The Unexpected Perks of Triple Board Training: COVID-19 Response
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LETTER TO THE EDITOR
The Unexpected Perks of Triple Board Training: COVID-19 Response Anish Raj 1 Received: 5 May 2020 / Accepted: 11 August 2020 # Academic Psychiatry 2020
To the Editor: The 5-year combined training program in pediatrics, general psychiatry, and child and adolescent psychiatry (Triple Board Program), originally conceived as an experiment in medical training, has established itself as a sustainable pathway in recent decades. While early evaluations focused on the primary objective of addressing the shortage of child psychiatrists, more recent reflections have emphasized the novel perspective and skillset fostered by training in the integrated program [1]. The importance of these considerations has only been amplified in the setting of the ongoing COVID-19 global pandemic. At a time when the healthcare workforce and stock of personal protective equipment are being stretched, institutions are working overtime to consolidate and conserve resources [2]. With one foot planted firmly in the realm of pediatrics, and the other in psychiatry, Triple Board physicians stand in a unique position to contribute in a variety of hybrid roles to help ensure that children continue to receive the care they need while also limiting exposure risks and supporting infection control. In anticipation of the expected surge in cases related to COVID-19, and the prospect that frontline pediatric providers may be deployed to cover adult medicine units, a pilot project was initiated at Hasbro Children’s Hospital in Providence, Rhode Island, in March of 2020. With the support of both pediatrics and child psychiatry leadership, a position was created on a trial basis for a senior Triple Board resident. The envisioned role was conceptualized as being hybrid in nature―serving as a pediatrics senior resident for patients admitted to a medical bed awaiting availability at a psychiatric facility, as well as an extended member of the inpatient child and adolescent consult-liaison psychiatry team. Rationale supporting the initiative included the reality that by the fifth year of most Triple Board curriculums, trainees have completed the majority of their pediatrics requirements, are often
* Anish Raj [email protected] 1
Brown University, Providence, RI, USA
board-certified pediatricians, and also serve as child psychiatry fellows. The hope was to streamline communication, expedite disposition planning, and offer a familiar point of contact on-site as much of the psychiatry department’s consultation activities transitioned to telemedicine. A notable circumstance, for which the hybrid role has been particularly beneficial, has been in the management of primarily psychiatric patients admitted to a medical bed due to positive COVID-19 status. Given the known challenges of providing robust therapeutic options on a medical floor, coupled with the limited resources to address behavioral dysregulation, and further complicated by the precautions necessary due to COVID-19, it has been imperative to seek creative solutions [3]. A conscious
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