I first heard about the Triple Board program at the end of my third year of medical school when I was trying to decide between pediatrics and psychiatry. In college, I volunteered on a psychiatric inpatient unit and really enjoyed working with people with severe and persistent mental illness. I also recognized that the lifestyle which accompanies psychiatry would be more enjoyable for me than the time-intensive demands of primary care, with which I was quite familiar. However, as the daughter of two physicians, I felt the need to have a solid foundation in a more medically-oriented specialty. I also really enjoyed my 3rd year pediatric clerkship, particularly the focus on the family environment and prevention.

At the time I entered the Triple Board program, I did not know exactly what I would do with my training. This understanding developed during the course of my residency. After shifting between pediatric and psychiatry rotations a few times, the gaps between the two became apparent. Consult-liaison psychiatry was appealing because it offered an opportunity to bridge the gap between the two fields in patient care and professional communication. Near the end of my training, I became interested in the psychiatric care of physically ill children and incorporated a pediatric diabetes clinic into my 5th year residency schedule. I subsequently presented a grand rounds on the use of Motivational Interviewing to improve treatment adherence in youth with diabetes. Following graduation, I joined the faculty at the University of Utah and completed a year's training in the ULEND program (Utah Leadership Education in Neurodevelopmental Disablities). Currently, I work in a medical home clinic that serves children, adolescents, and adults with neurodevelopmental disabilities and co-morbid psychiatric disorders. In this setting, patients receive both their primary medical care and behavioral health care. Many of these patients have a history of prematurity, genetic disorders, and neurologic disorders that impact behavior and functioning. This offers an opportunity to utilize my training in pediatrics and psychiatry.

Deborah Bilder, M.D.