Clinical Training

Part of a mural in the Duke Children's Evaluation Center, one of the fellowship training sites.
Part of a mural in the Duke Children's Evaluation Center, one of the fellowship training sites.

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 can pursue specific clinical and academic interests in a range of specialty clinics.

At each clinical rotation, fellows receive close supervision and mentoring by experienced faculty members invested in their success. We are committed to serving patients from diverse backgrounds, addressing health disparities and social determinants of health, and increasing access to care.

Read on to learn more about how first- and second-year fellows spend their time in the program.

During the first year, CAP fellows gain experience in several diverse clinical settings, including a state psychiatric hospital, Duke University Hospital, psychotherapy training (family therapy and individual cognitive behavioral therapy), and exposures to pediatric neurology and outpatient psychopharmacology clinic.  Sample schedules of our block rotations are included below. 

Central Regional Hospital (Inpatient)

First-year CAP fellows rotate on child and adolescent units at Central Regional Hospital (CRH) in Butner, North Carolina. One of three state psychiatric inpatient facilities in the state, CRH serves a broad range of patients and their families from central and coastal North Carolina. At CRH, multidisciplinary teams comprising physicians, psychologists, social workers, nurses and behavioral specialists collaborate to treat children and adolescents. 

First-year fellows spend roughly one-half of their time working with latency-age children and one-half working with adolescents. Trainees work with patients with autism spectrum disorder, gender dysphoria, early onset psychosis, complex chronic medical problems and complex psychosocial problems, as well as mood and behavioral disorders.

Fellows work at CRH part time for two 3-month blocks.  A typical schedule is included below.

  Monday Tuesday Wednesday Thursday Friday
AM CRH CRH CRH Academic Half Day CRH

Psychsocial Treatment Clinic

CRH CRH Family Studies clinic CRH

Duke Children’s Hospital (Consult-Liaison Service)

Fellows also spend time rotating on the pediatric psychiatry inpatient consultation-liaison (C/L) service at Duke Children’s Hospital. Fellows round with multidisciplinary teams including psychologists and social workers in intensive care units and pediatric floors, develop into team leaders, and teach medical students and residents.  Over the course of the rotation, fellows develop expertise treating infant delirium, eating disorders and mood disorders, among other conditions. 

Fellows work at on the C/L service part time for one 3-month block.  A typical schedule is included below.

  Monday Tuesday Wednesday Thursday Friday
AM C/L C/L C/L Academic Half Day C/L
PM Psychosocial Treatment Clinic C/L C/L Family Studies C/L

Duke University Medical Center (Emergency Psychiatry)

Fellows gain experience in pediatric emergency psychiatry at Duke University Medical Center. Fellows round in the emergency department (ED) with Child and Adolescent Psychiatry faculty and collaborate with nursing and case management on patient evaluations, treatment and dispositions. Fellows are involved of the care of patients experiencing mental or behavioral health crises, and enhance their skills in crisis management, safety planning and psychopharmacology. 

Fellows work at on the ED service part time for one 3-month block.  This rotation also includes time to pursue individual scholarly interests, a dedicated experience in pediatric neurology clinic, and exposure to outpatient pediatric psychopharmacology clinic with one of our core faculty.

A typical schedule is included below.

  Monday Tuesday Wednesday Thursday Friday
AM Scholarly time ED Pediatrics Neurology Clinic Academic Half Day ED
PM Psychosocial Treatment Clinic ED Outpatient Pediatric Psychopharmacology Clinic Family Studies Clinic ED

Outpatient Clinics

Fellows also develop psychotherapy skills in two outpatient clinics, the Psychosocial Treatment Clinic and the Family Studies Program. They receive weekly scheduled supervision and didactics alongside psychology pre-doctoral trainees.

The Psychosocial Treatment Clinic is a cognitive-behavioral therapy based clinic for children and adolescents with a variety of conditions. Fellows develop competency in both short- and long-term evidence-based psychotherapy with close supervision from teaching faculty.  This rotation occurs weekly for 12 months.

The Duke Family Studies Program and Clinic, an innovative 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. This rotation occurs weekly for 12 months.

Second-year CAP fellows devote their time to outpatient child psychiatry. Fellows benefit from core clinical experiences at the Child and Development and Behavioral Health Center (CDBH), Duke Autism Clinic, school based mental health (COPE) program, and continue their work in the Psychosocial Treatment Clinic.

Additionally, second-year fellows participate in a wide range of specialty clinics and enjoy the freedom to explore interests and develop expertise through electives. Fellows have spent time in a range of Duke clinics, community clinics and clinics embedded within local schools. Advanced psychotherapy training is available in Trauma Focused CBT, individual and family based treatment of eating disorders, Parent Management Training, Parent-Child Interaction Therapy, and Acceptance and Commitment Therapy among others. Fellows can also bolster their skills as clinician educators via advanced training and mentorship. Finally, many fellows dedicate time to pursuing research projects via a structured research elective.

A sample second year fellow schedule is included below, illustrating the amount of flexibility we ensure fellows have to pursue their individual interests:


Monday Tuesday Wednesday Thursday Friday

COPE twice per month.

Elective or administrative when not at COPE

Elective Elective Academic Half Day Autism Clinic
PM Psychosocial Treatment Clinic CDBH Elective vs. Research Elective vs. Administrative Elective


Learn more about core and elective Duke training sites.

There is no in-house overnight call. CAP fellows provide weekend daytime coverage at the Duke University Hospital System pediatric psychiatry consult-liaison and emergency department with direct supervision from a core faculty member for 6-7 weekends per year (including holidays). Fellows also provide phone coverage for two pagers (urgent concerns from the pediatric C/L team and clinic outpatients who have urgent concerns).