An Overview of Combined Training Program in Internal Medicine and Psychiatry at Duke

The Departments of Internal Medicine and Psychiatry offer a five-year combined training program, which is approved by both the American Board of Internal Medicine and the American Board of Psychiatry and Neurology. The goal of the program is to provide comprehensive training in the care of patients with medical and psychiatric problems. The integration of these two nationally recognized residency training programs has evolved over the years into a unique and multifaceted graduate medical education experience. At the end of residency, graduates will be eligible for board certification in both internal medicine and psychiatry.

Philosophy/Goals: Our Combined-Training program in Internal Medicine and Psychiatry was founded in 1992 after identifying a need for physicians with expertise in both areas. While the fields of internal medicine and psychiatry have been traditionally viewed as separate disciplines, we believe that knowledge in both areas is essential for addressing the needs of patients within a biopsychosocial model of care. The goal of the Program is to provide an environment in which the attainment of knowledge and competency in both fields is fostered and encouraged. Excellence in training, in care, and in research make Duke University Medical
Center and the Combined-Training Program in Internal Medicine and Psychiatry one of the finest in the country.

A Summary of the Duke Combined Internal Medicine and Psychiatry Residency Training Program

Residents in the combined training program at Duke spend five years total in graduate medical education activities, divided between Internal Medicine (total 30 months) and Psychiatry (total 30 months).

Med/Psych residents face the same requirements as residents in Internal Medicine and perform 12 months of intern-level Internal Medicine rotations followed by 18 months of upper level Internal Medicine resident rotations. Experiences include medical and cardiac intensive care, general medical wards, subspecialty care, emergency care, ambulatory care, and elective rotations. The residents participate in continuity clinics in Internal Medicine throughout all five years of training. Residents in the combined program frequently experience fewer elective rotations than residents in the categorical Medicine program, although they are given the opportunity to participate in the same electives as categorical Medicine residents and are considered for International Health rotations, the course in Clinical Epidemiology, and subspecialty electives that are available to categorical residents.

Residents in this program spend 30 months of their training in the department of Psychiatry and Behavioral Sciences. Residents rotate through inpatient psychiatry ward, psychiatry consultation-liaison, emergency department psychiatry service, have a weekly continuity clinic at the Duke Psychiatry Outpatient Clinic, and provide couples and family counseling in a supervised setting at the Duke Center for Child and Family Studies. Residents gain experience in substance abuse treatment and have the opportunity to rotate through a nationally recognized inpatient substance abuse treatment center, Fellowship Hall, as well as the Durham VA substance abuse clinic, and the Triangle Residential Options for Substance Abuse in Durham, NC. They also rotate through the Duke Eating Disorders Clinic and the geropsychiatry service. Residents are provided opportunities to complete child and adolescent psychiatry electives, as well as community psychiatry electives at Durham, Wake, and other county mental health centers. In addition, residents are able to learn and become certified in the administration of electroconvulsive therapy in the world-renowned Duke ECT Program, are exposed to a wide array of psychiatry electives, including pain clinic, neurology clinic, psychotherapy electives, palliative care electives, neurobiology course, psychodynamic theory seminar, and an abundance of research opportunities, among others.