Policy and Procedure
Administrative Organization of Training Program
The Fellowship Training Program is run by the training director in close collaboration with the Training Committee in Child and Adolescent Psychiatry. This committee is composed of the training director, triple board coordinator, Division director, clinical and medical directors of Child and Adolescent Psychiatry outpatient clinic, and director of the Child Psychiatry Inpatient Unit. The chief resident in Child and Adolescent Psychiatry attends every meeting. This committee meets every other week for one hour and reviews all matters pertaining to training, including assignment of trainee rotations, supervisory assignments, review of progress in training, program assessment and selection of new trainees.
Evaluation of Training
Through a systematic and interactive process, trainees are given feedback regarding their performance in the program. Evaluations are conducted every six months. Service directors and supervisors give feedback directly to the trainee, fill out a standard evaluation form, and discuss their evaluations in a meeting of all faculty and supervisors. Based on a review of all material, the training director meets with each trainee to review the status of training, monitor treatment logs, and identify goals for the trainee. The evaluation process is intended to identify areas of both strength and weakness, and the overall experience intended to be collegial and constructive.
In addition to the evaluation of performance on clinical rotations, there are two written examinations and one oral annual examination of the trainee's knowledge base and clinical performance. All fellows take the PRITE written examinations in General Psychiatry (optional for trainees at PGY-5 level and above) and in Child and Adolescent Psychiatry. In addition, trainees participate in a full day oral examination structured along the lines of the Board examination in Child and Adolescent Psychiatry. This "Mock Board Examination" is conducted in conjunction with several other programs locally. Results are shared with trainees at the time of the exam and during the spring meeting with the training director.
Review of Program
Evaluations of the training program by the trainees are solicited and carefully monitored. There are written evaluations of each didactic course, clinical rotation and supervisory contact. These evaluations represent one component in the evaluation of faculty members and are incorporated into planning done for program development.
Input from Trainees Regarding Program Administration and Problem-Solving
The training director and the training committee regularly and systematically solicit input from the trainees regarding the content and quality of the training program. The training director meets with the trainees as a group every other week to disseminate information, review any problems that may arise, and facilitate the process of training at the group level. In addition, the trainees meet every other week without the training director to discuss program issues on their own, which they can then bring back to the training director the following week.
There is a chief resident for the Child and Adolescent Psychiatry program, as well as a Triple Board chief. The Child and Adolescent Psychiatry chief resident is chosen by the training committee and may either be a resident in Child and Adolescent Psychiatry or a Triple Board resident. The position may be assigned for as long as one year; and some years it is shared by more than one trainee. The principle duties of the chief resident are to serve as a liaison between the program and the trainees, meet with the trainees and the training director to gather information and to problem-solve, facilitate the scheduling of meetings between the trainees and training director, and make up the monthly resident on-call schedule. The chief resident attends every training committee meeting, and may assist in the scheduling of the Divisional Grand Rounds. Through these activities the chief resident gains experience in administrative functions.
Requirements for Program Completion
The Child and Adolescent Psychiatry Fellowship is a two-year full-time program. The Triple Board program is a five-year full-time program in which each trainee spends approximately 18 months as a member of the Child and Adolescent Psychiatry fellowship. In some circumstances part-time training will be considered, at the discretion of the training committee. In order to successfully complete the program, each trainee must meet the requirements for each of the service rotations, as indicated on the trainee evaluation form for that service. At the completion of training, the training director will certify that there has been no evidence of professional or ethical misconduct during the program, and that all training requirements have been completed.
In the rare event that a trainee's performance falls significantly below the expectations of the program, every effort is made to assist him/her in optimizing performance, and extra help is provided as needed. In the extremely rare event that such interventions are not sufficient, it may be necessary for the trainee to be placed on probation. Should a trainee not be offered a position to continue in the second year of the program, Hospital policies regarding due process require that the trainee be notified of this action by November 15th. As is the case for all employees in the medical center, trainees may be "terminated for cause," i.e. for serious violations of Hospital policies or professional misconduct.
The Mount Sinai Hospital holidays follow the schedule for national holidays. The following days are given: New Year's Day, Martin Luther King Day, Presidents' Day, Memorial Day, Fourth of July, Labor Day, Thanksgiving Day, and Christmas Day. Up to four personal days are allowed each year for observance of religious holidays, and so on.
There are four weeks of vacation time, which must be approved by the relevant service chiefs and the training director ahead of time. Vacations are generally taken in blocks not longer than two weeks, unless special permission is arranged. The time should be staggered so that two weeks are taken in the period July - December, and two weeks are taken January - June, with the following exceptions: first year child and adolescent psychiatry fellows and second and fifth year triple board residents should not take vacation during July-August, when the summer orientation course is offered. Vacation is not granted beyond the first week of June, except by special arrangement.
Permission for moonlighting is granted at the discretion of the training director. In order to qualify, trainees must be in good standing in the program, have a permanent license suitable for the location of the employment, and provide written documentation of malpractice coverage (please note: Mount Sinai malpractice insurance does not provide coverage for clinical activities conducted outside the training program). Moonlighting must not interfere with the training responsibilities of the house staff or the number of hours worked for programs in New York State to be in compliance with Part 405.4 of the New York State Health Code.
Female trainees are allowed 8 weeks paid maternity leave, and may elect to schedule their vacation time contiguously in order to extend the leave. It is recommended that not more than two weeks of vacation time be utilized for this purpose. Additional leave of absence may be granted upon request. Trainees who anticipate the need for maternity leave should make their needs known as soon as possible so that appropriate scheduling of training experiences can be undertaken and coverage arranged. The hospital policy for paternity leave is 1 day.
Clinical and academic assignments are based on a 45-hour/week schedule, of which approximately 38 hours are clinical assignments (including all service based supervision and teaching). Six hours are for formal didactic instruction, and 1 hour is for the weekly fellows meeting. It is generally expected that in addition to daytime work hours, one evening per week will be made available to see patients and their families.
Trainees take call to the Pediatric Emergency Room on rotation, approximately one time per week, and only in the first year of the two-year fellowship. During call coverage, fellows are not on-site but carry a long-range beeper and respond to calls on an as-needed basis until 10PM. Faculty back-up supervision is provided. Trainees on-call do not provide coverage for: 1) patients who present to the Pediatric Emergency Room after 10PM; 2) the Child Psychiatry Inpatient Unit; 3) adolescents seen in the Psychiatry Emergency Room; 4) inpatient pediatric consultation-these functions are carried out by Adult Psychiatry residents. While on-call, transportation costs are reimbursed.
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