New Application: Child and Adolescent Psychiatry
Review Committee for Psychiatry
ACGME
515 North State Street, Suite 2000 Chicago, Illinois 60654  312.755.5000  www.acgme.org
SPONSORING INSTITUTION
1. Will the sponsoring institution provide the program director with at least 50 percent salary support
and protected time of 50 percent FTE (at least 20 hours per week) for program administration,
education, and supervision? [PR I.A.2.] ....................................................................... ☐ YES ☐ NO
2. Will programs with an approved fellow complement of 20 or more require 30 hours per week effort
and/or the appointment of an associate program director? [PR I.A.3.] .......................... ☐ YES ☐ NO
3. Is a designated program coordinator available to support the program? [PR I.A.4.] ..... ☐ YES ☐ NO
PROGRAM PERSONNEL AND RESOURCES
Program Director
Briefly describe how the program director will monitor fellow stress, including mental or emotional
conditions inhibiting performance or learning, and drug- or alcohol-related dysfunction. [PR II.A.4.p)]
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Resources
Will the program provide fellows access to:
1. office space? [PR II.D.1.] ............................................................................................. ☐ YES ☐ NO
2. space for physical and neurological examinations? [PR II.D.2.] ................................... ☐ YES ☐ NO
3. access to laboratory testing? [PR II.D.2.] ..................................................................... ☐ YES ☐ NO
4. equipment with the capacity for recording and viewing clinical encounters? [PR II.D.3.]☐ YES ☐ NO
5. space and equipment specifically designated for seminars, lectures, and other educational
activities? [PR II.D.5.] ................................................................................................... ☐ YES ☐ NO
FELLOW APPOINTMENTS
Will the program accept only applicants who, prior to appointment, demonstrate sufficient command of
English to permit accurate and unimpeded communication? [PR III.A.2.] .......................... ☐ YES ☐ NO
If NO, explain how non-English fluency is addressed.
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EDUCATIONAL PROGRAM
Scheduled Didactic Seminars
Child and Adolescent Psychiatry
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 5/2015
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For each year of the program, list all scheduled seminars and didactic courses which will be attended
by fellows using the format below. If attended by all fellows, list in both years, but provide a full
description only the first time the course is listed. Number seminars consecutively so that they may be
more easily referenced in later narratives. Do not include teaching experiences — ward rounds,
treatment conferences, etc. — that are primarily service-related activities attended by fellows only when
assigned to a particular service. Such activities should be described in the Clinical Services table
below. Do not include these examples in the final submission of the document. [PR IV.A.3.]
Format:
Year
No.: Title
a)
b)
c)
d)
e)
Required or elective; level of education
Principal instructor(s) with professional degree
Brief description
Additional attendees
Length of session, frequency, and total number of sessions
Example:
Year I
01. Seminar in Child and Adolescent Development
a) Required for first-year fellows
b) R. Jones, MD and W. Green, PhD
c) This is a reading seminar in which fellows review classical and current literature on
development from conception to early adulthood. The topics discussed include genetics,
physical growth and development, the development of the CNS, personality and social
development, sex differences, and cognitive development.
d) Psychology interns and social work students
e) 1.5 hours weekly for 36 weeks
Year II
02. Continuous Case Seminar
a) Required for second-year students
b) T. Smith, MD
c) Dr. Smith leads a discussion of a fellow’s treatment of one child or adolescent outpatient. The
focus is principally on dynamic psychotherapy, but other issues such as medication therapy,
working with parents or behavioral management arise from time to time.
d) Attended by only second-year child psychiatry fellows.
e) 1.5 hours every other week throughout the year. (25 sessions)
03. Child Psychiatry Research Seminar
a) Required for second-year fellows, elective for others
b) R. Jones, MD (others present in rotation)
c) Dr. Jones coordinates this informal conference during which various members of the staff
discuss their own research. Visiting professors are scheduled at least twice a year. Fellows may
present their work.
d) This conference is open to all staff and fellows.
e) 1.5 hours monthly throughout the year.
Child and Adolescent Psychiatry
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 5/2015
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Seminar and Course Listing:
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Patient Care
Indicate the settings and activities in which fellows will demonstrate competence in the evaluation and
management of the following areas of patient care. Also indicate the method(s) that will be used to
assess competence.
Competency Area
Evaluation and treatment of
patients representing the full
spectrum of psychiatric illnesses
in children and adolescents,
including developmental and
substance use disorders
[PR IV.A.5.a).(1).(a)]
Treatment of children and
adolescents for the development
of conceptual understanding and
beginning clinical skills in major
treatment modalities, including
brief and long-term individual
therapy, family therapy, group
therapy, crisis intervention,
supportive therapy,
psychodynamic psychotherapy,
cognitive-behavioral therapy, and
pharmacotherapy
[PR IV.A.5.a).(1).(b)]
Evaluation and treatment of
patients from diverse cultural
backgrounds and varied
socioeconomic levels
[PR IV.A.5.a).(1).(c)]
Performance and documentation
of an adequate individual and
family history, mental status,
physical and neurological
examinations when appropriate,
supplementary medical and
psychological data, and
integration of these data into a
formulation, differential diagnosis,
and a comprehensive treatment
plan
[PR IV.A.5.a).(1).(d)]
Settings/Activities
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Assessment Method(s)
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Medical Knowledge
Indicate the activities (lectures, conferences, journal clubs, clinical teaching rounds, etc.) in which
Child and Adolescent Psychiatry
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 5/2015
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fellows will demonstrate knowledge in each of the following areas. Also indicate the method(s) that will
be used to assess knowledge.
Area of Knowledge
Basic neurobiological,
psychological, and clinical
sciences relevant to psychiatry
and the application of
developmental, psychological,
and sociocultural theories
relevant to the understanding of
psychopathology
[PR IV.A.5.b).(1)]
The full range of
psychopathology in children and
adolescents, including the
etiology, epidemiology,
diagnosis, treatment, and
prevention of the major
psychiatric conditions that affect
children and adolescents
[PR IV.A.5.b).(2)]
Recognition and management of
domestic and community
violence, including physical and
sexual abuse, as well as neglect,
as it affects children and
adolescents
[PR IV.A.5.b).(3)]
Diversity and cultural issues
pertinent to children,
adolescents, and their families
[PR IV.A.5.b).(4)]
The appropriate uses and
limitations of psychological tests
[PR IV.A.5.b).(5)]
Settings/Activities
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Assessment Method(s)
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Practice-based Learning and Improvement
1. Briefly describe one learning activity in which fellows demonstrate the ability to investigate and
evaluate their care of patients, to appraise and assimilate scientific evidence, and to continuously
improve patient care based on constant self-evaluation and life-long learning. [PR IV.A.5.c)] (Limit
response to 400 words)
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2. Briefly describe one planned learning activity in which fellows engage to identify strengths,
deficiencies, and limits in their knowledge and expertise (self-reflection and self-assessment); set
learning and improvement goals; and identify and perform appropriate learning activities to achieve
self-identified goals (life-long learning). [PR IV.A.5.c).(1)-(3)] (Limit response to 400 words)
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Child and Adolescent Psychiatry
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 5/2015
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3. Briefly describe one planned quality improvement activity or project that will allow fellows to
demonstrate the ability to analyze, improve, and change practice or patient care. Describe planning,
implementation, evaluation, and provisions of faculty member support and supervision that will
guide this process. [PR IV.A.5.c).(4)] (Limit response to 400 words)
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4. Briefly describe how fellows will receive and incorporate formative evaluation feedback into daily
practice. (If a specific tool is used to evaluate these skills, have it available for review by the site
visitor.) [PR IV.A.5.c).(5)] (Limit response to 400 words)
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5. Briefly describe one example of a learning activity in which fellows engage to develop the skills
needed to use information technology to locate, appraise, and assimilate evidence from scientific
studies and apply it to their patients' health problems. [PR IV.A.5.c).(6)-(7)] (Limit response to 400
words)
The description should include:
 Locating information
 Using information technology
 Appraising information
 Assimilating evidence information (from scientific studies)
 Applying information to patient care
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6. Briefly describe how fellows will develop teaching skills necessary to educate patients, families,
students, fellows, and other health professionals. [PR IV.A.5.c).(8)] (Limit response to 400 words)
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Interpersonal and Communication Skills
1. Briefly describe one learning activity in which fellows demonstrate interpersonal and communication
skills that result in the effective exchange of information and collaboration with patients, their
families, and health professionals. [PR IV.A.5.d)] (Limit response to 400 words)
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2. Briefly describe one learning activity in which fellows develop competence in communicating
effectively with patients and families across a broad range of socioeconomic and cultural
backgrounds, and with physicians, other health professionals, and health-related agencies. [PR
IV.A.5.d).(1)-(2)] (Limit response to 400 words)
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3. Briefly describe one learning activity in which fellows develop their skills and habits to work
effectively as a member or leader of a health care team or other professional group. In the example,
identify the members of the team, responsibilities of the team members, and how team members
communicate to accomplish responsibilities. [PR IV.A.5.d).(3)] (Limit response to 400 words)
Child and Adolescent Psychiatry
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 5/2015
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4. Briefly describe how fellows will be provided with opportunities to act in a consultative role to other
physicians and health professionals. [PR IV.A.5.d).(4)] (Limit response to 400 words)
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5. Briefly describe how fellows will be provided with opportunities to maintain comprehensive, timely,
and legible medical records, if applicable. [PR IV.A.5.d).(5)] (Limit response to 400 words)
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6. Briefly describe how fellows will collaborate with other professional mental health personnel,
pediatricians, teachers, and other school personnel in the evaluation and treatment of patients. [PR
IV.A.5.d).(6)] (Limit response to 400 words)
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Professionalism
1. Briefly describe the learning activity(ies), other than lecture, by which fellows demonstrate a
commitment to carrying out professional responsibilities and an adherence to ethical principles,
including: compassion, integrity, and respect for others; responsiveness to patient needs that
supersedes self-interest; respect for patient privacy and autonomy; accountability to patients,
society, and the profession; and sensitivity and responsiveness to a diverse patient population,
including to diversity in gender, age, culture, race, religion, disabilities, and sexual orientation. [PR
IV.A.5.e).(1)-(5)] (Limit response to 400 words)
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2. Briefly describe one learning activity in which fellows will demonstrate the ability to maintain
appropriate professional boundaries, including those specific to psychiatric practice. [PR
IV.A.5.e).(6)] (Limit response to 400 words)
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Systems-based Practice
1. Briefly describe the learning activity(ies) through which fellows demonstrate an awareness of and
responsiveness to the larger context and system of health care, as well as the ability to call
effectively on other resources in the system to provide optimal health care. [PR IV.A.5.f)] (Limit
response to 400 words)
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2. Briefly describe the learning activity(ies) through which fellows demonstrate competence in the
elements of systems-based practice: working effectively in various health care delivery settings and
systems, coordinating patient care within the health care system; incorporating considerations of
cost-containment and risk-benefit analysis in patient care; advocating for quality patient care and
optimal patient care systems; and working in interprofessional teams to enhance patient safety and
care quality. [PR IV.A.5.f).(1)-(5)] (Limit response to 400 words)
Child and Adolescent Psychiatry
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 5/2015
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3. Briefly describe an activity that fulfills the requirement for experiential learning in identifying system
errors and implementing potential systems solutions. [PR IV.A.5.f).(6)] (Limit response to 400
words)
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4. Briefly describe one learning activity in which fellows will develop knowledge of how types of
medical practice and delivery systems differ from one another, including methods of controlling
health care cost, assuring quality, and allocating resources. [PR IV.A.5.f).(7)] (Limit response to 400
words)
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5. Briefly describe one learning activity in which fellows will advocate for quality patient care and
assisting patients in dealing with system complexities, including disparities in mental health care for
children and adolescents. [PR IV.A.5.f).(8)] (Limit response to 400 words)
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6. Briefly describe one learning activity in which fellows will develop knowledge of how to advocate for
the promotion of health and the prevention of disease and injury in populations. [PR IV.A.5.f).(9)]
(Limit response to 400 words)
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7. Briefly describe one learning activity in which fellows will participate in the practices of utilization
review, quality assurance, and performance improvement. [PR IV.A.5.f).(10)] (Limit response to 400
words)
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Child and Adolescent Psychiatry
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 5/2015
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Curriculum Organization and Fellow Experiences
1. Indicate the clinical experiences for each required patient care experience.
Educational Experiences Yes
Pediatric neurology
☐
[PR IV.A.6.e).(1)]
Intellectual disability
☐
(intellectual development
disorder), and other
developmental disorders
[PR IV.A.6.e).(2)]
Psychiatric emergencies
☐
[PR IV.A.6.e).(3)]
Acutely- and severely☐
disturbed children and
adolescents
[PR IV.A.6.e).(4)]
Consultation
☐
[PR IV.A.6.e).(5).(a).(i)(iii); IV.A.6.f)]
Pediatric
☐
Clinical
Services, if
applicable
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Relevant
Didactics, if
applicable
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Briefly, in no more than two sentences, state the
expected learning outcome for each educational
experience.
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☐
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☐
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No
☐
☐
☐
☐
School
☐
☐
Legal
☐
☐
Community
☐
☐
☐
☐
☐
☐
Observation and
interaction with normally
developing
[PR IV.A.6.i)]:
Preschooler
Child and Adolescent Psychiatry
©2015 Accreditation Council for Graduate Medical Education (ACGME)
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Educational Experiences Yes
School-aged child
☐
No
☐
Adolescents
☐
☐
Specific didactics
☐
☐
☐
☐
Development, to
include
neurobiological,
phenomenological,
psychological, and
sociocultural
[PR IV.A.6.j)]
Clinical
Services, if
applicable
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Child and Adolescent Psychiatry
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Relevant
Didactics, if
applicable
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Briefly, in no more than two sentences, state the
expected learning outcome for each educational
experience.
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2. Describe how faculty child and adolescent psychiatrists will be involved in the supervision of the
fellows. [PR IV.A.6.g)]
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3. Will each fellow be provided at least two hours of faculty preceptorship weekly? [PR IV.A.6.h)]
.................................................................................................................................... ☐ YES ☐ NO
a) Will at least one hour of this faculty preceptorship be individual? [PR IV.A.6.h)] ..... ☐ YES ☐ NO
Fellows’ Scholarly Activities
Briefly describe and reference seminar numbers from the Scheduled Didactic Seminars section.
[PR IV.B.2.]
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EVALUATION
Fellow Evaluation
1. Will there be an annual evaluation procedure, including a written examination of the knowledge
base? [PR V.A.2.e)] ..................................................................................................... ☐ YES ☐ NO
If “YES,” describe briefly.
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2
Will there be a formal documented clinical skills examination? [PR V.A.2.e)] ............... ☐ YES ☐ NO
If “YES,” describe briefly.
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3. Will the final evaluation of each fellow document unethical behavior, unprofessional behavior, or
clinical incompetence? [PR V.A.3.b).(4)] ...................................................................... ☐ YES ☐ NO
Child and Adolescent Psychiatry
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 5/2015
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