271 - Implementing a Collaborative Pediatric–Psychiatry Training Model to Meet New ACGME Mental Health Training Requirement

Publication Number: 3260.271

Amanda Kimberg, Duke University School of Medicine, Durham, NC, United States; Alexis French, Duke University School of Medicine, Durham, NC, United States; Catherine P. Hart, Duke University School of Medicine, Durham, NC, United States; James Fox, Duke University School of Medicine, Durham, NC, United States; Julie Penzner, Duke University School of Medicine, Durham, NC, United States; Gary Maslow, Duke University School of Medicine, Durham, NC, United States

Background: Pediatric mental health concerns are increasingly prevalent, yet many U.S. pediatric residents report graduating without confidence in managing them. Effective July 1, 2025, the ACGME requires pediatric residencies to include 4 weeks of mental health training. In response, we developed a collaborative model between the departments of pediatrics and psychiatry, in which pediatric residents provide supervised mental health care within a Child Psychiatry (CAP) outpatient clinic.

Objective: To describe a collaborative educational model and evaluate its impact on (1) patient access, (2) patient acceptability, and (3) resident education.

Design/Methods: Prior to implementation, pediatric and psychiatry faculty, residency directors, and clinic operations staff collaboratively designed a CAP clinic rotation for upper-level pediatric residents. Residents serve as front-line providers under direct supervision from CAP faculty. The rotation is embedded within an existing CAP outpatient clinic with shared administrative and nursing infrastructure. Program design details are shown in Figure 1.

Educationally, residents complete asynchronous learning from the Association of Pediatric Program Directors (APPD) Education in Mental Health improves Patient Outcomes, Well-being, and Emotional Resiliency (EMPOWER) curriculum.

Resident and patient outcomes are tracked. Residents complete pre- and post-rotation surveys evaluating knowledge and attitudes.

Results: As of October 2025, the rotation has been active for four months. The median time from referral to intake was 24 days in the resident clinic compared with 35 days in the broader CAP clinic (Table 1). Sixty new patients were seen, and most returned for a follow-up visit (86%). Patients ranged in age from 4 to 18 years (mean 11). Common diagnoses were ADHD (60%), anxiety/OCD (37%), autism and other neurodevelopmental disorders (22%), and mood disorders (20%). Preliminary survey data indicate that pediatric residents value increased interactions with child mental health experts and report greater comfort with safety planning following the rotation.

Conclusion(s): A collaborative Pediatrics-Psychiatry model meets new ACGME training requirements by embedding pediatric residents in psychiatry clinics for high-quality, supervised experiences and expands access to child mental health care through shorter wait times and strong patient acceptability, as evidenced by high visit return rates. This scalable approach addresses educational gaps; future work will evaluate learning outcomes and sustainability.

Figure 1. Collaborative Pediatric-Psychiatry Training Model
Goals: (1) patient access (2) excellent patient care (3) hands on learning for residents

Table 1. Details about referral, intake, and follow-up visits
Note: Of the 60 total patients, 55 patients had a scheduled follow-up (2 had no clinical need for follow up, 1 moved out of country, and 2 reason unknown). Of the 55 patients with scheduled follow ups, 6 patients did not attend and 11 patients have a follow-up visit scheduled in the future.

Figure 2. Type of Patient Mental Health Diagnoses
N = 60. Patients may have more than one diagnosis. Depressive disorders, bipolar disorders, and disruptive mood dysregulation disorder are included in mood disorders. Other disorders include trauma, tics, oppositional defiant disorder, adjustment disorder, trichotillomania, selective mutism, behavioral difficulties. Mean age of patients was 11 years.