Program Overview

The program has been in existence since 1992; its goal is to provide comprehensive training in both medicine and psychiatry. The integration of these two nationally recognized residency training programs has evolved over the years into a unique and multifaceted graduate medical education experience.  After completion of the residency program, graduates will be eligible for board certification in both disciplines.  The training is spread over five years with equal time devoted to medicine and psychiatry.

Internal medicine and psychiatry rotations take place at Duke University Medical Center and the Durham Veterans Administration Hospital with opportunities to rotate on internal medicine services at Durham Regional Hospital.  Inpatient psychiatry training also occurs at Central Regional Hospital, one of the state psychiatric facilities.

Cohesion between the disciplines is accomplished through didactics, case conferences, and journal article discussions which take place weekly.  The weekly MedPsych conference emphasizes issues at the interface of both fields and provides dedicated time for faculty and residents to get together.  Separate, weekly continuity clinics in both medicine and psychiatry run throughout each year of the residency program.

The combined program takes the best of the two excellent categorical programs and combines them into a rewarding training experience.  Please visit the Internal Medicine Residency page and the General Psychiatry Training Program's page to get a better idea of the similarities and differences between these programs and the MedPsych program. 

Rotation Schedule

Rotations listed below indicate the total amount of time in the year, they may be scheduled for 2 to 4 weeks duration at a time.  All rotations are at Duke Hospital or the Durham VAMC, unless otherwise specified.

PGY 1 – Intern Year

This year is comprised mostly of rotations in internal medicine.  The internal medicine internship is completed after this year.  Continuity clinic in medicine is throughout the year.

PGY-1  
General Medicine Wards 8 weeks
Subspecialty Medicine Wards 
(Hematology-Oncology, Cardiology)
8 weeks
Cardiac Critical Care 4 weeks
Ambulatory Medicine 8 weeks
Geriatrics 4 weeks
Inpatient Neurology 4 weeks
Inpatient MedPsych Service 4 weeks
Inpatient Psychiatry 4 weeks
Psychiatry Emergency Clinic 4 weeks

PGY 2

During this year, trainees complete second-year rotations in medicine and are Junior Assistant Residents in medicine.  They complete a combination of first and second-year rotations in psychiatry. Trainees rotate between the two departments every 3-4 months.  Continuity clinic in each specialty is throughout the year.

PGY-2  
General Medicine Wards 4 weeks
Ambulatory Medicine 4 weeks
Medical ICU 6 weeks
Emergency Medicine 4 weeks
MedPsych Service 2 weeks
Subspecialty Medicine Consults 4 weeks
Inpatient Psychiatry 4 weeks
State Psychiatric Hospital Adult Unit 8 weeks
State Psychiatric Hospital Geriatric Unit 4 weeks
Psychiatry Emergency Services 4 weeks
Psychiatry Consultation-Liason Service 4 weeks

PGY 3

During this year, trainees complete all second-year rotations in medicine and in psychiatry.  Trainees rotate between the two departments every 3-4 months.  Continuity clinic in each specialty is throughout the year.  Trainees may apply for a one month elective in study design and evidenced-based medicine that occurs during medicine training.

PGY-3  
General Medicine 8 weeks
Ambulatory Medicine 8 weeks
Subspecialty Medicine Consult Services 8 weeks
Inpatient MedPsych Service 4 weeks
Psychiatry Consultation-Liason Service 8 weeks
Child Psychiatry Consultation 4 weeks
Outpatient Psychiatry Elective 8 weeks

PGY 4

This year is comprised of 8 months of continuous training in outpatient psychiatry, with a focus on core psychotherapy skills.  Trainees begin their senior year in medicine in the spring and complete 4 months of medicine block rotations.

PGY-4  
Outpatient Psychiatry* 8 months
General Medicine 4 weeks
Cardiac Critical Care of Medical Critical Care 4 weeks
Medicine-Psychiatry Service 4 weeks
Ambulatory Medicine 4 weeks

*Includes general clinics at Duke and Durham VA, CBT or related therapies, Child and Family Studies, substance use disorders clinic

PGY 5

Trainees complete 6 contiguous months of outpatient psychiatry and then 6 months of medicine.  Trainees often spend time in leadership positions, such as Assistant Chief Resident in Medicine or Chief Resident in Medicine-Psychiatry.  Trainees may apply for 2-3 month experience in Global Health in medicine.  Dedicated research time is also a possibility.

PGY-5  
Outpatient Psychiatry* 6 months
General Medicine 4 weeks
Medicine-Psychiatry Service 4 weeks
Ambulatory Medicine 8 weeks

*Includes general clinics and electives, including:  Electroconvulsive therapy, Psycho-oncology, Neurology, Collaborative Care, Pain medicine, Sleep medicine, Transplant Psychiatry, Community psychiatry