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 medicine and psychiatry run throughout each year of the residency program, and psychiatry continuity clinic starts in the third year of the 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 medicine 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, spending 8 months in medicine and 4 months 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 evidence-based medicine that occurs during medicine training.
| PGY-3 | |
|---|---|
| General Medicine | 4 weeks |
| Ambulatory Medicine | 10 weeks |
| Subspecialty Medicine Consult Services | 12 weeks |
| Medicine Night Float | 4 weeks |
| Inpatient MedPsych Service | 4 weeks |
| Psychiatry Consultation-Liaison Service | 4 weeks |
| Child Psychiatry Consultation | 4 weeks |
| State Psychiatric Hospital Adult Unit | 4 weeks |
| Emergency Psychiatry | 4 weeks |
PGY 4
This year is comprised of 10 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* | 10 months |
| 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