The Triple Board Philosophy

Absolutely. One of the biggest areas of concern that triple board applicants express is about training in pediatrics. At IU School of Medicine, there is a wide range of exposure and training opportunities. You will care for “bread and butter” conditions to the most specialized/complex diagnoses in all three disciplines. While in each discipline, the goals and expectations of your training and work will be equivalent to peers in the other disciplines.

IU Health is the largest health care system in Indiana and supports the only triple board residency and child psychiatry fellowship. Our organization considers the entire state population to be our responsibility. Many innovative programs have been developed as a way to tackle gaps in services:

• Multiple mechanisms for integrated behavioral health in primary care settings, designed to deliver integrated behavioral health in primary care settings.

• The Department of Psychiatry has a long-standing and close-working relationship with the Indiana State Division of Mental Health and Addiction, with faculty members serving on various government task forces and committees addressing child and adolescent mental health. Residents are able to participate and obtain solid advocacy experiences and skills through the residency advocacy elective.

• Indiana Behavioral Health Access Program for Youth (Be Happy) — A service available to primary care and specialty providers throughout the state to “phone a friend”/consult a child psychiatrist on the mental health care of a patient in need. The goal of the service is to improve evidence-based practice throughout Indiana.

• The Indiana Psychotropic Medication Advisory Committee — An initiative launched by IU School of Medicine Department of Psychiatry, the Department of Child Services (DCS), the Office of Medicaid Policy and Planning (OMPP), the Division of Mental Health and Addiction (DMHA), and the Family Social Services Administration for reviewing evaluation and treatment of DCS-involved youth who are on multiple psychotropic medications. A multidisciplinary team reviews best practice guidelines, monitors prescription patterns, provides education, and consultation.

• Project ECHO (Extension for Community Healthcare Outcomes) — A movement to connect local primary care teams with interdisciplinary specialist teams via technology to improve treatment for complex and chronic health conditions. State-supported Project ECHOs include topics in general psychiatry, child psychiatry, and addiction psychiatry. Many interesting options available, including a series on LGBTQ health care.

• IU Health “Virtual Hub” — Behavioral health clinicians located in a “virtual hub” evaluate patients who have presented in crisis to IU Health ERs throughout the state.

• Cross Teaching between Specialties — Opportunities for faculty, residents and fellows to provide didactics on psychiatric topics for the medical school and other residency programs (e.g., general pediatrics program, emergency medicine program, child protection, developmental behavioral pediatrics program).

• Psychiatry Outpatient Clinic for Categorical Pediatrics — A clinic option for pediatricians who plan to practice primary care pediatrics, to gain more comfort in diagnosing and treating psychiatric conditions.

• Neurodevelopmental Hubs — The Neurodevelopmental Hubs are a well-integrated, statewide system of care for children with neurodevelopmental and behavioral conditions to improve access to care.

• Residents work on an inpatient pediatric rotation with the developmental pediatrics complex care service, a multidisciplinary team caring for children with neurodevelopmental and genetic conditions.

• Outpatient Developmental Pediatrics

• The Neurodevelopmental Hubs are a well-integrated, statewide system of care for children with neurodevelopmental and behavioral conditions to improve access to care.

• Developmental-Behavioral Pediatric Fellowship

• The Autism Spectrum and Developmental Disorders Outpatient Program provides psychiatric care to children with neurodevelopmental conditions and autism. 

• Hands in Autism is a state-wide training and resource center providing evidence-based behavioral and educational practices for providers and other stakeholders across settings (educational, medical/clinical, home/community).

• Robust specialty pediatric services — Riley Hospital for Children, the only tertiary care hospital in Indiana, is ranked among the top children’s hospitals in the country by U.S. News & World Report. Riley Hospital provides care for several specialty services, including hematology, oncology, stem cell, gastroenterology, rheumatology, nephrology, cystic fibrosis and pulmonology, cardiology, emergency medicine, burn, developmental pediatrics, pediatric intensive care, neonatal intensive care, and heart/kidney/multivisceral transplants.

• Riley Hospital consultation-liaison (C/L) team — The C/L service is an interdisciplinary team of psychiatrists, pediatric psychologists and LCSW therapists. On the team, there is a potential mix of triple board and general psychiatry residents, child psychiatry fellows, residents in neurology/developmental behavioral pediatrics/general pediatrics, psychology interns and medical students. Trainees have opportunities to participate in “bread and butter” C/L evaluation and diagnosis, diagnostic conundrums, treatment with medications and psychotherapies, care conferences, working with many specialty teams in clinical care, and in addressing systems problems.

• Opportunities to work with pediatric psychologists — Pediatric psychologists are embedded on the C/L service and in multiple specialty, interdisciplinary clinics, including the headache clinic, conversion clinic, oncology clinic, pain clinic, GI clinic and sleep clinic.

• Inpatient pediatric rehabilitation — The Riley Hospital inpatient rehabilitation unit cares for patients with spinal cord injuries, burns, chronic pain conditions, trauma, etc. Trainees have opportunities to work on the unit as consultants while on the consultation-liaison rotation at Riley Hospital.

• Charis Center for Eating Disorders — The Charis Center offers a multidisciplinary team providing outpatient and partial hospitalization to patients dealing with eating disorders.

• Integrated behavioral health in primary care settings.

• Consultation-Liaison Fellowship

• Interhospital C/L rounds — During interhospital C/L rounds, teams from Riley Hospital, IU Health University Hospital, Eskenazi Hospital and IU Health Methodist Hospital meet weekly for didactics and case presentations.

• Eskenazi Pecar Health Center is a medical home where families can receive comprehensive care (e.g., pediatrics, adolescent, substance, mental health) and access to a food pantry, social services, WIC and many other services.

• Spanish-speaking pediatrics clinic at Eskenazi Pecar Health Center and 38th Street Clinics.

• Opportunities to work with Spanish-speaking attendings and populations.

• The Academic Model Providing Access to Healthcare (AMPATH) is a global network of academic health centers, led by Indiana University, Moi University and Moi Teaching and Referral Hospital in Eldoret, Kenya.

• The Global Health Pathway equips residents to address health disparities and encourages long-term commitment to global health issues, both domestic and international. The curriculum is co-curricular alongside each participant’s residency educational mission and requirements. This is an internationally recognized partnership through which many triple board residents have rotated in Eldoret, Kenya. This program enables residents the opportunity to work on the pediatric wards at Shoe 4 Africa Children’s Hospital and various psychiatry experiences through Moi Teaching and Referral Hospital in Eldoret, Kenya for up to two months. In addition to learning about international medicine, there is ample time for travel and learning about other cultures. Residents may also pursue global health rotations elsewhere as a pediatric elective.

• The Eskenazi Gender Health Program provides primary care and specialty services for older adolescent and adult transgender patients of all gender identities.

• The Riley Gender Health Program is a comprehensive team of adolescent medicine doctors, pediatricians, pediatric urologists, pediatric endocrinologists, psychologists and social workers. The program provides care to children, teens and young adults who may experience gender dysphoria.

• The LGBTQ Project ECHO (Extension for Community Healthcare Outcomes) is a movement to connect local primary care teams with inter-disciplinary specialist teams via technology to improve treatment for complex and chronic health conditions specific to LGBTQ care.

• The Dr. Alan & Diane Breier Prevention and Recovery Center (PARC) for Early Psychosis is a full-service center for young people, ages 16–35, who are at high risk for, or are currently experiencing, the earliest stages of a psychotic disorder.

• The Indiana Psychotropic Medication Advisory Committee is an initiative launched by IU School of Medicine Department of Psychiatry, the Department of Child Services (DCS), the Office of Medicaid Policy and Planning (OMPP), the Division of Mental Health and Addiction (DMHA), and the Family Social Services Administration for reviewing evaluation and treatment of DCS-involved youth who are on multiple psychotropic medications. A multidisciplinary team reviews best practice guidelines, monitors prescription patterns, provides education and consultation.

• Child Protection Services

• Pediatric Center of Hope provides comprehensive medical evaluation for children alleged to have been sexually assaulted. Children are referred primarily by Child Protective Services, law enforcement, and health care providers. Patients are seen for both scheduled and acute examinations (often involving forensic evidence collection). Additional Center of Hope rooms in the Emergency Department for acute evaluations.

• Child Abuse Pediatrics Fellowship

• The Riley Pediatric Palliative Care team provides inpatient and outpatient services.