Career Opportunities

A career in child and adolescent psychiatry

Child and adolescent psychiatrists are physicians who have taken further specialty training over four or more years and are registered as Psychiatrists by the specialty granting body, the Royal College of Physicians and Surgeons of Canada, or equivalent. They specialize in working with children, youth and families whose mental, emotional and behavioral lives are not developing as desired by the child, teen or family. Such difficulties in development may be the result of a variety of biological, traumatic and psychosocial factors. Child psychiatrists work in a variety of settings.

 

Child and adolescent psychiatrists promote quality care and service to the children, youth and families of Canadians within an approach that encompasses the biological, the psychological and social world; with multiple types of other professionals; and interacting with a variety of health and other organizations. Their work is based on an understanding of healthy growth and development of children and families. They may be found working in communities, outpatient clinics, hospitals, universities, and research and teaching institutions. Clinical work may be in private, individual, group or hospital practice, providing services and consultations to individuals and families and other health care professionals, teams and health care organizations. Consultations may be direct (with the individual or family), indirect (to other health care team members) and through tele-health (when distances preclude the opportunity for face-to-face meetings).

 

Canadian Academy of Child and Adolescent Psychiatry recommends a ratio of 6 child and adolescent psychiatrists per region of 100,000 people. (please see below link for further information)

Child and adolescent psychiatrists are in short supply throughout Canada and career opportunities abound as a result of this. Similarly, competition to find child and adolescent psychiatrists is also very high.

 

Posting Career Opportunities in your community 

The Academy maintains the section CAREER OPPORTUNITIES for review by members who may be seeking opportunities to move to new communities and for communities to post their opportunities and make them available to child and adolescent psychiatrists. If you wish to make a posting, please contact us for pricing information.

 

Advocating for child psychiatry in your community

Note that the CACAP has long been concerned about the numbers of child psychiatrists in Canada and has provided resource information.

Many communities are without adequate child and adolescent psychiatry support. As a result, such services are provided by general practitioners, paediatricians, general psychiatrists and other allied health care professionals.

 

Many of the above provide an excellent level of service and while that is helpful to many communities, when complex questions arise with respect to assessment of risk, diagnosis, management and medications the community professionals do not have the support of the one medical professional trained specifically to work with the mental, emotional and behavioral health of children, youth and families. It is with this in mind that many professionals and health service administrators desire to improve the range of professionals available in a community by adding child and adolescent psychiatrists to the community health care services and teams.

 

Child and adolescent psychiatrists may work in private practice on a fee-for-service basis and within community organizations (e.g. fee-for-services, sessional fees, contracts, salary). Frequently they work with other members of a team for a number of reasons:

  • Working with families, agencies and school personnel requires the support of a variety of professionals
  • Other allied health care professionals have complementary skills allowing a more complete and higher quality of service for the child.
  • Fee-for-Service payments sometimes make it difficult for child psychiatrists to be paid for the wide variety of work, meetings, conferences and people to see for a particular child

It is as a result that many communities and health care organizations have openings for child psychiatrists. Indeed, the more common problem is that many more communities have openings than training programs across Canada are allowed to train each year. The challenge becomes one of how to lend community support to those who are already seeking child psychiatrists and to the university programs training them.

 

Occasionally further advocacy is needed. For communities lacking in child psychiatrists, some points may help in the creation of positions and the recruitment of child and adolescent psychiatrists.

 

Assessing the Need:

  • What is the population base?
  • What are the present mental health services human resources?
    • Present number of child psychiatrists
    • Present number of general psychiatrists and nature of their services to children and youth
    • Present number of other mental health professionals working in public mental health services
    • Present number of private mental health professionals
  • Duration of wait for children and youth seeking services for mental, emotional or behavioral reasons
  • Are there local, regional health service plans for the future and what do they establish as the need and future planning for mental health services for children and youth? If child psychiatry is mentioned and is a need, this will help immensely. If not, work may need to be done to establish a plan or to build child psychiatry into present plans (see building support-below).
  • Use your provincial/territorial government for information and support. Find out ‘who' in the government is responsible for mental health services for children and youth, what strategic planning reports are available, what advice they can provide about needs, proposals and submissions with follow-up. These people have an interest in the mental health of children and youth within government, can be important spokespeople and can help guide processes. Keep in mind that they have a provincial responsibility and cannot favour one community, process or politician more that any other. They must follow government policies and can only advise you to work with your local politicians if you believe the policies need to change.
  • Note that sometimes a full plan already exists and the most useful way to proceed is to work with and find ways to offer support from communities for those attempting to implement the plan.

Building Support

Many communities have a variety of health care needs and services and professionals to work with the mental health of children and youth are but one of many needs that communities must determine and prioritize. With this in mind, any proposal to enrich the professionals available for this services benefits by the more it is a cooperative proposal and the higher it is on the list of health care priorities for a community. The following concepts are designed for child psychiatrists working within larger public organizations. Modifications should be made for child psychiatry in private practice. With this in mind, some of the following can be considered:

  • Identify a key leader within health care, especially within administration and higher management levels, who has an interested in this area (this will mean that the proposal is more likely to be mentioned when needs and priorities are discussed within health care meetings)
  • Enlist the support of other relevant professionals and their organizations such as:
    • Local mental health services providers (this group is essential, without them, the need for child psychiatrists will be questionable)
    • Local health care services delivery agency
    • Local medical society
    • Local psychiatrists
    • Local paediatricians
  • Create a proposal that includes the following:
    • Executive summary - must not exceed one page
    • Background
    • The Need
    • Proposal (how many, doing what, located where, operating under what authority)
    • Budget (without a budget, no proposal can be put forward)
    • Desired outcome
    • Time lines
  • Person's name responsible to the proposal and follow-up on it till a final conclusion is reached (a proposal without a responsible person and a champion will be unlikely to succeed).
  • Sell your community. When child psychiatrists are in demand everywhere, and financial remuneration is acceptable in many locations, it is the community itself, in addition to the nature of the career opportunity, which brings the specialist. Indeed, some people believe that lifestyle issues are the final and most important factors for child psychiatrists and their families in making a decision to move.

Submission and Follow-up

Frequently, there are many people and organizations who will be determining whether a proposal will succeed and the more these people and organizations are onside, the more likely the proposal will succeed. These can include:

  • Local health care services and agencies (which should be addressed in the section above, Building Support)
  • Financial support - ensuring that a child psychiatrist will be paid is often not a simple as you might think. For instance:
    • If fee-for-service is used, will the work that is required be reimbursed by the provincial and regional health care agencies?
    • Will fee-for-service allow comparable income to other specialists? If not, seeking a child and adolescent psychiatrist to earn less funding than others, including general practitioners sometimes, will be much more difficult.
    • Is there funding available for contracts, sessional fees or even salary? How does it compare to other medical specialties?
    • What is provided for the child psychiatrist (office, secretarial support, interview areas) within any contract or community support?
  • Regional health services agency. Since many health care services are organized and delivered in Canadian jurisdictions these days by health services agencies, usually their support is required before any proposal will proceed.
  • Learn the route, committees and people who must review a proposal before it succeeds. Contact them, offer support, clarification and changes that may help a proposal succeed.
  • For non health care employees and citizens in a community, be sure to keep your local political representatives informed and onside. Writing to a Minister may be helpful when there is confusion of undue process but keep in mind that Ministers work with very large organizations with many high demands. Usually and frequently each organization believes their proposal warrants a higher priority than others facing a region and a government. It is not easy for decisions to be made as a result of this and no matter what decision is made, someone will believe it is the wrong decision.

Please note that the above is a guide only. While it has pointers on advocacy, it is clear that developing mental health services for children and youth and finding child psychiatrists as part of the team, is, on its own, a team effort. Finding the dedicated and significant people who can implement a plan and supporting this team is one of the most valuable roles for community members.

 

The suggestions noted are subject to many variations in different regions of Canada. If you believe that parts of it could be more complete or rewritten to be more helpful, please Contact Us selecting Psychiatry Posting for the subject line.

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