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Clinical Rotations

Training at UC Irvine provides exposure to a wide range of clinical settings, patient populations, and treatment acuity levels, allowing fellows to develop a comprehensive skill set.

The following list provides a brief description of the core experiences fellows will rotate through during their training.

UC Irvine Adolescent Inpatient Unit »

During this first-year rotation, fellows work on this high-acuity, locked inpatient unit with patients ages 12 to 17 years.

Being one of the few inpatient psychiatric resources available to the pediatric population in the region, this unit serves a diverse demographic with a rich diagnostic pool, providing exposure to virtually all major DSM diagnoses.

During the course of the rotation, fellows gain expertise in acute stabilization, pharmacotherapy, brief psychotherapy, and comprehensive work-up of newly presenting mental illness.

Fellows assume a leadership role in a multidisciplinary team, and work with social work and case management to develop disposition plans, engage families in education, and coordinate with outside providers and schools. This rotation also provides an excellent opportunity for fellows to work as educators with rotating PGY-2 residents and medical students.

Partial Hospitalization Program »

The partial hospitalization program is a day program which incorporates group, individual, allied and family therapy with medication management for children and adolescents ages 13 to 17 years. 

Fellows rotate here during their first year and participate in assessment, treatment planning, medication management, therapy, and family education.

A unique opportunity for continuity of care is provided in that many partial hospital patients will step-down from the inpatient unit and ultimately follow-up with the fellows in the outpatient clinic, allowing fellows to observe their patients and adjust their treatment strategies in these different settings.

UC Irvine Emergency Evaluations »

This primarily first-year rotation ensures that fellows gain experience in conducting emergency evaluation, crisis intervention, safety assessment and triage. 

Fellows provide consultation to the emergency room physicians and become experts at determining level of care needs. As this rotation runs concurrently with the inpatient and partial hospitalization rotations, fellows are often able to continue to follow the patients they evaluate in the ER.

CHOC Children's Consultation & Liaison Psychiatry Service »

During this rotation that spans the first and second years, fellows gain experience in providing consult and liaison services at Orange County’s state-of-the-art and nationally renowned children’s hospital.

Fellows are supervised by an attending who is quadruple-boarded (general psychiatry, child psychiatry, pediatrics and psychosomatic medicine), and receive valuable training in all facets of pediatric psychosomatic medicine. 

At CHOC, fellows are supported by a well-established psychology department, whose members actively manage disposition and psychosocial issues, allowing fellows to focus on psychiatric issues and questions. 

CHOC Children's Outpatient Clinics »

During the consultation rotation, first-year fellows are embedded in specialty outpatient clinics at CHOC.

In the bulimia anorexia nervosa (BAN) clinic, fellows will work with attending pediatricians, dietitians, social workers and a supervising psychiatrist in a team-based approach toward treating eating disorders.

When their patients are admitted from the clinic, fellows can follow them as a consultant in the hospital where they are essentially provided the services of an inpatient eating disorder unit including the use of NG tubes, psychological services, dieticians and weekly interdisciplinary team rounds. Fellows will learn several psychosocial interventions as well as appropriate psychiatric treatment of this population during this rotation.

In the CHOC outpatient psychopharmacology clinic, fellows have the opportunity to work exclusively with underserved patients with co-occurring medical conditions. This clinic also provides an introduction to medication management to training psychologists and provides fellows a unique opportunity to train in collaboration of care with treating therapists. Fellows also gain training in and exposure to the use of various therapeutic modalities such as biofeedback and hypnosis in the medically ill population.

Outpatient Clinics »

One of these rotations spans both years of fellowship, allowing fellows the opportunity to experience a full two years of continuity of care with their outpatients, while another clinic allows further development of outpatient skills in the second year.

Cases are diverse and range from pre-school aged children with ADHD to developmentally delayed teenagers. Fellows engage in comprehensive assessment, treatment planning, medication management, and coordination of care while receiving individual supervision on each case. 

The clinic utilizes an evidence-based model of treatment, with relevant research/articles pertaining to cases or clinical questions discussed. Fellows are provided with 90-minutes for new cases and 30 minutes for follow-ups. Graduating fellows are given the opportunity to retain patients if they choose to practice in the area.

Forensic Rotation »

This second-year rotation occurs at the Orange County Juvenile Hall, two Juvenile Day Schools, and the County’s primary group home for children who have been abused, abandoned, and/or neglected.

Fellows provide psychiatric evaluation and treatment to youth who are incarcerated or on probation, while learning about forensic issues in child and adolescent psychiatry.

Fellows work with an interdisciplinary team in these settings including case managers, social workers, therapists and probation officers. Fellows have the opportunity to attend drug court, family court and to interact with judges for adjudicated youth. They are also exposed to challenges inherent to these populations and learn strategies to improve their systems-based practice.

Fellows provide psychiatric care to those children who may have PTSD, depression or other psychiatric disorders as a result of experiencing abuse or neglect.

Outpatient Therapy Clinic »

In this second-year rotation, fellows see child and adolescent patients for individual psychotherapy, typically with 50-minute weekly visits.

Initial evaluation is staffed with the attending psychiatrist, with both a bio-psycho-social and psychodynamic formulation considered, followed by weekly group supervision for fellows. 

Fellows also seek input from their Individual Supervisors who are Voluntary Faculty typically in a private practice setting in the community. Fellows develop a treatment plan and are encouraged to consider a variety of possible therapeutic modalities.

Families of Children Under Stress (FOCUS) »

FOCUS is a county-funded treatment program specializing in the treatment of sexually abused children and their families. FOCUS offers individual, group, family, parenting and pharmacotherapy treatment to patients and families referred by Orange County Social Services for sexual abuse.  

Fellows rotate at FOCUS during their second year of training. During this rotation, fellows’ caseload and treatment modalities are monitored to ensure breadth of experience and supervision. 

It provides a unique opportunity to practice long-term individual psychotherapy with children of all ages, both victims and family members of victims of sexual abuse. Play therapy is frequently employed, with close supervision by therapists with extensive experience in this modality. Fellows are also given the opportunity to participate in family and group therapies, parenting classes, and medication management.  

School Consultation »

This second-year rotation occurs at the UC Irvine Child Development Center School. The faculty consists of a full-time child psychologist, teachers, behaviorists, graduate students and research associates. 

The UC Irvine Child Development Center School, in association with the Orange County Department of Education, operates a model school-based treatment program for children with behavioral and academic problems in first through sixth grades (with planned expansion to grade 8).

The program includes daily social skills for children in the program and parent participation through parent training and multiple family groups. 

Fellows participate in all aspects of care, working with educators, therapists, students and their families. They also assist in developing a behavioral plan to transition children from specialty school back to mainstream classes. 

During this rotation, fellows have the opportunity to participate in community outreach by engaging parent groups in education on general child psychiatry topics. They are exposed to a highly integrated token economy system.

Mood Disorders Clinic »

This subspecialty Mood Disorders Clinic during the second year of training provides opportunities to increase expertise in evaluating and treating patients with mood disorders, especially bipolar disorder. The clinic is supervised by an attending psychiatrist with expertise in this area.

One of the goals of this rotation is to help fellows appreciate the complexity of this diagnosis as well as differentiate between various mood disorders in the pediatric population due to many areas of overlap. Further expertise in medication management for this population will be achieved.

Pediatric Neurology »

During this second-year rotation, fellows work alongside world-renowned neurologists with a variety of subspecialty experience at the CHOC outpatient pediatric neurology clinic to gain exposure to the treatment and management of childhood neurological disorders. 

Assigned readings and individual instruction occurs with a pediatric neurology attending, and fellows will learn to provide a comprehensive neurological exam.

Fellows will provide outpatient psychiatric consultation for a wide range of neurological conditions allowing them the opportunity to become comfortable with the various anti-epileptic medications prescribed as well as common and rare neurological conditions.

Neuro Epilepsy Psychiatry Clinic »

The overall goal of this outpatient rotation in the second year is to help the fellow build on skills gained in the first year of consultation-liaison training and become more sophisticated in evaluation and treatment of patients with co-morbid neurological disorders, specifically epilepsy. 

This clinic is integrated within the CHOC Neurology Outpatient Clinic and all patients seen are referred to psychiatry by the CHOC neurologists. 

The fellow will be exposed to pediatric patients with complex medical problems, epilepsy, developmental disorders and psychiatric co-morbidities. The fellow will demonstrate competence in managing these complex patients in an integrative outpatient setting. Fellows will see new patients for 60-70 minute visits and follow-up visits for 20 minutes. 

The fellow will then discuss evaluations with the attending psychiatrist utilizing a biopsychosocial formulation. All patients will be seen by the attending physician after the fellow has first evaluated and staffed the patients. Fellows are expected to develop a treatment plan which should include psychological treatment recommendations as well as medication recommendations, if indicated. 

Center for Autism »

This second-year rotation occurs at the Center for Autism where fellows gain increased exposure to patients with developmental disabilities and become more proficient in medication management of this population with unique challenges and needs.

There will be opportunities to also learn about various other treatment modalities utilized in the treatment of this population, as the center houses specialists in developmental and behavioral pediatrics and occupational therapy, among other professionals.

Training will incorporate learning about how the various modalities of treatment apply to each patient’s individualized treatment plan, whether it is applied behavioral analysis, medication management or social skills training.

Research »

Fellows are required to complete a research project by the end of their second year. Fellows are expected to develop a working knowledge of all phases of the research process, including literature review, IRB approval, grant writing, project management and publication. 

They will demonstrate understanding of common statistical methods, data management, research design, as well as perform a thorough review of the literature to establish special expertise in one area of child and adolescent psychiatry.