The start of the day for a child and adolescent psychiatry trainee at Yale can have a steady rhythm—until it doesn’t. A consultation with a patient admitted to Yale New Haven Children's Hospital (YNHCH) can become a family meeting. A routine follow-up visit can become a puzzle that involves a school, a social worker, and a state program. The work is rarely simple or predictable.
That’s not a flaw in the training. It reflects the reality of children’s behavioral healthcare. At Yale Child Study Center (YCSC), child psychiatry training is built around that reality. The training is developmental, team-based, and designed for many settings. Instead of forcing patients to fit into a rigid system, the approach is to meet children and families where they are and build care for them.
Recent YCSC training graduates Savion Smith, MD, and Alayna Freeman, MD, describe a typical week as “a mix of clinical work, teaching, and plenty of learning opportunities.” They say it is demanding but grounded in empathy and respect. “What makes this fellowship special isn’t just the training. It’s the community,” Freeman says. That sense of community—how it’s built and protected—sits at the center of the training.
Two flagship programs
YCSC has two central training programs in child and adolescent psychiatry. They serve different career goals but share the same overall values. These include strong clinical training, careful supervision, and an emphasis on development and systems. The programs reflect a forward-looking idea: child psychiatrists need to know how to treat symptoms, while also understanding development, families, and systems. They have to work to help close the gap between the high demand for care and the limited access many children face.
Child and Adolescent Psychiatry (CAP) Fellowship
The CAP Fellowship is a two-year program for physicians who have already completed a general psychiatry residency. The program is designed to build skill in:
- Clinical care and psychiatric consultation
- Teaching and supervision
- Research and academic work
- Administrative and leadership roles
Albert J. Solnit Integrated Program
The Albert J. Solnit Integrated Program is a longer path that combines residency and a specialty in child psychiatry. It’s built for physicians who want to become clinician-researchers. Trainees receive substantial research time, increasing over a six-year training period.
Learning through hospital consultation
A hospital-based consult-liaison (CL) service is a key part of the training. This service brings psychiatry into a more traditional medical setting. Fellows work with pediatric teams and patients who are hospitalized for medical reasons but also have mental health needs.
In his second year as a Solnit Fellow, Richard Zhang, MD, wrote about a “day in the life” of training in the CL service. He describes learning under two attendings as “a bonus to get to learn from two different teaching styles.” He also highlights something simple but meaningful: the team meets in the social work office. That detail reflects the reality of this work. Psychiatric care in a hospital depends on close collaboration with social workers, nurses, pediatricians, and other professionals.
When the “plan” involves more than medicine
A fellow’s day may also include working with a long-term patient struggling with substance use and serious barriers to placement. Placement can be difficult for many reasons: safety concerns, school needs, insurance limitations, family circumstances, or a lack of available programs. In these cases, medical knowledge alone is not enough. Fellows coordinate across systems and help build realistic plans with other professionals.
Breanna Keepers, MD, MBA, says her favorite part of the day is patient interaction. “I love being able to feel like we can take the time that we need to work with our patients and their families to determine the most appropriate in hospital and eventually out of hospital recommendations,” she explains.
That time matters—especially when resources are limited, and decisions have long-term consequences. Families often arrive overwhelmed and unsure what to do next. Fellows learn how to explain diagnoses clearly, talk about treatment options honestly, and help families plan for what happens after discharge.
Understanding young children on their terms
Even within a busy hospital setting, YCSC training keeps a strong focus on development. Fellows who provide evaluation services receive supervision that focuses specifically on young children. Keepers recalls evaluating a four-year-old for hyperactivity and impulsivity. For many trainees, working with preschool-age children is a major learning curve. Young children cannot always explain what they feel or why they act a certain way. Fellows learn to understand a child’s inner world through behavior and play.
Keepers describes this as challenging, and says supervision was essential. She also points to the way fellows support one another. Over lunch, co-fellows share suggestions and insights in a way she describes as “informative but communal.” Collaboration is not only part of patient care at YCSC—it is also a major part of how trainees learn.
Support with growing independence
Fellows describe a training culture that balances structure and independence. Zhang describes the Solnit track as steady and longitudinal. Learning builds over time with consistent supervision and responsibility. He explains that rotations alternate by weekdays. During his first year, he spent six months at a residential treatment facility and another six months on a high-acuity inpatient unit. Over time, he says, “my co-fellows and I gained increasing autonomy while benefiting from rich supervision and weekly didactics.”
This balance is important. Too much independence too early can be unsafe and stressful. Too little independence can leave graduates unprepared. The goal is to help trainees become confident clinicians who can make decisions, communicate clearly, and lead teams—while still having access to strong supervision and guidance.
Protected teaching time that truly matters
Didactics—or teaching through lectures—is a core part of the training. This is a protected, scheduled time devoted to teaching and learning. Fellows across tracks describe these days as meaningful, not something rushed or symbolic. The curriculum includes many therapy approaches and clinical modalities. Fellows also receive training in:
- Intervention and crisis support
- Consultation with medical teams and community partners
- Advocacy and systems work
- Teaching and supervision skills
- Presenting and writing skills
A strong curriculum is not simply a list of topics, though. Fellows say that what makes the training coherent is the leadership, and the way the program’s values show up in daily practice.
Making the world better for children and families
That leadership includes Dorothy Stubbe, MD, who recently received a Yale Medicine Distinguished Clinical Career Award. Stubbe has served as program director for the CAP fellowship for 30 years and has led the Solnit integrated program since its inception in 2004.
Long leadership can sometimes lead to a program that gets stuck. Jose Paez, MD—associate program director for the New Haven track and a graduate of the program—describes it differently. “I’ve seen how this program evolves and changes with the times, and to meet the needs and demands of the community it serves,” he says.
Stubbe stresses that she continues to enjoy the work. “I love the fellows, and all of the creativity they bring,” she says, continuing, “And the faculty are also brilliant. I learn every day.” YCSC Chair Linda Mayes, MD, adds, “Our child psychiatry fellows teach us, too. They bring their ways of seeing the world, their questions, and their ideas that keep all of us learning together.”
Stubbe describes the overall philosophy of the training programs as focused on making the world better for children and families. She says that mission is intentionally broad, because trainees bring different strengths and interests. The goal of the program, she explains, is to help fellows leave ready to carry that mission forward in their own way.
Building a career, not just completing training
When applicants ask current fellows why they chose YCSC, the answer is not only that Yale offers wide clinical exposure and a strong academic environment, though both are important. Fellows also point to the way the program is designed to help trainees build a career. That support is built into the structure of the program, including:
- Clear didactic programming
- Structured supervision
- Team-building retreats
- A leadership team that plans and protects support systems
Paez notes that many programs can meet accreditation standards and provide basic training. He believes YCSC goes further. “What I think sets us apart,” Paez says, “is that we not only give you the scaffolding—the foundations—but we give you the bricks. We give you the mentors, the access. We give you the information, so that you can build the career that you see yourself having.”
What fellows take with them
Fellows’ experiences suggest that YCSC trains child psychiatrists to take development seriously every day, not just in theory. That includes:
- Sitting with families long enough to build realistic, thoughtful recommendations
- Learning how to understand young children through play and behavior
- Working closely with schools, social workers, and community programs
- Gaining independence while still receiving close, supportive supervision
Trainees are treated not just as learners, but as future leaders who will move the field forward through clinical care, research, advocacy, systems improvement, or a combination of all three. “Training the next generation of mental health professionals is at the heart of our mission,” says Mayes. She notes that the phrase "from generation to generation" has always been central to the center’s work.
Application timeline and match information
Each program has specific application processes and match timelines.
- CAP Fellowship: Applications are accepted online from July through August, with matching in January.
- Solnit Integrated Residency Program: Applications are accepted starting September 15, with matching in March. Applicants to the Solnit program must also apply to the general Yale Residency Training Program in Psychiatry.
Both programs use a match process that relies on a computerized mathematical algorithm. The algorithm is designed to place applicants into their most preferred positions among programs that also prefer them.