Clinical Training

Clinical Training

Duke Child and Adolescent Psychiatry (CAP) fellows provide patient care in a variety of clinical settings to establish a solid foundation in core competencies. In addition to core clinical rotations, fellows have the time and opportunity to pursue specific clinical and academic interests in a range of specialty clinics. All fellows enjoy protected academic time.

First Year Experience:

First-year CAP fellows rotate on Central Regional Hospital (CRH) Child and Adolescent Units. One of three state psychiatric inpatient facilities in the state of North Carolina, CRH serves a broad range of patients and families from central and coastal North Carolina. Multidisciplinary treatment teams comprising physicians, psychologists, social workers, nursing, and behavioral specialists collaborate to treat often the most complicated and behaviorally compromised children from our state. First-year fellows spend roughly one third of their time at the state hospital working with latency age children and two-thirds of their time working with adolescents. Trainees work with patients experiencing Autism Spectrum Disorder, Gender Dysphoria, early onset psychosis, complex chronic medical problems, and complex psychosocial problems in addition to mood and behavioral disorders.

Fellows also spend three months rotating on the Child and Adolescent Psychiatry inpatient consultation-liaison service at Duke Children’s Hospital. Fellows round with multidisciplinary teams including psychologists and social workers in the multiple Duke intensive care units and regular pediatric floors and develop expertise treating infant delirium, eating disorder, and mood disorders among other diagnoses. 

During the first year of fellowship and inpatient learning, trainees also develop psychotherapy skills during two outpatient therapy half-days. Fellows focus on psychotherapy in the Psychosocial Treatment Clinic, supported by weekly scheduled supervision and weekly didactics alongside psychology trainees, and also participate in the Duke Family Studies clinic, a unique training model that incorporates live-observed supervision facilitated by a two way mirror and computer console feed. With teams of learners and weekly systems-based didactics, trainees acquire invaluable techniques and perspective on family system dynamics and pathology.

Second Year Experience:

Second-year CAP fellows devote their time to acquiring outpatient child psychiatry experiences. Fellows benefit from core clinical experiences at the Child and Development and Behavioral Health Center and continuing their work in the Psychosocial Treatment Clinic, and also enjoy protected academic time.

Additionally, second year fellows participate in a wide range of specialty clinics and enjoy the freedom to develop particular interests through electives. Current and past fellows have spent significant time in diverse settings including Pediatrics Integrated Mental Health clinic, Autoimmune Brain Disorder clinic (jointly conducted with neurology and rheumatology), the Duke Center for Autism and Brain Development, The Duke Child and Adolescent Gender Care Clinic, and Lincoln Community Health Clinic for the uninsured. Recent innovations have involved staffing clinics imbedded within local schools through a collaborative between Duke and the Durham County school system. The Duke Children’s Evaluation Center in its second year also represents an innovation in delivering care as it strives to divert children from emergency departments by offering urgent care-like diagnostic and treatment services with case management. Please see links below for more information about core and elective Duke outpatient training sites.