In Year 1 of the fellowship, you will complete core rotations across treatment settings and levels of care resulting in a solid foundation necessary for the practice of child and adolescent psychiatry. Rotations are not dependent on fellows to ensure a focus on education rather than service needs. Core rotations in Year 1 include family-based acute inpatient treatment, Consultation-Liaison and Emergency Department, Partial Hospitalization, Residential Addiction Treatment, Pediatric Neurology, Developmental and Behavioral Pediatrics, District Court, County Community Services, and Pediatric Pain Rehabilitation. There is also one block of elective time in Year 1. 

Throughout Year 1, you will learn about the variety of community settings that serve youth and families by visiting local and regional facilities such as schools, including a school for the deaf and blind, and community sites including a juvenile correctional facility, a residential treatment program, and a youth shelter.

Beginning in Year 1 and expanding in Year 2, you will have dedicated time for outpatient clinic including weekly psychotherapy. Clinic is directly staffed by faculty, providing you with on-the-spot consultation and built-in teaching time. You will also meet weekly with faculty for both case management and psychotherapy supervision,

First-year rotations provide child and adolescent psychiatry fellows with a strong foundation in typical and disrupted development in children and adolescents across a variety of settings.

Child and Adolescent Acute Psychiatric Care Inpatient Unit (3 blocks): Fellows rotate on two different services on our Child and Adolescent Inpatient unit. Here, fellows serve as a leader of the multidisciplinary treatment team, providing family-based treatment for children of all ages across a broad spectrum of diagnoses. On the Blue team (1 block), child and adolescent psychiatry fellows supervise general psychiatry fellows and medical students. On the Green team (2 blocks), fellows collaborate with a nurse practitioner or physician assistant (NP/PA). In both roles, fellows round daily with faculty to learn about acute psychiatric management and effective leadership of an inpatient multidisciplinary team.

Consultation-Liaison and Emergency Psychiatry (3 blocks): Fellows gain experience in acute crisis management in the Emergency Department and in consultation to medical and surgical services. Care involves management of psychiatric and comorbidities of acute and chronic medical illness and liaising with inpatient pediatricians. During these blocks, fellows better understand the complementary roles of psychiatry and psychology, and of psychiatrists and NP/PAs, in clinical practice while learning to delegate duties and consider the management of finite resources.

Pediatric Pain Rehabilitation Center (1 block): Fellows participate in this nationally recognized multidisciplinary, family-based, three week program for adolescents with chronic pain or other symptoms that interfere with functioning. Learning fundamental principles of a rehabilitative approach to physical and psychological symptoms, fellows lead psychoeducational groups with patients or parents, and observe sessions with psychology, occupational therapy, physical therapy, nursing, and recreation therapy.

Olmsted County District Court and Olmsted County Social Services (1 block): Fellows observe family court at the Olmsted County District Court to understand the legal system as it relates to juvenile justice and family law issues. Fellows observe hearings related to child protection, divorce and custody issues, adoption, and truancy and juvenile delinquency, and have the opportunity to interact with judges, county attorneys, public defenders, and probation officers. During this rotation, fellows also join social workers from Olmsted County Social Services as they investigate child abuse reports, meet with youth and families in their homes and schools to provide case management services, and interact with other community systems of care.

Hazelden Betty Ford (1 block): Fellows learn evidence-based interventions for youth with addiction at this world-class treatment program, which is located in Plymouth, MN, in the Minneapolis suburbs. Here, fellows have the opportunity to practice assessment skills with close supervision, learn motivational interviewing techniques, and co-facilitate groups with youth and families. Hazelden provides free housing for fellows within a 10-minute drive of the center.

Pediatric Neurology (1 block): Fellows participate in Mayo Clinic’s outpatient Pediatric Neurology clinic and/or inpatient Pediatric Neurology service where they are involved in assessments of patients with a wide range of neurologic problems, including epilepsy, movement disorders, autoimmune disorders, headaches, and neurodevelopmental disorders.

Developmental and Behavioral Pediatrics (1 block): Fellows learn about autism and other neurodevelopment disorders in a comprehensive family-centered clinic where they work closely with developmental pediatrics, neuropsychology, speech and language pathology, occupational therapy, social work, and nursing.

PrairieCare (1 block): At PrairieCare, located in Rochester, fellows learn to provide assessment and treatment of children and adolescents in the setting of a partial hospitalization program (PHP) which includes group, individual, and family therapy. Fellows, with supervision, lead treatment team rounds, meet with patients for medication management, and join group sessions.

Elective (1 block): With support from the program, fellows design their own electives to meet their educational needs. Fellows will have 3 additional blocks of electives in Year 2. Past electives include research, Integrated Behavioral Health, Transgender and Intersex Specialty Care Clinic, additional time in subspecialty areas, ECT, TMS, and experiences outside of Mayo Clinic including the Mother-Baby Program at Hennepin County Medical Center, a first episode psychosis program at M Health Fairview, and international electives supported by the Mayo International Health Program scholarship. Fellows preparing for the adult psychiatry board certification exam may take a one month elective to prepare for board preparation.

Additional longitudinal experiences throughout Year 1 include:

Community Experiences: To learn about the variety of settings that serve youth and families, fellows visit local and regional facilities including public schools and daycare centers, residential academy for the Deaf and Blind, a psychiatric residential treatment center, and a juvenile prison facility for the Minnesota Department of Corrections.

Continuity Clinic: Beginning in Year 1, fellows have dedicated time for outpatient clinic, including weekly psychotherapy. Clinic is directly staffed by faculty providing fellows with on the spot consultation and built-in teaching time. Across both years of training, fellows receive weekly supervision for psychotherapy and for case management and pharmacology.

In Year 2, you will evaluate new patients in a consultative role while continuing your continuity outpatient practice. Each new evaluation is performed with supervision from faculty, who will spend time seeing the patient in collaboration with you, providing clinical education along the way.

In this year, you will also spend time in subspecialty clinics including young child, ADHD, and mood, in addition to anxiety clinic where you will join a multidisciplinary team for a week-long intensive program for treatment of anxiety disorders. Additional experiences during these blocks include teleconsultation to physicians in rural areas, collaborative care with primary care physicians, and joining the Child Abuse team.

In Year 2, you will also return to the family-based acute inpatient unit where you will build on your skills with a particular focus on education of trainees and leading the multidisciplinary treatment team. During Year 2, you will have three blocks of elective time to focus on your individual interests and professional development. Electives can be internal at Mayo Clinic as well as external such as in the community, nationally, or internationally.

During Year 2, fellows gain experience in treating more complex clinical conditions as well as with integration of assessment and interventions in comprehensive treatment of youth. Significant flexibility is provided as fellows continue to develop their professional identify and transition to practice.

Child and Adolescent Acute Psychiatric Care Inpatient Unit (1 block): Fellows return to the family-based inpatient psychiatric unit for one block on the Blue team where they take a leadership role in supervising general psychiatry fellows and medical students and working with the multidisciplinary treatment team.

Outpatient Clinics (9 blocks): In Year 2, fellows have increased dedicated time to expand their longitudinal outpatient clinic. Outpatient clinics continue to be directly staffed by faculty with opportunity for fellows to have growing independence in their practice. Across two blocks, fellows gain further experience in comprehensive outpatient assessments and continuity care. Fellows also spend two blocks in each team-based subspecialty clinic: Mood Disorders, ADHD, and Anxiety (including a 5-day intensive anxiety disorders program), as well as Integrated Behavioral Health, Child Abuse, and telepsychiatry to Mayo Clinic Health Systems sites. Fellows also spend one block in Young Child clinic where they have the opportunity to learn about assessment and treatment of young children and their families. Fellows who are especially interested in working with children ages 0-7 may pursue Parent-Child Interaction Therapy (PCIT) training with protected time via the Young Child track.

Elective (3 blocks):  In addition to one block of elective time in Year 1, fellows can complement their core rotations by customizing 3 additional blocks of elective time.