Mastering Pediatrics-Psychiatry Residency: A Comprehensive Research Guide

Understanding the Landscape: What Makes Pediatrics-Psychiatry Unique?

Before you can design a strong program research strategy, you need a clear mental model of what “peds psych residency” actually means and how it differs from other pathways. Pediatrics-Psychiatry is a highly specialized training route that prepares you to care for children and adolescents with complex medical and psychiatric needs across settings.

There are two primary types of relevant training pathways:

1. Formal Triple Board Programs (Pediatrics–General Psychiatry–Child & Adolescent Psychiatry)
   These ACGME-accredited programs (commonly called “triple board”) are typically 5-year integrated residencies that combine:

   • Pediatrics (categorical pediatric training)
   • Adult psychiatry
   • Child and adolescent psychiatry

   Graduates are board-eligible in three specialties:

   • Pediatrics
   • General Psychiatry
   • Child & Adolescent Psychiatry

2. Alternative Pathways with a Peds–Psych Focus
   Not all peds psych–interested applicants go through triple board. Other options include:

   • Categorical pediatrics residency followed by:
     • Child & adolescent psychiatry fellowship for pediatricians (rarer, often research/consult-focused roles), or
     • Behavioral pediatrics, developmental-behavioral pediatrics, or related subspecialties
   • General psychiatry residency followed by:
     • Child & adolescent psychiatry fellowship, with clinical emphasis on medically complex youth
   • Combined pediatrics–child psychiatry tracks offered internally by some institutions (e.g., pediatrics residency with a protected pathway for child psych fellowship)

For this article, we’ll focus primarily on how to research residency programs in the triple board and peds psych–oriented spaces. The same framework, however, can be adapted to related pathways.

Why Thorough Program Research Matters More in Peds-Psych

Peds psych is relatively small, and program structures vary widely. Two triple board programs may have the same length but dramatically different:

• Rotations and curriculum design
• Patient populations and clinical settings
• Culture around wellness and workload
• Opportunities in advocacy, research, and integrated care
• Post-residency career trajectories of graduates

Because of this variability, your ability to evaluate residency programs thoughtfully will have a major impact on both your training experience and your long-term career.

In other words: in peds-psych, “any triple board program is fine” is simply not true. The better your program research strategy, the more likely you’ll end up somewhere that truly fits your clinical interests, learning style, and life priorities.

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Step 1: Clarify Your Goals and Deal-Breakers Before You Start

Good program research starts before you open a single residency website. You need to know what questions you’re trying to answer.

Define Your Career Vision (Even If It’s Fuzzy)

You do not need a fully formed 10-year plan, but you should have a working hypothesis about where you’re headed. Ask yourself:

• Do I see myself primarily as:

  • A consult-liaison psychiatrist bridging pediatrics and psych?
  • A primary pediatrician with strong behavioral and mental health expertise?
  • A child & adolescent psychiatrist who deeply understands medical comorbidities?
  • An academic clinician–educator?
  • A researcher in child mental health, neurodevelopment, or integrated care?
  • An advocate or policy leader in youth mental health?

• What patient populations most energize me?

  • Neurodevelopmental disorders (ASD, ADHD, intellectual disability)
  • Medically complex children (oncology, cardiology, chronic illnesses)
  • Eating disorders
  • Early-onset psychosis, mood disorders
  • Trauma and child welfare–involved youth

• Where do I imagine practicing?

  • Academic medical center
  • Children’s hospital
  • Community mental health
  • Integrated primary care
  • Rural or underserved settings

Even preliminary answers help you prioritize programs whose strengths match your direction.

Identify Personal and Practical Constraints

Your program research strategy must balance ambition with real-life constraints. Consider:

• Geography

  • Regions you prefer or must avoid (family, finances, visas, partner’s job)
  • Willingness to live in urban vs suburban vs smaller cities

• Personal Life Factors

  • Partner or spouse career needs
  • Children or caregiving responsibilities
  • Need for specific medical care or support systems

• Training Environment

  • Size of program (small, intimate vs large, diverse)
  • Culture (collaborative vs competitive; formal vs laid-back)
  • Diversity and inclusion climate

Write down:

• 3–5 must-haves
• 3–5 deal-breakers
• 3–5 “nice-to-haves”

These will guide how you filter and compare programs later.

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Step 2: Build Your Long List – A Systematic Program Research Strategy

Once you know your priorities, you can start identifying which programs might fit.

Start with Official Listings and Match Data

For triple board and peds psych–relevant programs:

1. ACGME / ERAS Listings
   Search using:

   • Combined Pediatrics–Psychiatry–Child & Adolescent Psychiatry
   • Categorical Pediatrics programs with behavioral/developmental tracks
   • General Psychiatry programs with strong child & adolescent divisions

2. Specialty Organization Websites

   • American Academy of Pediatrics (AAP)
   • American Academy of Child & Adolescent Psychiatry (AACAP)
   • American Psychiatric Association (APA)
     These often list combined, innovative, or integrated training programs.

3. NRMP and FREIDA

   • FREIDA (AMA) lets you filter for combined and pediatric-linked psychiatry training.
   • NRMP data can show:
     • Historical positions offered
     • Fill rates
     • Program size and trends

Record programs in a tracking spreadsheet with columns for:

• Program name
• City/state
• Type (Triple Board, Peds with psych emphasis, Psych with strong child focus)
• Program director
• Contact email
• Website URL
• Number of residents per year
• Initial “fit” score (subjective; 1–5)

This becomes your working program research dashboard.

Mine Residency Websites Strategically

When you visit each program’s website, don’t just browse—extract data consistently. For each program, look for:

Structure & Curriculum

• How is the 5-year (or combined) curriculum laid out?
• Sequence of:
  • Pediatrics rotations
  • Adult psychiatry
  • Child & adolescent psychiatry
• Exposure to:
  • Inpatient pediatrics
  • NICU/PICU
  • Outpatient continuity clinics
  • Inpatient psychiatry
  • Emergency psychiatry
  • Child psych consult-liaison services
• Any unique rotations:
  • Integrated behavioral pediatrics clinics
  • Specialty clinics (ASD, eating disorders, gender clinic, IDD, chronic pain)

Clinical Volume and Settings

• Children’s hospital vs general hospital
• Outpatient/community sites
• Rural or underserved clinical experiences

Faculty and Leadership

• Program director background (peds vs psych vs triple board)
• Core faculty with dual or cross-department appointments
• Faculty with visible roles in:
  • AAP, AACAP, APA
  • Research networks
  • National guidelines or policy work

Educational and Scholarly Opportunities

• Protected research time
• Required scholarly project(s)
• Tracks or focus areas:
  • Global health
  • Health equity
  • Quality improvement
  • Medical education
• Conferences residents attend or present at

Culture and Support

• Resident wellness initiatives
• Call schedules and changes over time
• Mentorship structures (formal vs informal)
• Diversity, equity, inclusion (DEI) efforts and demographics
• Parental leave and part-time options (if applicable)

Record brief notes for each category in your spreadsheet. Over time, you’ll see patterns that help in evaluating residency programs at a glance.

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Step 3: Deep-Dive Evaluation – How to Compare Peds-Psych and Triple Board Programs

Once you’ve built your long list and gathered basic data, move into comparative evaluation. This is where you distinguish “good on paper” from “actually right for me.”

Curriculum Fit: Does the Training Match Your Future Practice?

For peds psych and triple board, curriculum design is critical. Ask:

1. Balance of Pediatrics vs Psychiatry

   • Do you want to be more pediatric-heavy or psychiatry-heavy in your identity?
   • How many months of:
     • Inpatient pediatrics
     • Pediatric emergency
     • NICU/PICU
     • Adult inpatient psychiatry
     • Inpatient child psychiatry
       are built into the program?

2. Continuity Over Time

   • Are there continuity clinics that bridge pediatrics and psychiatry?
   • Do you see the same patients longitudinally, or is the training highly fragmented?

3. Integration vs Parallel Tracks

   • Does the program intentionally integrate pediatrics and psychiatry (joint conferences, co-supervised clinics, shared projects)?
   • Or is it more like doing “some pediatrics years, then some psychiatry years” with less connection?

If your goal is true peds-psych integration, prioritize programs that:

• Have combined clinics (e.g., pediatric primary care with embedded psych)
• Encourage or require cross-disciplinary teaching
• Discuss “triple board identity” explicitly on their website and during interviews

Clinical Breadth and Depth: What Will You Really See?

To practice effectively at the intersection of pediatrics and psychiatry, you need robust exposure to:

• Common pediatric conditions (as a pediatrician)
• Severe mental illness in adolescents
• Neurodevelopmental disorders
• Medically complex and technology-dependent children
• Trauma, abuse, and child welfare issues
• Emergency presentations (suicidality, agitation, delirium)

Look for:

• Children’s hospital volume and reputation
• Child psych bed capacity and service lines
• Access to specialty clinics (ASD, eating disorders, early psychosis)
• Strength of consult-liaison services (both psych-on-peds and peds-on-psych)

Programs that frequently mention:

• Multidisciplinary teams
• Integrated behavioral health
• Pediatric subspecialty collaborations
  are often stronger for a future peds psych clinician.

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Step 4: Assess Culture, Mentorship, and Career Outcomes

Numbers and structures matter, but culture and outcomes often determine how satisfied you’ll be.

Culture: How Does the Program Feel?

Because triple board cohorts are small (often 2–4 residents per year or fewer), you need to be comfortable with:

• Close, longitudinal working relationships
• Being “known” by faculty and co-residents
• Navigating two or three departments (peds, adult psych, child psych)

When evaluating residency programs for culture, look for:

• Videos or resident testimonials on the website
• Evidence of collaboration between departments (joint events, retreats)
• Clear, transparent policies around:
  • Duty hours
  • Wellness days
  • Conflict resolution

During interviews and open houses (virtual or in-person), ask:

• “How do peds and psych departments collaborate around triple board residents?”
• “How are triple board residents perceived by categorical peds and psych residents?”
• “What changes have residents asked for in the last 2–3 years, and what has actually changed?”

Red flags:

• Vague answers about culture
• Tension or silos between departments
• Residents appearing overly guarded or rehearsed

Mentorship Structure: Who Will Guide You?

Because peds psych training spans multiple disciplines, you’ll need multiple mentors, for example:

• A pediatrician deeply engaged in behavioral or developmental pediatrics
• A child psychiatrist skilled in integrated or collaborative care
• Possibly a researcher or educator in your area of interest

When researching programs, look for:

• Formal mentorship or advisory systems
• Dedicated triple board program directors or associate directors
• Faculty profiles that show clear interest in:
  • Consult-liaison work
  • Integrated behavioral health
  • Neurodevelopmental or psychosomatic medicine

Action tip: As you research faculty, jot down 1–2 people per program who might be good mentors and why. This helps you later formulate program-specific questions and, if you match there, identify early contacts.

Career Outcomes: Where Do Graduates Go?

Perhaps the single most powerful way to evaluate residency programs is by looking at graduate trajectories:

• Do they:
  • Work as triple-boarded clinicians in academic centers?
  • Lead integrated care programs?
  • Enter research careers?
  • Join community mental health or hospital-based consult teams?

On program websites, look for:

• Alumni pages or “where our graduates are now”
• Mention of graduates in leadership roles
• Listed fellowships that grads have pursued (even beyond child psych)

If your goal is:

• Academic research → Prioritize programs with NIH-funded faculty, clear research pathways, and graduates in academic positions
• Clinical leadership in integrated care → Look for robust consult-liaison experiences and alumni running such services
• Community-focused practice → Programs with strong community hospital or public sector experiences may be stronger fits

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Step 5: Use People and Networks – The Human Side of Program Research

Online materials can only tell you so much. To truly understand a peds psych residency, you need conversations.

Leverage Home Institution and Local Mentors

Start by identifying:

• Child & adolescent psychiatrists
• Pediatricians with behavioral or developmental focus
• Any triple board–trained faculty or alumni (even if they trained elsewhere)

Ask them:

• “Which triple board or peds psych programs do you consider particularly strong, and why?”
• “Are there programs you’d recommend I pay special attention to?”
• “Do you know anyone in leadership or training roles at these programs?”

Mentors often have informal insights about:

• Program reputations
• Changes in leadership
• Hidden strengths or weaknesses
• Recent culture shifts

If they have contacts, ask whether they’d be comfortable sending an introductory email on your behalf.

Connect with Current Residents and Recent Graduates

Talking to current triple board or peds psych–oriented residents is invaluable. Ways to connect:

• Program-sponsored Q&A sessions or open houses
• Alumni from your medical school now in peds psych
• Social media (Twitter/X, LinkedIn, specialty Facebook groups, interest groups in AAP/AACAP)

When you get time with a resident, go beyond superficial questions. Ask:

• “What surprised you most about this program—good and bad?”
• “How does the program respond when residents give feedback?”
• “How are triple board residents integrated with categorical co-residents?”
• “What kind of graduates does this program tend to produce?”
• “If you could change one thing about the program, what would it be?”

Take notes immediately after each conversation. You’ll start to see themes that guide your ranking decisions.

Attend Specialty Meetings and Student Interest Groups

Peds psych and triple board often have a strong presence at:

• AAP Section on Developmental and Behavioral Pediatrics or related groups
• AACAP annual meetings
• Local/state pediatric and psychiatry society meetings

Look for:

• Student or trainee sessions
• Panels featuring triple board residents or faculty
• Networking events

A brief, thoughtful conversation at a conference can give you depth of insight that no website can match.

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Step 6: Organize, Synthesize, and Decide Where to Apply

By now, you’ll likely have more information than your brain can comfortably hold. The last step is to systematize your decision-making.

Build a Comparison Framework

From your earlier must-haves and priorities, create a simple scoring rubric. Example categories:

1. Curriculum Fit (0–5)

   • Integration of peds and psych
   • Alignment with your clinical interests

2. Clinical Opportunities (0–5)

   • Children’s hospital strength
   • Variety and complexity of cases
   • Access to specialty clinics

3. Mentorship and Faculty (0–5)

   • Availability of mentors in your area of interest
   • Faculty engagement and accessibility

4. Culture and Support (0–5)

   • Resident satisfaction (from conversations)
   • Wellness practices
   • Departmental collaboration

5. Scholarly and Career Development (0–5)

   • Research or QI support
   • Graduate outcomes in roles you find appealing

6. Personal/Geographic Fit (0–5)

   • Location, cost of living
   • Family or partner considerations

Give each program a score in each category plus a short narrative comment (2–3 sentences describing your overall impression). The numeric scores won’t make the decision for you, but they help highlight patterns and surface outliers.

Decide on Application Strategy

Triple board programs are few and competitive. Many applicants interested in peds psych also hedge with:

• Categorical pediatrics applications
• General psychiatry applications
• Child psych–friendly programs with strong peds connections

Questions to ask yourself:

• Am I triple-board-or-bust, or do I see multiple viable paths to my career goals?
• How geographically flexible am I?
• Do I want to over-apply for security or target selectively?

A common program research strategy is:

• Apply to most or all triple board programs (given the small number)
• Add a curated set of:
  • Peds programs with strong behavioral/mental health emphasis
  • Psychiatry programs with very strong child/adolescent divisions

This ensures you have multiple training routes to end up in peds psych–adjacent practice, even if you don’t match into a triple board slot.

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Frequently Asked Questions

How many triple board programs are there, and do I need to apply to all of them?

The exact number fluctuates slightly year to year, but there are relatively few triple board programs in the U.S. Compared with categorical pediatrics or psychiatry, the field is small. Most applicants serious about a peds psych residency via triple board apply to all or nearly all active programs to maximize interview opportunities.

However, if there are clear deal-breakers (location, culture, or fit), it’s reasonable to skip those. Use your earlier research to decide which truly cannot work for you.

How is researching triple board programs different from researching regular pediatrics or psychiatry programs?

The main difference is that triple board requires you to think about three identities at once: pediatrician, adult psychiatrist, and child psychiatrist. When evaluating residency programs, you must assess:

• The quality and culture of each department (peds, psych, child psych)
• How well they collaborate and integrate
• Whether the program supports a cohesive identity, not just three parallel mini-residencies

In traditional peds or psych, you usually only evaluate one department; here, your research must be three-dimensional.

What if my school doesn’t have child psychiatry or triple board mentors?

You can still build a strong program research strategy by:

• Reaching out to faculty at other institutions (especially those who publish or present in peds psych areas)
• Attending virtual interest group meetings (AAP, AACAP, APA often have trainee events)
• Contacting triple board program coordinators and asking if they can connect you with a current resident for an informational chat
• Using alumni networks (school, regional) to find graduates now training in triple board or child psych

Most people in peds psych are enthusiastic about mentoring learners; a polite, concise email often opens doors.

Should I prioritize prestige or “fit” when choosing peds psych programs?

Fit generally matters more in peds psych than raw prestige. A program with a famous name but:

• Poor integration between peds and psych
• Weak mentorship in your area of interest
• A culture that doesn’t align with your values

may be less beneficial than a slightly less “prestigious” program that:

• Strongly supports triple board residents
• Has longitudinal, integrated clinics
• Produces graduates who do exactly the type of work you hope to do

Use prestige as one data point, but let your curriculum fit, culture, mentorship, and graduate outcomes carry more weight in your final decisions.

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By approaching your search with a deliberate, structured program research strategy—clarifying your goals, gathering comparable data, talking with real people, and systematically evaluating residency programs—you’ll be far better positioned to find a peds psych residency or triple board program that truly supports the kind of physician you want to become.