LAUSR

To the Editor: Despite approximately 8000 child and adolescent psychiatrists in the USA, the number may meet only 30% of the country’s pediatric mental health needs by 2020 [1, 2]. The American Academy of Child and Adolescent Psychiatry has employed various strategies to address this issue without much success [1]. One possible approach is to expose students to the child and adolescent psychiatry (CAP) field early in their education. Here, we provide a description of a structured CAP shadowing program offered to Johns Hopkins University (JHU) undergraduate students interested in attending medical school and assessed the short-term impact that this program had on their career interests. A year-long medical practicum is offered through the JHU Pre-Professional Advising Office [3]. Students apply to the practicum and match with physicians at Johns Hopkins Medical Institutions (JHMI), in Baltimore, MD, based on their interest and feasibility. Students complete all relevant trainings and other requirements prior to enrollment. The practicum is structured to allow 60–80 contact hours per semester, and the students receive up to 2 pass/fail credits upon completion of the practicum. One of the authors founded and established a CAPmedical practicum in 2011 to enable undergraduate students at JHU to shadow and conduct research in developmental child neuropsychiatry at Kennedy Krieger Institute, JHMI. Dr. Budimirovic, a full-time faculty at Johns Hopkins School of Medicine, serves as the practicum director. To strengthen this educational experience, he established objectives that upon completion of the practicum, the student will (1) show a working knowledge of how to use the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), and be able to articulate the differences between DSM-5 and the previous version (DSM-IV), (2) list the major symptoms of fragile X syndrome (FXS) and autism spectrum disorder (ASD), and other relevant diagnoses in CAP as well as their evolution and the treatments that are used, and (3) describe the genetic and environmental risk factors involved with ASD, and theories on the biological correlates of symptoms encountered in idiopathic ASD. Through a combination of clinical exposure, assigned readings on the topics 1–3, and discussions with the faculty, students learn how the categorical DSM approach, despite its dimensional shortcomings, is used to evaluate a range of the patients observed. To enhance their understanding of the progression of different disorders, students review patient histories with the aid of a JHU IRB-approved educational binder. At the end of the program, students prepare a scholarly 4–5page report to capture their experience and demonstrate what they learned. To evaluate the short-term impact of the practicum, an anonymous survey was administered to the course’s participants from 2011 to 2019. The survey consisted of 13 items: 12 items were statements that participants ranked on a 10-point scale (10 = strongly agree, 1 = strongly disagree), and one item provided space for participants to leave additional comments as they felt necessary. Scores are categorized for analysis as high (9–10), high-medium (6–8), medium-low (3–5), and low (1–2) and reported as mean ± SD. This study was approved by Johns Hopkins Medicine Institutional Review Board. The completion of the survey served as the participant’s consent to be in the study. Our results found that of the 23 students contacted, 17 (74%) completed the survey. Two-thirds were females (65%), and the sample included a mixture of sophomores (52%), juniors (22%), and seniors (26%). The vast majority (83%) were neuroscience majors followed by psychology (9%), biophysics (4%), and public health (4%). All the students that responded have been accepted or matriculated into medical school. * Dejan B. Budimirovic [email protected]