Combined Medicine and Psychiatry Training: It’s a Thing

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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. Harris Eyre, Psychiatry Trainee, Pharmacogeneticist

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By Gloria Onwneme, Medical Student, University of Nottingham, UK

Dr. Harris Eyre, MD, PhD, Fulbright Scholar (WG Walker) is a psychiatry trainee, and Chief Medical Officer and Co-Founder of CNSDose, a company which has developed and deployed a world-leading genetic test to aid the antidepressant selection process for primary care physicians, psychiatrists, and people with depression. He is also an executive-in-residence at the Texas Medical Center in Houston, the world’s largest medical complex.

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Q&A with Dr. Ahmed Hankir, Psychiatrist and Mental Health Campaigner

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Dr. Ahmed Hankir MBChB PGCert (Psychiatry) PGCert (Epidemiology) is a specialty trainee in psychiatry in the National Health Service (UK), an Associate Professor of Psychiatry with the Carrick Institute for Graduate Studies (USA), and a Senior Research Fellow for the Bedfordshire Centre for Mental Health Research in association with Cambridge University (UK).

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Q&A with Physician-Author Femi Oyebode

Dr Femi Oyebode is a Professor of Psychiatry at the University of Birmingham and a published poet. He obtained his medical degree from the University of Ibadan (1977), followed by his MD at University of Newcastle, and his PhD in Wales (1998). In November 2016, he received a lifetime achievement award from the Royal College of Psychiatrists.
He is the author of the textbooks Sims’ Symptoms in the Mind: An Introduction to Descriptive Psychopathology, 4th Edition, Madness at the Theatre and Mindreadings: Literature and Psychiatry. He has also published 6 volumes of poetry, including Adagio for Oblong Mirrors; Master of the Leopard Hunt; and Indigo, Camwood and Mahogany Red.

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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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Mental Health and More: A Look at Psychiatry

Central to the skillset of every physician is the differential diagnosis; this is the process by which new patients are evaluated to establish the most likely diagnosis. Similarly, the first clinical year of medical school is like a differential for each student, except instead of a medical diagnosis, students are seeking to determine which specialty they will choose. This column explores this differential: experiences from each rotation by a current third year student.

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Q&A with Physician Writer Christine Montross

Dr. Christine Montross is Assistant Professor of Psychiatry and Human Behavior and the Director of Counseling Resources at the Warren Alpert Medical School of Brown University. She works as a staff psychiatrist at Butler Hospital in Providence, Rhode Island. Before attending medical school at Brown, Dr. Montross graduated from the University of Michigan with a Master of Fine Arts in poetry, and undergraduate degrees in French and Natural Resources.

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Of Capacity and Communication

I am about 45 minutes from the end of my night float shift, that dangerous hour all residents learn to wait through with baited breath, when my pager goes off. Pushing the button to silent its insistent beep, I read the text: “STAT 4-9876.” I am slightly bemused. STAT pages in psychiatry are few and far between. If one of the patients on the psych floor has had an MI, stroke, or something else that necessitates an immediate response, I may be the last to find out, as the nurse will often call a code and bring a medicine team running before letting me know what is going on. Even a consult for a suicidal patient on a medicine floor, considered a psychiatric emergency, doesn’t exactly necessitate the same sort of urgency as anaphylaxis or an acute abdomen. I like pondering and deliberation, making me naturally suited for psychiatry. Rather than engendering excitement, the word STAT makes my blood run a little cold. Besides, I typically assume that if someone is paging me, urgency is implied, and I return the call immediately; the two year old inside me smarts at being told to hurry up.

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