TRIPLE BOARD PROGRAM

PGY1

PGY2

PGY3

PGY4

PGY5

PGY6, (optional)

"PIT" Program

Applications Procedure

The University Health Centers of Pittsburgh Triple Board brings together premier programs in pediatrics, adult and child & adolescent psychiatry, as well as clinical and research strengths at the interface of these fields. Each component is outstanding in its own right, and we are striving to create a well-integrated training experience that builds upon these strengths.

The Department of Pediatrics and Children’s Hospital of Pittsburgh (CHP)   have an excellent reputation for patient care, postgraduate teaching and academic excellence. A 260 bed capacity hospital, Children's is the only hospital in western Pennsylvania dedicated to the care of infants, children and  young adults, with more than 13,000 admissions a year, half of which are treated primarily by medical services.  Additionally, there are more than 400,000 outpatient encounters and about 60,000 visits to the emergency room, where residents have first line responsibility in the care of the patients. The academic program within the Department of Pediatrics continues to grow.  Considering total NIH funding of Children's Hospital and the Department of Pediatrics, we now rank ninth in the country among all departments of pediatrics, whether they report funding through a children's hospital or a university.

The Department of Psychiatry at WPIC is a national leader in clinical care, research and education. It is one of the largest and most academically productive psychiatric departments in the nation, and offers advanced diagnosis and treatment for psychiatric disorders across the age range. The prominence of the academic activities in the department is reflected in its receiving more NIMH funding than any other department in the US. There are currently about 190 full-time faculty specializing in a variety of psychiatric disciplines, many of whom are acknowledged leaders in their fields. Western Psychiatric Institute and Clinic (WPIC) is a 260 bed facility serving more than 15,000 patients each year, about 37,000 inpatients as well as more than 11,000 outpatients. WPIC also provides psychiatric consultation to more than 2,000 patients annually within the University of Pittsburgh Medical Center (UPMC), one of the largest integrated health care delivery systems in the US.

Western Psychiatric Institute and Clinic and Children's Hospital of Pittsburgh, under the auspices of the University of Pittsburgh Medical School, are the participating institutions and the primary clinical sites for Triple Board training. They are conveniently located within a block of each other in the Oakland section of Pittsburgh. Each year, two TBP residents will join 24 categorical pediatric residents, 4 medicine/pediatric residents , 2 family practice/psychiatry residents and 13 general or combined adult/child psychiatry residents at the PGY1 level. At the end of 5 years of training, TBP residents will have completed 24 months of pediatrics, 18 months of general psychiatry and 18 months of child & adolescent psychiatry. The program is designed to provide a planned and integrated educational experience, with graduated responsibility for patient care and teaching as residents advance. Interaction with pediatric and psychiatric resident colleagues is ongoing, both in the clinical settings and within didactics. The formal educational curriculum is ongoing throughout the 5 clinical years, with, on average, a minimum of 5 to 6 hours a week of classroom or other formal instruction. Additionally, a child psychiatry faculty supervisor will be assigned to meet with a resident regularly throughout training, to discuss clinical issues encountered in all training experiences.

PGY 1

The clinical emphasis during the PGY 1 year is on pediatric medicine.  Residents spend a total of 10 months that year in pediatrics - 6 months on inpatient units (general medical inpatient as well as cardiology/neurology, pulmonology,  endocrinology/ hematology, oncology and GI), one month in NICU, and the remaining 3 months in ambulatory care (emergency medicine, primary care and child advocacy centers and the newborn  nursery).  Call is Q4 during the intern year.   In addition, ½ day a week is spent in a pediatric continuity clinic, an experience that continues throughout the 5 years of training. During pediatric time, residents attend a daily one hour pediatric didactic session and participate in daily morning report and teaching rounds.

An additional two months of this year are spent in the Psychiatric Emergency Room (DEC), providing a vigorous introduction to psychiatry. Two weeks of this rotation are spent on the night shift with one to one attention by an attending psychiatrist.

During either the first or the second half of the academic year, residents will join their PGY1 psychiatry colleagues for Thursday afternoon didactics for 6 months. This is scheduled concordant with the resident's  DEC experience.

PGY 2

Five months of PGY2 focus on pediatrics, with two weeks each of the Child Development Unit and adolescent medicine clinic and one month each of the emergency room, NICU, PICU and as a senior on an inpatient unit.  Responsibilities during these first 4 months build on the first year experiences and include supervision of more junior residents and medical students. The call for pediatrics transitions to a night float system this academic year. 

Residents will then transition to psychiatry where they will complete rotations on the adult psychiatry inpatient units (4 months to include adult mood, psychosis, dual diagnosis and child and adolescent psychiatry) and on the adult psychiatry consultation/liaison service (2 months) at the large tertiary care adult medicine hospital within the UPMC Health System. Residents also begin seeing adult longitudinal psychotherapy outpatients during this time, the focus being on the use of interpersonal psychotherapy (IPT). Psychiatry call is approximately Q8.

Starting in PGY2, residents participate in weekly psychiatry didactics (on thursday afternoons) for the entire academic year. This continues throughout the remainder of training.

Residents will also complete one month on adult neurology during this academic year.

Residents will continue with 1/2 day per week in pediatric continuity clinic with the option of transtioning to 1/2 day every other week depending on career goals.

PGY 3

This academic year typically begins with one month of child neurology. 

Pediatric training then continues for  5 months of this year, with one month NICU, two months as inpatient senior (subspecialty and general medical), two weeks as the supervising resident for the Acute Concerns Clinic and 6 weeks of subspecialty elective.

The remaining 6 months are devoted to adult psychiatry outpatient training with exposure to diverse populations including: adult mood disorders, geriatrics, the chronically mentally ill and child and adolescent psychiatry.  This will complete all adult psychiatry training requirements for the triple board trainee. 

The resident's  adult psychotherapy training resumes in the second half of the academic year with an emphasis on cognitive behavioral therapy (CBT).  Additionally residents may begin seeing a longitudinal psychodynamic psychotherapy patient.  Didactics will also focus on dialectical behavioral therapy (DBT), group therapy and family therapy.

PGY 4

This year includes four months of pediatrics, with 3 months of subspecialty electives and one month as a senior resident on an inpatient service.   This will complete the required pediatrics portion of the training, with the exception of the pediatric continuity clinic which will continue throughout the five years of training.

The remainder of the year, 8 months, is concentrated in child and adolescent psychiatry.  Experiences include: four months on inpatient units (general child & adolescent unit and the John Merck Inpatient Unit for Mental Retardation, Autism and Developmental Disabilities), followed by 2 months at the Adolescent Acute Partial Hospitalization Program, then 2 months on the pediatric consultation/liaison service. 

During these 8 months, the trainee will also begin a child and adolescent psychiatry continuity clinic ½ day/week, and begin longitudinal psychotherapy with a minimum of 2 child and adolescent patients.  The latter two experiences will continue throughout the remainder of training.

During this academic year, residents will take call from home for the consultation-liaison service, an average of 7 weeks throughout the academic year.

PGY 5

Child and adolescent psychiatry training is completed over the course of the remaining 12 months of this final obligatory training year. One month will focus on the Infancy/Early Childhood population at Matilda Theiss Center for Child Development and one month at the Center for Overcoming the Problems of Eating (COPE). Each resident will continue their child and adolescent outpatient continuity clinic 1/2 day per week and also participate in a unique family therapy experience with the clinical psychology interns 1/2 day per week for 6 months. This clinic is supervised live by 2 instructors, providing hands on feedback and guidance for development of family therapy skills.

The predominant focus of the remaining 10 months is on outpatient experiences and electives.  Outpatient experiences which are required include forensics, school consultation, and community psychiatry.  A wide range of elective experiences are available and include clinical and teaching senior residencies, neuropsychology, managed care, administrative and research experiences.

Research Fellowships        

Consistent with the guidelines developed by the ABP and ABPN, the University of Pittsburgh TBP seeks to prepare clinical physicians for the medical challenges of the 21^st century by training them to evaluate critically new and established approaches to the assessment and treatment of mental and emotional disorders across the age range.  We also seek to recruit and training physicians who are likely to pursue academic and research careers and to make valuable contributions in the areas of scientific knowledge, education, program development and/or health and mental health care policy.

In an effort to encourage academic development in the peds/psych interface, we offer research fellowships to qualified candidates with a talent for and interest in a research career.  The Departments of Pediatrics and Psychiatry have faculty involved in research in all areas of mental disorders in childhood and adolescence, including developmental psychopathology, psychobiology of illnesses, neuroimaging, assessment and treatment, as well as services and outcome research. All TBP trainees will have a clinical and academic mentor throughout their training to assist in career development and decision making. 

IP SR - Inpatient senior

adult C/L - adult consultation-liaison

ACC - Acute Concerns Clinic

SSE- Subspecialty elective

AAPHP - Adolescent Acute Partial Hospitalization Program

CHP C/L-  Children's Hospital consultation and liaison

We remain excited about this program, by the quality of applicants drawn to the challenge of triple board training and the possibility of having such individuals train here at the University of Pittsburgh. The program also gives two very strong and nationally recognized academic departments the opportunity to shape the future direction of our fields by training tomorrow’s leaders in clinical care, research and education.

APPLICATION PROCEDURE & ADDITIONAL INFORMATION

Applicants for the Triple Board Residency Training Program must be a senior in an approved medical school or hold an MD degree.  We encourage applications from minority students.  Applicants with specialty training in in other areas of medicine are also welcome.  

Applications are accepted through ERAS (Electronic Residency Application Service).  We require a complete application form, personal statement (including a statement regarding areas of interest), medical school transcript and three letters of reference. Applications will be accepted till December 31. After completion of the review process by the Selection Committee, applicants will be notified by email or mail.  Dates for the interview will be determined at the time of the invitation.  We generally interview on Mondays, November through early January. 

Further information may be obtained by contacting:

Abigail B. Schlesinger, M.D.
Director, Child & Adolescent Psychiatry Residency Training
Western Psychiatric Institute & Clinic

University of Pittsburgh

3811 O'Hara Street

Pittsburgh, PA 15213

(412) 246-5320

Email: schlesingerab@.upmc.edu