Albert J. Solnit Integrated Program

Residents begin their training within the Yale Department of Pediatrics in order to best facilitate immersion in medical care at a tertiary children's hospital.

The internship year is made of 13 four-week blocks. Five 4-week blocks of general pediatrics, including 3 inpatient blocks, one emergency pediatrics block, and a pediatrics acute care block. These pediatrics blocks are interspersed with one block of adult neurology consult, one block of child neurology consult, one block of inpatient child and adolescent psychiatry (ages 12-17 years old), one block of child consultation-liaison psychiatry and one block of dedicated research time.

The final rotation of the year consists of 3 blocks on an inpatient adult psychiatry unit at the Veterans Hospital where the two Integrated residents have a chance to work together and with other general psychiatry interns. The combination of pediatrics, child psychiatry, and research elective sets the foundation of the child psychiatry research identity.

The PGY2 year focuses on establishing psychiatric clinical skills with 75% of the year spent in intensive clinical training. However, this clinical skills year involves substantial research time with one 3-month research rotation, known as the CASE (Clinical and Academic Skills Enhancement) elective. During these months, residents work with a mentor of their choosing, who may be in any of Yale’s departments. Research is also integrated into one of the 2-month clinical blocks, on the Clinical Neuroscience Research Unit (CNRU), where residents work with inpatients enrolled in clinical trials. The remainder of year consists of five months of Adult Psychiatry (Emergency Psychiatry (1 month), Adult Consult-Liaison Psychiatry (1 month), Geriatric Psychiatry (1.5 months), and Addictions Psychiatry (1.5 months)), and two month of inpatient Child Psychiatry (12 years old and under).

During this year, Integrated residents get to know their adult resident colleagues well through shared clinical rotations, and by attending adult PGY2 weekly didactics. This year also continues the development of the resident’s research interests through individualized career guidance meetings and monthly seminars with all trainees from the Integrated program. Residents may also investigate the opportunity to pursue an additional degree during their residency training, and are encouraged to decide on any additional degrees by December of the PGY2 year. Residents receive long-term adult psychotherapy cases that begin during this year. Integrated residents take 67% of the adult psychiatry resident overnight call at the two inpatient hospitals.

The PGY3 year consists of an integrated 12 months of training in both research and outpatient psychiatry, mostly with adult patients, but also with the addition of a long-term psychodynamically-focused child case.

Residents have one day a week of protected mentored research time. Trainees select their own research mentor who will foster their growth as an academic child psychiatrist and help them start a successful research project. Residents are able to participate in the Child Study Center research seminar as they develop their own project in their chosen mentor's lab. In this year and others, residents may choose to take courses designed to enhance understanding of research methods or scientific tops. Residents attend adult PGY3 didactics and take adult psychiatry call overnight in the Psychiatric Emergency room..

As residents enter their PGY4 year, the focus of clinical training shifts to working primarily with children and trainees have substantial research time. Four months are spent on the Child Psychiatry inpatient unit (12 years old and younger), to solidify the skills learned in the PGY2 rotation. An additional month is spent on the child psychiatry C-L service. The remaining seven months are protected research time. The long-term adult and child psychotherapy cases (one each) are maintained throughout the year. Integrated residents take 50% of Child Psychiatry Fellowship overnight (home) call during the five months that they are on clinical service.

The PGY5 and PGY6 years allow residents to focus on their research interests while maintaining clinical training experiences in outpatient psychiatry. Both of these years focus on developing and completing the research program the resident has initiated throughout residency. Training in long- and short-term outpatient psychiatry will also continue in both child and adult psychiatry.

This training program is flexible by design, particularly in these last two years, and residents are largely able to pursue the balance of clinical and research training that suits their academic needs. For example, residents may choose to do additional clinical rotations (e.g. chief residents on clinical units). The resident will receive assistance in preparing for and applying for post-graduate research awards (i.e. NIH K awards, NIH research grants), as the training goal is to have residents prepared to smoothly transition into post-graduate academic careers.