Child and Adolescent Psychiatry Fellowship Program

The MedStar Health—Georgetown University Hospital Fellowship Program in Child and Adolescent Psychiatry

We are very pleased that you are interested in learning more about our training program. We are a relatively young program, founded in 2010 and also connected to the collective knowledge and experience of a Child and Adolescent Psychiatry division that has been thriving for over 50 years. In our training program, we have taken the opportunity to start fresh and have implemented innovative, evidence-based teaching and skills-building methods.

We also emphasize having fun while learning and building meaningful relationships with each other along the way. These relationships create a sense of safety and security that helps our trainees take chances, reflect honestly on their strengths and vulnerabilities, challenge each other and their supervisors, and explore the many exciting opportunities available within our division and within the Washington, D.C., metro area as a whole. We strongly believe that diversity, inclusion, equity, justice and authenticity are essential elements of a thriving learning environment, and we consider them among our core values. Our faculty also place a strong emphasis on positive psychiatry, a strengths-based approach to assessment and treatment that centers on promoting well-being, and we practice what we preach clinically by working actively to improve the well-being of our faculty, trainees, and staff.

Follow us on Instagram: @medstargeorgetown_cap

Why train here

Program Mission:

Our program aims to train critically conscious, family-centered, structurally competent, community-oriented, and culturally humble child and adolescent psychiatrist leaders, clinicians, and healers, equipped with the knowledge, skills, behaviors, and attitudes to prevent and alleviate youth mental health problems, promote positive youth mental health, and build health equity by bringing state-of-the-art, research-based psychiatric care to the diverse communities of the Washington DC Metro Area.

In our training program, we have implemented innovative, evidence-based teaching and skills-building methods. We strive to create a learning experience that embodies the mission of our entire Child and Adolescent Psychiatry division. Our program mission is to:

Prevent and alleviate youth mental health problems
Promote positive youth mental health
Build health equity

We do this by providing state-of-the-art, research-based psychiatric care that is holistic, family-centered, community-based, and culturally attuned to the diverse communities of the D.C. metro area.

As a clinical Division, we focus on improving access to care for families in the D.C. metro area through working in schools and primary care clinics in underserved areas as well as by accepting the broadest range of public and private insurance of any academic clinic in the area. We are also specifically interested in allying with, learning from, and providing support to the historically marginalized African-American/black and Latinx communities living in Washington, D.C.,

To learn more about the training program, read this letter from the Division Chief

Seminar curriculum

First-Year Curriculum:

The overall seminar experience for the first year is focused on:

Adhering to adult learning theory principles
Being interactive and experiential
Staying as clinically relevant as possible
Providing opportunities to practice teaching PGY3 psychiatry residents, PGY3 pediatric residents, and medical students

Clinical Foundations Seminar
(3 hours/week for 2 months): The first year starts out with an 8-week Clinical Foundations Seminar providing introductory education on working with children, adolescents, families, and the systems with which they interact. Another major goal of this seminar series is to help fellows form lasting, meaningful relationships with both core faculty and their co-fellows.

Previous topics covered have included:

Evaluation and formulation of youth and their families (every year)

Introduction to human development (every year)

Core outpatient skills (topics change yearly depend on faculty/fellows) e.g.

Working across cultural differences

Core psychopharmacology knowledge and skills

Suicide and other risk assessment

School-based mental health

CAP systems of care

Inpatient and outpatient consultation/liaison

Working up the acute case

Legal/forensic issues in child psychiatry

Working with parents and talking about parenting

Mindfulness-based self-care for trainees
Psychopathology, Clinical Neuroscience, and Therapeutics Seminar
(2 hours/week for 10 months): Fellows learn about the epidemiology, etiology, psychopathology, clinical neuroscience, assessment, treatment, and prevention of a disorder or set of disorders in this core module series. Fellows frequently prepare presentations and teach each other along with residents and medical students. These seminars are interactive, discussion-based, and case-based, with faculty working to make the material as clinically relevant as possible. Most modules have both CAP 1 and CAP 2 fellows. CAP 1 fellows attend the following modules:

ADHD & Learning Disorders

Mood Disorders

Disruptive Behavior Disorders

Anxiety Disorders

OCD & Tic Disorders

Trauma-related Disorders

Autism Spectrum Disorder

Eating Disorders
Psychodynamic Psychotherapy Seminar

(1 hour/week for 7 months): This combined first and second year course guides fellows through the psychodynamic approach to assessment, formulation, and treatment of children, adolescents, and their families. Theoretical concepts are discussed and supported with supplementary texts. Psychodynamic therapeutic technique is discussed in detail via psychodynamic case presentations by both fellows and faculty.
Positive Psychiatry Seminar

(2 hours/month for 5 months): This seminar grew out of an innovative, cross-institutional collaboration between faculty at Georgetown, the University of Vermont, New York University, and McLean Hospital. Expert faculty from each institution provide presentations via podcast episodes and discussion outlines about various topics within the field of positive psychiatry, and Georgetown faculty lead discussions with fellows. Example seminar topics include the science of happiness and positive emotions, the neurobiology of wellness, music and the mind, mindfulness and meditation, and nutrition, exercise, and sleep.
Evidence-Based Medicine Seminar

(2 hours/month for 10 months): Residents meet with Dr. Matthew Biel, the CAP Division Chief, to discuss both seminal articles in the field as well as contemporary articles that inform practice. Residents learn structured methods to analyze the evidence-base available to the field and discuss the challenges and opportunities in child and adolescent psychiatry research.
Circle of Security Parenting Seminar

(1hr/week for 8 weeks): Residents meet with Dr. Emily Aron, Medical Director the the MedStar Georgetown Infant and Early Childhood Clinic, for an 8-week training in the international attachment-based parenting approach, Circle of Security. Dr. Aron is also trained in Parent-Child Interaction Therapy and Child-Parent Psychotherapy. The Circle of Security program uses a combination of video clips, discussion and hands-on activities. Via COS, residents will be able to help the parents they work with recognize that their child’s behavior is actually communication, ‘be with’ their child through strong and difficult emotions, and repair the relationship when a rupture has occurred. Through the Circle of Security parenting program, parents and caregivers will also learn that in order for a child to learn effectively, they must feel safe and secure and have developed a strong attachment. With this secure attachment comes the confidence and curiosity to become more independent and go out and explore the world because the child knows that whenever they need to – they can return to that safe, secure base for comfort, reassurance and support.
Dialectical-Behavioral Therapy (DBT) Seminar

(1hr/week for 4 weeks): Residents meet with Shana Simkin, LMFT for four consecutive weeks to learn the basics of utilizing DBT principles and techniques in psychotherapy with youth. Fellows also typically have the opportunity to co-lead a DBT group during their second year.

Second-Year Curriculum

For the second year, the overall seminar experience is focused on:

Adhering to adult learning theory principles
Being interactive and experiential
Staying as clinically relevant as possible
Providing opportunities to practice teaching CAP 1s, PGY3 residents, and medical students

Clinical Foundations Seminar:
(3 hours/week for 2 Months): The second year starts out with an 8-week Clinical Foundations Seminar focused on preparing the CAP 2 fellow for increased outpatient and leadership responsibilities via interactive, case-based seminars led by core faculty.

Previous topics covered have included:

Evaluation and formulation of youth and their families (every year)

Psychopharmacology 2.0 (every year)

Core community mental health skills (topics change yearly depend on faculty/fellows)
Psychopathology, Clinical Neuroscience, and Therapeutics Seminar
(2 hours/week for 10 months): Fellows learn about the epidemiology, etiology, psychopathology, clinical neuroscience, assessment, treatment, and prevention of a disorder or set of disorders in this core module series. Fellows frequently prepare presentations and teach each other along with residents and medical students. These seminars are interactive, discussion-based, and case-based, with faculty working to make the material as clinically relevant as possible. Most modules have both CAP 1 and CAP 2 fellows. CAP 2 fellows attend the following modules:

ADHD & Learning Disorders

Mood Disorders

Disruptive Behavior Disorders

Anxiety Disorders

OCD & Tic Disorders

Trauma-related Disorders

Substance Use Disorders

Psychotic Disorders
Human Development: Theory and Practice

(2 hours/month for 5 months): This seminar reviews principles and theories of human development and grounds them in day-to-day clinical practice. Models describing development from a variety of theoretical perspectives are considered. Neurobiology, genetics, and gene-environment interaction effects are explored in terms of their relevance to typical development and developmental psychopathology.
Psychodynamic Psychotherapy Seminar

(1 hour/week for 7 months): This combined first and second year course guides fellows through the psychodynamic approach to assessment, formulation, and treatment of children, adolescents, and their families. Theoretical concepts are discussed and supported with supplementary texts. Psychodynamic therapeutic technique is discussed in detail via psychodynamic case presentations by both fellows and faculty.
Evidence-Based Medicine Seminar

(2 hours/month for 10 months): Residents meet with Dr. Matthew Biel, the CAP Division Chief, to discuss both seminal articles in the field as well as contemporary articles that inform practice. Residents learn structured methods to analyze the evidence-base available to the field and discuss the challenges and opportunities in child and adolescent psychiatry research.
Cognitive-Behavioral Therapy Group Supervision

(1 hour/week for 12 months): Fellows meet weekly with an expert faculty member in order to develop their skills in a variety of cognitive-behavioral therapy modalities. Fellow learning is enriched by a variety of approaches including case presentations and videotaped and live clinical interviews.
Family Therapy Seminar/Supervision

(1 hour/week for 12 months): This seminar reviews basic systemic principles, techniques of family therapy, and working with families in general as a CAP. It includes a book club, case presentations, videotaped and live clinical interviews, and direct supervision during family therapy sessions.
Leadership/Career Development Seminar

(2 hour/month for 12 months): Residents meet with the Program Director as well as volunteer faculty from the community to discuss career goals, build their CV’s, develop and practice their interviewing skills, and discuss the various career options available to child and adolescent psychiatrists. The lineup of volunteer faculty is put together via collaboration between the Chief Fellow for Culture and the Program Director. Residents also meet regularly with the Program Director and Program Coordinator to work on fellowship improvement projects, provide feedback to program leadership, and to develop leadership and management skills.

CAP 1 YEAR ROTATION SCHEDULE
Rotation	4 Months Adolescent Inpatient	4 Months Adolescent Outpatient – IOP/PHP	3 Months Consultation-Liaison - Inpatient and Outpatient	1 Month
Site	MedStar Montgomery Medical Center	MedStar Montgomery Medical Center	MGUH/MWHC/DC Public Schools	Project/ Elective Time
% Time/Week	80%	80%	80%	80%
Weekly Outpatient Clinic Medstar Georgetown Hospital 10% Weekly Seminars MGUH 10%

CAP 2 YEAR ROTATION SCHEDULE
Fellows 1 & 2	Mon	Tues	Wed	Thurs	Fri
AM	Mary’s Center Community Mental Health	Weekly Seminars	Project/ Elective Time	Mary’s Center Community Mental Health	WISE School Based Mental Health
PM	Mary’s Center Community Mental Health	Medstar Georgetown Hospital Outpatient Clinic	Medstar Georgetown Hospital Outpatient Clinic	Mary’s Center Community MH	WISE School Based Mental Health

Fellow 3	Mon	Tues	Wed	Thurs	Fri
AM	MedStar Fort Lincoln Community Mental Health	Weekly Seminars	Project/ Elective Time	MedStar Fort Lincoln Community Mental Health	WISE School Based Mental Health
PM	MedStar Fort Lincoln Community Mental Health	Medstar Georgetown Hospital Outpatient Clinic	House of Ruth Early Childhood Mental Health Clinic	MedStar Fort Lincoln Community Mental Health	WISE School Based Mental Health

Full Clinical Rotation Descriptions

Our people

Faculty from the Child and Adolescent Psychiatry Fellowship at MedStar Health pose for a photo outdoors.

Meet Our Faculty

Faculty and fellows from the Child and Adolescent Psychiatry Fellowship at MedStar Health pose for a photo outdoors.

Meet Our Fellows

Fellowship Program Mission Statement

We strive to create a learning experience that embodies the mission of our entire Child and Adolescent Psychiatry Division: to prevent and alleviate youth mental health problems, promote positive youth mental health, and build health equity by bringing state-of-the-art, research-based psychiatric care that is holistic, family-centered, community-based, and culturally attuned to the diverse communities of the Washington DC Metro Area. As a clinical Division, we focus on improving access to care for families in the DC Metro Area through working in schools and primary care clinics in underserved areas as well as by accepting the broadest range of public and private insurance of any academic clinic in the area. We are also specifically interested in allying with, learning from, and providing support to the historically marginalized African-American/black and Latinx communities living in Washington, DC.
Core Values
Diversity and intersectionality

Diversity - Cognitive: The differences in how we interpret, reason and solve and how these different styles can offer unique perspectives to a group. Cognitive diversity is inextricably linked to identity (compositional) diversity.

Diversity - Compositional: The numerical and proportional representation of various racial and ethnic groups.

Intersectionality: The interconnected nature of social categorizations such as race, class, and gender as they apply to a given individual or group, regarded as creating overlapping and interdependent systems of discrimination or disadvantage.

Inclusion and authenticity

Inclusion: The act of actively involving every employee's ideas, knowledge, perspectives, approaches, and styles to maximize success and creates the sense for the employee that they are part of the fundamental fabric of the organization.

Authenticity: A quality of being genuine and feeling safe to allow each of your identities to manifest without the fear of being judged.

Equity

Equity in health is the absence of systematic disparities in health (or in the major social determinants of health) between groups with different levels of underlying social advantage/disadvantage—that is, wealth, power, or prestige (Braveman 2003). We apply this same principle to our clinical and educational teams, striving to eliminate systematic disparities in opportunities for growth, mentorship, advancement, and promotion among our faculty, staff, and trainees.

Positive psychiatry & Personal Wellbeing

We have a strengths-based approach to assessment and treatment that centers on promoting well-being, and we practice what we preach by working actively to improve the well-being of our faculty, trainees, and staff.

Growth mindset

Humor and fun

Intellectual curiosity as well as humanistic curiosity

Service and sense of community responsibility

Humility and Service: Joining with, learning from, and sharing with families

Accountability to colleagues and community
Fellowship Culture
We deliberately address issues of culture, ethnicity, race, and difference during our fellow orientation each year and explicitly state our intention to create an inclusive learning environment.

Our department formed an Equity, Diversity, and Inclusion Committee, currently chaired by Dr. Kristine Goins, who will be the Associate Program Director of the fellowship starting July 1st, 2020. The committee is charged with formulating our program and departmental diversity statement, sharing recommended strategies and best practices for everyone who is involved in the recruiting process, and developing and implementing policies and processes to promote equity, diversity, and inclusion in the department.

Several CAP Division faculty members are on the committee, including Dr. Kristine Goins, Dr. Erica Coates, Dr. Colin Stewart, and Dr. Matthew Biel.

Curriculum

Fellowship leadership is actively working on developing a comprehensive two-year curriculum in Sociopolitical Determinants of Mental Health, Structural Competency, and Social Justice. Elements of this curriculum already exist but the expansion of this curriculum is one of the explicit goals of the fellowship leadership team for AY 2020-2021.

Within this broader curriculum’s umbrella will be a new curriculum on How to be an Anti-Racist Child and Adolescent Psychiatrist that will include seminar, experiential, project-based, and advocacy components.

Resources

As a clinical and research faculty, we have expertise and experience in community mental health, community-based research, and clinical and organizational approaches to promoting equity, diversity, and inclusion.
Equity, Diversity and Inclusion at Georgetown School of Medicine
The Office of Diversity and Inclusion at the GUSOM is committed to cultivating, promoting and advancing the diversity and inclusion of students, faculty, and staff.

https://som.georgetown.edu/diversityandinclusion/
Equity, Diversity and Inclusion in Recruitment
Overall, we use a Holistic Review Framework drawn from the AAMC's Roadmap to Diversity document, as we feel that is the gold standard for increasing diversity in our program and creating a sense of inclusion and equity in our recruitment process. It is also essential in maintaining an inclusive culture for trainees once they join our program and ensuring they have equitable opportunities for advancement and leadership opportunities.

We deliberately put together our Recruitment Committee to be representative of the diversity of our training program.

As a committee, we integrate knowledge and skills from training in implicit bias reduction when reviewing letters of recommendation.

We utilize ranking criteria that account for life experience that might make an applicant better prepared to work with the under-served, marginalized communities we serve.

We have virtually eliminated the impact of exam scores in our assessment process given that exams are typically biased towards students who attended better funded schools.

We deliberately develop our criteria for ranking both applications and applicants during and after their interview days BEFORE we review applications and maintain those criteria throughout the recruitment process.

The criteria are specifically chosen to help us determine which applicants will best help us achieve our mission and uphold our values.

Behavioral Interviewing: For the past six years, we have utilized behavioral interviewing to create equity across applicant interviews and to decrease the influence of implicit bias on the questions that individual applicants are asked.

As a committee, we reflect on our process each year and seek to improve it based on the outcome of our recruitment process and the changing demographic makeup of our patient population.

What’s happening in the DMV

Living and working the DMV area:

The “DMV” area which refers to DC, Maryland, and Virginia, is an excellent place to both live and work, as our faculty and fellows will attest. Living either within the nation’s capitol or very close to it offers so many unique and diverse experiences.

Washington D.C Neighborhoods:
DC is a large city made up of multiple neighborhoods, each with its own culture and attractions. Take a look at this website to learn more about each neighborhood:
https://washington.org/dc-neighborhoods
Getting around D.C.:

Many faculty and fellows utilize public transportation, including the “metro” and bus system. Washington D.C. has one of the cleanest public transportation systems in the country. DC is a very pedestrian friendly city, and the wide streets allow for good walkability without congestion as compared to other cities. It is also being more bike-friendly as well with the addition of designated bike lanes. Additionally, there are numerous bike share and scooter rental options to help you get around DC.

Metro system: https://wmata.com/

For those not close to a metro line, driving is certainly an option, though commute times can vary significantly depending on traffic. Ride share services are very easily accessible, as are taxis.

There are also two major airports, Dulles International Airport and Reagan National airport, which allow for easy and convenient travel nationally and internationally.
Diversity in the DMV:

A highlight of living in the DMV area is the cultural and ethnic diversity of the population. In addition, the DMV area has a robust and thriving job market in a variety of fields and attracts people from a broad range of backgrounds and experiences.
Areas of Interest:
Advocacy and Community Engagement: As our nation’s capital, Washington D.C. certainly offers numerous opportunities for those who are interested in advocacy. Below are a list of some of the national organizations with headquarters in DC, including AACAP which is down the street from the Georgetown psychiatry clinic!
AACAP: https://www.aacap.org/AACAP/About_AACAP/Contact.aspx
APA: https://www.psychiatry.org/about-apa/apa-headquarters
AAMC: https://www.aamc.org/about/contact/

If you are interested in local volunteer/service opportunities, the DC area is home to numerous non profit organizations that are always looking for passionate volunteers.
https://www.american.edu/ocl/volunteer/nonprofit-directories.cfm

Cultural Experiences/Places to Visit: Though the monuments and museums are traditionally considered “tourist attractions,” there is a plethora of free museums with rotating exhibits so there is always something new to see, or more to learn. In addition to the historic monuments and free museums, there are numerous other locations worth visiting, as referenced on this website:
https://travel.usnews.com/Washington_DC/Things_To_Do/

Some highlights include:

The Smithsonian museums

The US Capitol Building and Library of Congress

Monuments: Lincoln, WWII, Martin Luther King Jr, Vietnam and Korean War Veterans

The Botanic Gardens

Smithsonian’s National Zoo

Washington National Cathedral

Arlington National Cemetery

A unique experience is Passport DC, which occurs annually as a celebration of the cultural diversity in Washington D.C. and includes a tour of various embassies. The link below offers information for Passport DC 2020:
https://www.culturaltourismdc.org/portal/passport-dc1

History buffs will have plenty to explore in the DMV area, such as Mount Vernon, Lincoln’s Cottage, and Fort McHenry.

Music, Art and Theater: From small, intimate venues to large performing arts centers, you will always be able to find a concert or performance to attend in Washington D.C.

The John F. Kennedy Center for the Performing Arts offers free performances on a regular basis. Wolf Trap is a popular music venue in Vienna, Virginia, and offers a wide range of performances. http://www.kennedy-center.org/
https://www.wolftrap.org/
https://washington.org/visit-dc/live-music-venues-washington-dc
https://washington.org/theater-performing-arts-washington-dc
https://culturecapital.com/feature/98/galleries-in-metro-dc

Eclectic Food Scene: Many faculty and fellows are self proclaimed “foodies” and will enthusiastically agree that the DMV area is home to an extremely diverse food scene. From food trucks to Michelin star restaurants, the DMV has what you’re craving.

https://dc.eater.com/

In addition to the thriving food scene, D.C. is home to multiple breweries. Virginia Wine country is also a short drive away.

Sports: Whether you’re a die-hard sports fan or the occasional spectator, it’s always fun to catch a Nationals game or root for the Caps. There are multiple major sports team in the area including the Washington Redskins, Washington Capitals, Washington Nationals, D.C. United, Washington Mystics and Washington Wizards. There are also multiple universities in the area if you prefer college sports.

Outdoor Activities: Mountains and beaches are both easily accessible from the DMV area. There is hundreds of miles of walking/hiking trails within and nearby the DC area, and beautiful parks to explore including Rock Creek Park and Great Falls Park. Shenandoah National Park is a 75 mile drive from the DC area.
https://washington.org/visit-dc/free-things-to-do-outdoor-activities
https://www.nps.gov/locations/dc/index.htm

Wellbeing in the Georgetown CAP training program

Wellness and well-being are priorities within the MedStar Georgetown Child and Adolescent Psychiatry (CAP) fellowship for patients and their families as well as fellows and faculty. There have been numerous efforts within the CAP fellowship and child psychiatry division to promote well-being. Beginning the 2019-2020 fellowship year, there is a newly developed “culture” chief resident role in order to help develop and maintain wellness and social activities for fellows.

Wellness efforts include:

Two retreat days, usually one day in the fall and one day in the spring, funded by the fellowship for team building activities and providing program specific feedback
CAP get-togethers with faculty, staff and fellows within the CAP division
Free access to the gym at the 2115 Wisconsin Ave building
Financial support to attend national conferences such as AACAP
Catered lunch for fellows with Grand Rounds speakers

MedStar Health has many additional well-being efforts to provide support to residents/fellows:

The Physician Concierge Service connects MedStar Health physicians with a personalized assistant service to provide a wide range of services for emotional, social, physical, or financial challenges
MedStar Health Care@work program provides Care.com assistance for emergency childcare or adult care
Care for Caregiver program provides support for caregivers
Access to confidential self-assessment tools with resources for additional support
Complimentary access to BoardVitals for board preparation via Dahlgren Memorial Library/Georgetown University
Biostatistics assistance for research through MedStar Health

The Georgetown University School of Medicine has also recently developed a committee on Medical Student Well-Being. Committee members include several Department of Psychiatry faculty including Emily Aron, MD, Mayada Akil, MD, and Stacey Kaltman, PhD. Click here to learn more.

Application information

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