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.