@article{06aef7577f6a476ea98a5e3eee0e5e61,
title = "Preparing Trainees for Integrated Care: Triple Board and the Postpediatric Portal Program",
abstract = "Training combining the disciplines of pediatrics, psychiatry, and child and adolescent psychiatry dates back to World War II, but formal combined programs began more than 3 decades ago as the Triple Board Program and 10 years ago as the Postpediatric Portal Program (PPPP). Triple board training was rigorously examined as a pilot program and ongoing surveys suggest that it provides successful training of physicians who can pass the required board examinations and contribute to clinical, academic, and administrative/advocacy endeavors. As evidence grows showing the value of integrated care, physicians with combined training will offer a unique perspective for developing systems.",
keywords = "Combined training, Education, Integrated care, PPPP, Triple board",
author = "Gleason, {Mary Margaret} and Sandra Sexson",
note = "Funding Information: The Triple Board Program was developed in response to the Project Future call to action for considering more flexible pathways to training in CAP. The movement to develop these programs was led by John Schowalter MD, seen by many as the “grandfather” of the triple board programs, who led the Pediatrics-Psychiatry Joint Training Committee, which included representation from the American Board of Pediatrics (ABP), the American Board of Psychiatry and Neurology (ABPN), the Committee on Certification in Child and Adolescent Psychiatry, the American Academy of Pediatrics, the American Psychiatric Association, and the American Academy of Child Psychiatry, now the American Academy of Child and Adolescent Psychiatry (AACAP). 3 Dr Schowalter led the planning, selection, and evaluation of the programs and elicited endorsement for the project from the Society of Professors of Child Psychiatry, the American Association of Directors of Psychiatric Residency Training (AADPRT), the American Association of Chairmen of Departments of Psychiatry, and the Accreditation Council for Graduate Medical Education (ACGME) Review Committees (RCs) for Psychiatry and for Pediatrics. 3 After substantial discussion and negotiation, described by Dr Schowalter as “oratory, sweat, and blood,” 3 6 triple board programs, selected from 32 applications, opened their doors in 1986. The original training programs at Tufts, Brown, Utah, Kentucky, Mount Sinai, and Albert Einstein each admitted 2 residents per year. The programs were intended to recruit medical students who might otherwise have focused primarily on a pediatrics pathway but who were driven by an interest in physical and mental health of children. The Triple Board Program was designed to be shorter than the 8 years that training in pediatrics and separately psychiatry and CAP would require. The program required a total of 5 years of training: 24 months in pediatrics, 18 months in general psychiatry, and 18 months in CAP, requirements that remain to the present time. Because the program was a pilot, a rigorous 10-year evaluation plan was developed, with funding from the National Institutes of Mental Health. In 1995, after only 7 years, the evaluation was discontinued early, in part because of positive findings. At that time, the programs were left under the oversight of the ABPN and the ABP, although each training component program was required to be accredited by the ACGME. 4 An editorial published by Dr Schowalter 4 at the time highlighted positive outcomes of the training programs at the resident level, faculty collaboration level, and national organization level but also recognized the biases among non–triple board–involved faculty, who regularly advised medical students not to participate in the program. 4 Publisher Copyright: {\textcopyright} 2017 Elsevier Inc. Copyright: Copyright 2018 Elsevier B.V., All rights reserved.",
year = "2017",
month = oct,
doi = "10.1016/j.chc.2017.06.007",
language = "English (US)",
volume = "26",
pages = "689--702",
journal = "Child and Adolescent Psychiatric Clinics of North America",
issn = "1056-4993",
publisher = "W.B. Saunders Ltd",
number = "4",
}
