolescents, and their families in an accredited residency in child and adolescent psychiatry. Training is provided in different therapeutic modalities (group, individual, cognitive-behavioral, psychodynamic, psychopharmacologic, family systems) and treatment settings (inpatient, day hospital, outpatient, and residential). In addition to traditional training programs, physicians can become a child and adolescent psychiatrist through integrated training programs that combine adult and child psychiatry in five years. These programs allow for training in child psychiatry beginning in the first or second year of residency and are ideal for medical students who are certain of their career choice. Physicians can also participate in triple board programs where residents complete five years of training in pediatric, general psychiatry, and child and adolescent psychiatry in a single integrated experience. Graduates are board-eligible in all three specialties.

Where do I find out about available programs?
There are 110 accredited child and adolescent psychiatry programs in the United States and information on all programs can be accessed through the ACGME website including how to contact the training directors for an application. The list of programs also includes those centers with triple board residencies. For these, select "Peds/Psych/Child-Adolescent Psych" near the bottom of the dropdown menu. The American Academy of Child and Adolescent Psychiatry contains information on all subspecialty training including those in infant psychiatry, substance abuse, and research.

When do I apply?
Child Psychiatry participates in the NRMP and institutions that offer fellowships in Child Psychiatry are available on FRIEDA. Applications are specific to each institution but tend to be fairly uniform in the information requested. Interested applicants should contacts programs around July 1st for enrollment the following July. However, it is not unusual for some to begin the process in November for entry the following July. Consequently, for applicants who apply late, there may still be positions available. For match statistics, click here.

Why should I become a Child and Adolescent Psychiatrist?
Child psychiatry is exciting on multiple levels. It allows the physician to interact with both the child and the family and effect change in many domains. The increasing knowledge in the neurosciences makes this an ideal time to become a Child Psychiatrist as it provides the physician an opportunity to impact the emotional lives of the children while utilizing evidenced-based interventions. This unique specialty allows the physician to combine the science of medical treatments with the art of therapy. The excellent outcomes and functional improvements in the entire family system are highly satisfying. This plus a life style that can be tailored to the individual makes child psychiatry an extremely attractive specialty.

For more information about Child and Adolescent Psychiatry, visit these websites:
FRIEDA
American Academy of Child and Adolescent Psychiatry
American Psychiatric Association
American Board of Psychiatry and Neurology
Academy of Psychosomatic Medicine

Subspecialty Journals:
Journal of the American Academy of Child and Adolescent Psychiatry
Journal of Child Psychology and Psychiatry
American Journal of Psychiatry
Archives of General Psychiatry
Journal of Child and Adolescent Psychopharmacology
Psychosomatics
Child and Adolescent Psychiatry Clinics of North America