Combined Medicine and Psychiatry Training: It’s a Thing

med-psych

Most people asking what discipline I was pursuing during my fourth year of medical school were hearing “Med-Psych” for the first time. It wasn’t the best advertised of the 12 combined training residencies approved by the American Board of Internal Medicine (ABIM). So I’d reply, “Yeah, it’s like Med-Peds, but Med-Psych.” We clearly needed to fire John down in promotions.

The Accreditation Council for Graduate Medical Education (ACGME) approves numerous combined residency programs, including a few that combine psychiatry with various disciplines: family medicine, neurology, and a triple-certified program combining pediatrics, psychiatry, and child psychiatry. Psychiatry and internal medicine may seem like a counterintuitive combination. One involves the diagnosis and treatment of neuropsychiatric illnesses that hamper subjective measures of social and personal function, with mostly unidentified disease mechanisms. The other addresses diseases within the body that exhibit measurable and somewhat predictable effects on physiology and lifespan, with comparatively well understood disease mechanisms. Yet psychiatrists and internists rely heavily on each other in the field.

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Entering Third Year With An Open Mind

surgical specialties

By Adelle, Medical Student

I went into my third year with a somewhat open mind in terms of what I thought I liked and what I thought I wanted to do for the next 35 years or so of my life. Internal medicine interested me because you had to know so much about, well, so much. I felt like my brain was getting bigger every day I was on my internal medicine rotation—there was just so much to know! The number of patients you can see is also fairly high on a typical internal medicine service. On the other hand, I had completely discounted general surgery—I was never very interested in anatomy class and didn’t particularly enjoy teasing apart membranes from fascia from blood vessels and nerves. The thought of doing that for the rest of my life didn’t sit well with me. But, nevertheless, I went in with an open mind.

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Q&A with Dr. Knut Schroeder, General Practitioner

Dr. Knut Schroeder is a practicing  GP in Bristol, UK; a freelance medical author, and founder and director of Expert Self Care Ltd, a social enterprise which freely provides healthcare information via mobile apps. The company’s mission is to empower people to look after their own health and to know when to seek help. The ‘ESC Student’ app, which went live in June 2016, has been recommended by the Higher Education Policy Institute for use at all higher educational institutions.

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20 Clinical Practice Guidelines That Medical Students Should Know

Clinical practice guidelines are the backbone of evidence-based medicine. While there are literally thousands of published guidelines, a few of them are particularly relevant to medical students. SDN Partner Guideline Central is offering free access to the top 20 clinical practice guidelines for all SDN members! 

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Internal Medicine: The "Classic" Physician

By Brent Schnipke

If the average reader is asked to imagine a typical medical student, he or she might picture the following scene: a group of frazzled young people in short white coats, scurrying around the wards of a large academic medical center. They travel in hordes, flocking to the nearest attending, who calmly asks them asinine questions and then chides them for their lack of knowledge. This scene is stereotypical of an often-stereotyped field, and might be something one would see in a caricature of the hospital – on a show such as Grey’s Anatomy or Scrubs. Although this is only one example of what medical education can look like, it is helpful for giving a simplified look at the life of a third-year medical student in the throes of clinical rotations.

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Why Med-Peds? A Current Resident’s Perspective

med-peds residents

The transition from eager-to-learn-everything MS3 to self-assured MS4 with a clear residency goal comes much easier for some than others. I had planned on going into Family Medicine throughout the better part of medical school, but late in third year discovered the combined specialty Internal Medicine and Pediatrics (Med-Peds). How was I supposed to explain my interest in this four year program to my friends, mentors and, toughest yet, medicine department chair when I was just beginning to understand it myself? And then the inevitable follow-up question, why not just complete the three year Family Medicine (FM) residency program? FM training remains the perfect choice for many students looking to get broad-based, comprehensive training on how to care for people of all ages. The purpose of this article is to point out the subtle differences between these residency paths and give my top five reasons for why Med-Peds (MP) is a unique, exciting and attractive residency option for about 400 budding young doctors every year.

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Effects of Climate Change on Human Health–And Why Student Doctors Should Care

When most student doctors take a moment from their busy schedules to think about climate change, what probably comes to mind is rising ocean levels or melting polar ice caps. What many do not think about, even in the medical profession, is the effect that climate change potentially has on human health. As many of the foremost meteorological institutions predict that the climate is only destined to become warmer in coming decades, these health effects will very likely affect doctors going into practice in the near future.
This article will take a look at several of the categories of health problems that are more vulnerable to climate change – and that could have a big impact on physicians now going into practice.
Respiratory Diseases
One of the areas in which doctors will likely feel the impact of climate change is that of respiratory diseases, particularly allergies and asthma. According to the National Institute of Environmental Health Sciences (NIEHS), this impact will happen for a number of reasons. Firstly, increases in ground-level ozone levels can trigger respiratory symptoms like inflammation of the lungs, causing a decrease in lung function and other symptoms like chest pains, coughing and congestion. Increased temperatures and carbon dioxide will also increase levels of allergens such as pollen and mold spore counts, making it more difficult for sensitive people to cope.

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20 Questions: Terry L. Wahls, MD – Internal Medicine

Terry Wahls, MD, is a clinical professor of medicine at the University of Iowa, where she teaches internal medicine residents, sees patients in the traumatic brain injury clinic and conducts clinical trials. In addition, she’s director of the Extended Care and Rehab Service Line at the Veteran Affairs Iowa City Health Care System. She received a bachelor’s degree in fine arts from Drake University in Des Moines (1976), a Doctor of Medicine from University of Iowa in Iowa City (1982), and an MBA from University of St. Thomas in Minneapolis (2001). Dr. Wahls completed a residency in obstetrics and gynecology at Barnes Hospital, Washington University in St. Louis, as well as a residency in internal medicine at University of Iowa Hospitals & Clinics.

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The Med-Peds Residency: Big and Small, We Care for Them All

med-peds

As third year medical students you’re rotating through your general specialties and you think you’re seeing familiar faces but in new places. Isn’t that your newborn nursery resident who assigned APGAR scores, now leading the code in the medical ICU? Some of you may have had similar déjà vu experiences but rest assured, your mind isn’t fooling you. At 79 programs across the USA and Puerto Rico, Combined Internal Medicine and Pediatric residents walk (briskly) through the halls of the hospital carrying both PALS and ACLS cards in our coat pockets. Our minds have been shaped to think broadly and decisively. We carry an air of calmness from our critical care rotations yet we know when to appropriately turn to our goofy side to connect with our patients. Through four years of versatile training, we are training to be the 21st century physician.

The Combined Internal Medicine-Pediatrics (commonly referred to as “Med-Peds”) is a four-year residency-training program that leads to dual board certification in Internal Medicine and Pediatrics. While there are many combined training programs offered in the US, the Med-Peds residency is by far the most ubiquitous and popular program available. During the four years of training, residents undergo a rigorous schedule of rotations ranging from adult and pediatric wards, MICU, PICU, NICU, CCU, Med-Peds clinic and specialty electives. By graduation, residents will have completed a total of 2 years of adult and 2 years of pediatric training. The frequency at which residents switch from one “side” to another changes depending on the individual residency program. The end product is the same: Individuals who are prepared to deal with acute, complex, chronic and preventive care for both adult and pediatric medical conditions. The broad training creates an endless list of career possibilities. We each carve out a niche that best fits the career interest we have in mind.

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20 Questions: Rebecca A. Lubelczyk, MD, Correctional Healthcare

Rebecca A. Lubelczyk, MD, is a utilization review advisor physician for Massachusetts Partners in Correctional Healthcare in Westborough, MA, and associate clinical professor of family and community health at University of Massachusetts Medical School in Worcester. Lubelczyk received a bachelor’s degree in biochemistry from Vassar College (1992), and her MD from University of Massachusetts (1996). She completed a residency in general internal medicine at Brown University School of Medicine, Rhode Island Hospital (1996-1999), followed by a residency in post graduate year 2 and 3 at the outpatient community site at Rhode Island Department of Corrections (1997-1999). Dr. Lubelczyk also completed a general medicine fellowship at Brown University School of Medicine, Rhode Island Hospital (1999-2001).

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20 Questions: Marc F. Stern, MD, MPH, FACP, Correctional Health Care

Marc F. Stern, MD, MPH, FACP, is a correctional health care consultant in private practice. He received a bachelor’s degree in biology from University at Albany (1975), and started his medical studies at Universitélibre de Bruxelles, facultéde Médecine in Brussels, Belgium, and transferred to University at Buffalo School of Medicine where he received his MD (1982). He completed a one-year residency in internal medicine at University at Buffalo Affiliated Hospitals (1985), and a VA/NIH fellowship in primary care medicine and health services research at Regenstrief Institute in Indiana and Richard L. Roudebush Veterans Administration Medical Center (1992). Dr. Stern received his MPH from Indiana University School of Public Health in Bloomington (1992).

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