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Training and Curriculum

Overview

The goal of the Pediatric Child Abuse and Neglect Training Program is the consummate preparation of physicians as Child Abuse and Neglect Specialists. The Fellowship Training Program meets this goal by building on the established tradition of excellence while developing new ideas in the following areas: mentorship/professional development, fellowship balance, education, patient care, and research.

Child Abuse Pediatrics is currently recognized by the American Board of Pediatrics as an official subspecialty of pediatrics. Physicians who successfully complete a three year ACGME fellowship in Child Abuse are eligible to take the Child Abuse Boards. The Duke Department of Pediatrics has an ACGME-accredited fellowship in Child Abuse Pediatrics as of October 2013. 

Inpatient Clinical Training

The Child Abuse and Neglect fellowship includes direct clinical training in both inpatient and outpatient settings. For inpatient clinical training, the fellow rotates on the on-call schedule for the Inpatient/ER Child Abuse and Neglect Consult Service. While on call, the fellow works with the Inpatient/ER Child Abuse and Neglect Consult Service performing inpatient consults when there are concerns of abuse/neglect for children admitted to Duke University Hospital or seen in the Emergency Room. Training and supervision for the fellow during inpatient child abuse/neglect consult work is with one of the three Child Abuse and Neglect attending physicians, all of whom are board certified in Child Abuse Pediatrics.

Outpatient Clinical Training

In addition, the fellow maintains an outpatient clinic schedule for follow-up of inpatient and ER cases, as well as for evaluation of cases of sexual and physical abuse referred by community medical providers and local child protective services and law enforcement agencies. Outpatient clinics operate through the Child Abuse and Neglect Medical Evaluation Team at the Duke Children’s Primary Care Clinic location. This site allows for collaboration with primary care, mental health, social work, radiology and lab services. Child interviews are conducted by one of two highly qualified licensed clinical social workers. Fellows receive training in these interviews from the clinic social worker and Child Abuse attending, utilizing videotaped recordings and feedback. The fellow is also an active participant in the Duke Foster Care Clinic as part of an ongoing Duke-Community Foster Care Collaborative to provide and assess quality of services offered to children in foster care in Durham and surrounding counties.   

Community Partners

The Duke Child Abuse and Neglect team works closely with our community partners in caring for children. Community partners include the Department of Social Services, law enforcement agencies, the Guardian ad Litem (GAL) Program, the NC Health Department, and the Center for Child and Family Health-NC (CCFH-NC). The CCFH-NC is an independent center that provides mental health services, family support services and legal advisory services for children who have experienced trauma, abuse or neglect and their families. The fellow will work closely with these community partners attending multidisciplinary community meetings and multidisciplinary medical reviews.

Electives and Rotations

Electives and rotations for specified training for the fellow have been established at Duke University Hospital, UNC-CH Hospital and within the Durham community. Below is a list of current available electives. Additional electives are available based upon the fellow’s interest.

  • Rotations in pediatric radiology, neuro-radiology and adolescent medicine are scheduled at Duke University Medical Center.
  • A rotation in diagnostic child interviewing is scheduled with CANMEC’s licensed clinical social worker who is nationally recognized for excellence in interviewing children.
  • A longitudinal rotation is scheduled in the Duke Foster Care Clinic.
  • A rotation in mental health/psychiatry is scheduled at the Duke Clinical Evaluation Center.
  • A rotation at the UNC-CH Burn Center is scheduled at UNC-CH Hospital.
  • Durham community rotations include Durham County Child Protective Services, Durham County Guardian ad Litem, and the North Carolina Office of the Chief Medical Examiner.
  • There is also an opportunity to obtain a Master's of Public Health at the UNC-CH School of Public Health.

Scholarship Project

Development and completion of original scholarship is a fellowship requirement. Scholarship projects should be designed to be completed within the three-year fellowship period. Examples of prior projects include: developing a data base for child fatalities in North Carolina, developing a system-wide first-responder protocol in North Carolina for child fatality cases, assessment of the quality and effectiveness of residency training in Child Abuse and Neglect in the United States, and conducting a comprehensive multi-institutional quality improvement initiative regarding foster care. Fellows have access to nationally recognized researchers in a variety of fields, including head trauma, mental health, medical education, prevention, public policy, sexual assault/abuse, foster care and more. Fellows will acquire skills in research, evidence-based medicine, quality improvement, and teaching through the Duke Fellows Core Curriculum, which promotes interaction with other pediatric fellows at Duke.