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Med/Psych

Discussion in 'Combined Residencies' started by FutureMedPsych, Sep 11, 2009.

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  1. FutureMedPsych

    FutureMedPsych

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    All this talk about Med-Peds, what about Med/Psych?

    Any other applicants out there?
  2. docrush

    docrush

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    i have also applied for med/psych
  3. lilnoelle

    lilnoelle Moderator Emeritus

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  4. cookymonster

    cookymonster

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    I'm applying to psych and med/psych. Have any of you guys gotten interview invitations from med/psych programs? I got my first one today, from UC-Davis.

    Good luck in this cycle!
  5. FutureMedPsych

    FutureMedPsych

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    cookymonster - i just got uc davis as well. no bites other than that.
  6. FutureMedPsych

    FutureMedPsych

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    btw - anyone doing med/psych away rotations?
  7. cookymonster

    cookymonster

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    I'm doing an away rotation in November. For the sake of anonymity, I'd rather not say where.
  8. lilnoelle

    lilnoelle Moderator Emeritus

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    I've gotten 4. Not UC Davis yet because I haven't filled out their extra application.

    KU (my home school)
    Iowa
    CAMC/WVU
    Brody School of Medicine

    I'm doing an away at Iowa in November. I gave up anonymity long ago.
  9. cookymonster

    cookymonster

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    Did Brody give you a list of days they were holding interviews? I haven't heard from them yet.
  10. lilnoelle

    lilnoelle Moderator Emeritus

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    These are the prime days.

    Monday, November 16
    Monday, December 7
    Monday, December 14

    I'm not available for any of those, so I called and was told a few fridays in January as other available options. I don't remember which ones off hand.... Apparently the important interviewers aren't available in January... its sort of difficult to schedule these interviews. I'm already running into trouble and I only have four!
  11. FutureMedPsych

    FutureMedPsych

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    i think i'm sitting at five...

    1 - uc davis
    2 - iowa
    3 - duke
    4 - camc/wvu
    5 - ku

    no word from brody, who knows how this process works...
  12. lilnoelle

    lilnoelle Moderator Emeritus

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    When are Duke's interview days?
    I'm suspecting my lack of psych LOR's is holding me back somewhat. I'm expecting one to get sent in soon, but unfortunately, I just have to be patient.
  13. cookymonster

    cookymonster

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    I have the same 5, except for KU, which I didn't apply to. I'd love to hear from MUSC and Emory, so I can stop playing travel agent.

    Here are Duke's dates (each session is 2 days + dinner the night before first day):
    12/3-12/4, 12/10-12/11, 12/17-12/18, 1/7-1/8.
  14. HazomboL

    HazomboL

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    Hi all.. I wish you great luck on your interviews. :)

    I heard about combined med/psych programs and was seriously considering that.. basically, because I can't overcome my love for int. medical diagnosis.. :)

    As you guys are probably pros on that I have a couple of questions..

    1- What are the privileges and downfalls of that combined residency? How would it come into real usefulness in post-residency careers? I heard that it could be distractive for the resident to follow up on both training systems.. how true and global is that?

    2- I know combined residencies are very competitive.. but, how competitive can they be? I am an IMG (a disadv), with little USCE (another..), but good board scores (270 on step 2 so far).. So, could I qualify for one? And what kind of USCE would make my application stronger? One in psych or in IntMed?

    Thanks, everybody..
  15. lilnoelle

    lilnoelle Moderator Emeritus

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    Got an invite from Medical University of South Carolina today. Gotta wonder why I haven't heard from Duke yet...
  16. FutureMedPsych

    FutureMedPsych

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    HazomboL:

    1 - I wouldn't say distractive. If anything, I would say its difficult having to switch betwen thinking "medically" and thinking "psychiatrically" but the hope is at the end you can do both simultaneously and effectively. The advantage is that you are more marketable and that you have a better understanding of medicine. There are a few "Med/Psych" wards that you would be competitive for but you could also find ways to integrate your residency training, especially in academic settings.

    2 - No idea how competitive it is. Its always a small sample size so you never know what to expect. Send in an ERAS and see what comes your way.

    lilnoelle: i got MUSC today as well and sorry about Duke but we'll see. Who knows why you got ECU and no one else has - this whole thing is a crap shoot.
  17. lilnoelle

    lilnoelle Moderator Emeritus

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    My Psych LOR finally was finally sent out today. :)
  18. lilnoelle

    lilnoelle Moderator Emeritus

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    Got an invite from Emory today. :)
  19. FutureMedPsych

    FutureMedPsych

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    Just got Tulane - no word from Emory. What are their dates?
  20. cookymonster

    cookymonster

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    here are emory's dates:

    November 16th or 20th
    December 4th, 11th or 14th
    January 15th
  21. clinicalskillz

    clinicalskillz

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    that's it for the interview dates for med/psych at Emory? By the way does anyone know if Emory's Med/Psych an accredited program? Are any of the med/psych programs accredited?
  22. FutureMedPsych

    FutureMedPsych

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    southern illinois university
  23. Packamylase

    Packamylase MSIV

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  24. zac16125

    zac16125

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    I have a question for you all, why did you decide the combo residency? Do you have specific goals/aspirations/plans up graduation, do you just want to be a more well rounded physician, or what? I ask because I am currently a 3rd year student and am seriously considering IM/psych. I am thinking this for a couple reasons, one of them being I really enjoy both psych and hospital medicine and I feel that being board certified in both would give me more oppurtunities in the future. I know that's kind of a cop-out and some people might say, just make a damn call, but I wondered if any of you who are currently applying are in the same boat. You couldn't decide between the two so did the combo residency?
  25. crstabel

    crstabel Junior Member

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    Hi Zac-

    I am a MS-4 applying to FM/Psych this year. I think that ambivalence between Medicine and Psychiatry is the wrong reason to pursue combined training. I think being a "Combo" really is kind of it's own thing - it's a different way of thinking and the Combined physicians I know really are quite different from their catagorical counterparts. I read a quote from a research article on combined training that put it like this "When you do both, the result looks like neither". I think combined training is great for those who want to be the PCP to chronically mentally ill patients, those who like working with rural or indigent/urban underserved populations where psych comorbidities very frequently complicate the general medical care of these patients. The nice thing about combined training is that you can dabble in psych private practice on the side, if you want to vary what it is that you do. But it is definitely it's own thing.

    IM/Psych tends to be a bit more slanted towards inpatient, and FM/Psych is more bio-psycho-social and outpatient oriented, plus you have outpatient Peds and OB patients (Most FP's don't do deliveries anymore, but you would have to as a resident).

    If you are still seriously considering combined, I would recommend attending the Assoc. of Medicine and Psychiatry Conference this Fall (it was in Sept. last year). It really helped me understand the culture of combined med/psych and the issues they like to work with.

    Good luck!
  26. Fleur1

    Fleur1

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    Hi,

    I will be starting my residency soon in Psych, in Sweden- although I am much more interested in a combined IM/Psych residency. But anyway, I did try to ask at a few hospitals in Sweden while applying if they have a combined residency as such but they don't! Actually one answered that it is a very 'strange' combination since the 2 specialties are very different and the only way i can do it is to be a resident for 10 yrs, 1nce in psych and then in IM. Well, if in 5 yrs im still interested in the combined residency I don't mind doing IM then. But I guess it's not as simple as that- i will have to work for a few years in psych first at the hospital ive been trained. AND i will have to keep in touch with IM in the meantime im studying psych...
    But anyway, i have a few questions- what is the outcome of these combined residencies? Can anybody who completed it (or by observing seniors) tell me how did it change their perspective?

    Where do you work after that?- in which department? Are there hospitals that have a specific IM/psych department in USA? If I do it in Sweden, I have yet no idea where I could work here, but I might relocate who knows.

    Another question, if I finish my psych residency in Sweden and then decide to come to US, do I need to do the USMLE exam?

    Also, please let me know of books/publications in this field of medicine and psych...

    Thanks!
  27. Studious

    Studious

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    Let's hear it for med/psych! I've noticed it's not nearly as popular as med/peds on SDN. Not too many people around that are doing or want to do med/psych?
  28. undecide

    undecide

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    Just curious, I know it's probably highly variable from year to year and given the small number of spots around, but is Med-Psych generally extremely competitive?
  29. group_theory

    group_theory EX-TER-MIN-ATE!' Moderator

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    According to the NRMP 2011 Match Data,

    11 Programs Total, 19 Positions Offered. 17 Matched, 9 of which were US MD students.

    60 Total Applicants, 21 of which were US MD students.
  30. Extralong

    Extralong

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    Does that still answer how competitive it is? This was more of how popular this combo is. ( not trying to offend anyone)
  31. primadonna22274

    primadonna22274 Senior Member

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    I'm resurrecting an old thread because I have recently had a "Eureka!" moment where I realized I could merge my loves of psychiatry and medicine in a combined residency. I am most interested in the MUSC program since I have lived in SC since 2006. I would appreciate hearing from folks who chose this route and how happy they are with that path.
    My specific interests are in geriatric psychiatry, dementia and the aging severely mentally ill person. I have an academic bent and plan to be active on medical education throughout my career.
    Thanks!
  32. Spikedsoymilk

    Spikedsoymilk New Member

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    Good luck! I have an interest in this as well, but I feel that I am way too early in my medical career to decide now. I'm just subscribing to this thread to follow developments for those pursuing this track. :)
  33. openmindedoc

    openmindedoc

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    I am interested in med-psych for residency because I enjoy both from a learning perspective. However, I am curious about the lifestyle and practice of med-psych docs.

    Can anyone with experience discuss what med/psych docs do after residency? Are they able to successfully integrate both fields into daily practice? What do most do?
  34. michaelrack

    michaelrack All In at the wrong time SDN Advisor

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    "Can anyone with experience discuss what med/psych docs do after residency"

    Those that go into private practice generally do psychiatry.
    Some do a fellowship. I know a couple of sleep psychiatrists who did a med psych residency.

    "Are they able to successfully integrate both fields into daily practice"- not in private practice, sometimes in academia.
  35. Lacktherof

    Lacktherof

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    Kind of off topic, but would someone who did a med/psych residency and then an addiction psychiatry residency be able to fill both the medical director and psychiatrist roles at a inpatient drug/alcohol treatment facility? Has anyone ever heard of this being done by med/psych, fp/psych, or otherwise?
  36. gopens67

    gopens67

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    i actually think med/psych would be perfect for that type of position. There are positions for medicine docs in an addiction setting. I'm sure dual training would be highly desirable for these positions.
  37. michaelrack

    michaelrack All In at the wrong time SDN Advisor

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    I ran a chemical dependency unit at the state hospital (MS) for a while, as a psychiatrist. I sent the acute medical issues to the medical consultants.

    IF I would have tried to take care of the acute medical issues myself, it would have slowed me down (in doing my psychiatry duties) and wouldn't have increase my pay.

    While theoretically addictions units would want a med/psych doctor, in practice the combo does not increase a person's competiveness. (by the way, that would be a total of 6 yrs training, addiction fellowship is 1 year, after the 5 yr med/psych residency)
  38. LoudBark

    LoudBark

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    It seems near impossible (if not down right impossible) to combine a career of IM and psych OUTSIDE of academics. Yes, the academic guys and girls cater their own careers and design how they spend each day. They can do a month of inpatient medicine attending and a month of psych consultation attending. They can do a medicine clinic 2 days a week and a psych clinic 2 days a week. They can do whatever they want.....and these same academic people will try to convince you it is doable in the private practice non-academic world. No way. If you are not going for a career in academics, ultimately you will have to choose between one or the other. Just know that going into the residency. It is a longer residency, at least one if not two more years tacked on, to ultimately have to choose between one or the other if you do not stay in academics.

    In addition, it is important not to let the belief of "my background in IM will make me a better psychiatrist" or "my background in psych will make me a better IM doc" when choosing which one to do and doing an extended residency. In the end if you go the private practice route, it really will not make any difference in the end.
    Last edited: Sep 1, 2013
  39. michaelrack

    michaelrack All In at the wrong time SDN Advisor

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    :thumbup:
  40. MaybellineBlush

    MaybellineBlush

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    Hello all,

    Just wondering if anyone here was applying this year to a combined med-psych program.
  41. primadonna22274

    primadonna22274 Senior Member

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    I applied to 3, haven't heard from any of them yet. Have interviews in IM and FM.
  42. ferning

    ferning Lifetime Donor

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    I think its kind of pathetic that when considering combined residency all people talk about is who will hire them.

    Instead of worrying about long term job prospects and medical training's translation into how insurance reimburses, why don't you try to be creative for once in your life.

    Grow a pair and instead of seeing whats there (job, insurance reimbursement), see whats not there with combined training after you graduate:

    What: Get a mortgage for a foreclosed bed & breakfast or ranch and open 10 beds for 30-120 day detox/rehab for rx opiates. Say forget insurance, if your facility doesnt meet the criteria for payment and charge 4-6k a month.

    How: Epidemic health crisis with unmet needs (never enough beds), as well as when its met it is priced astronomically. By owning/managing, being the primary doc as well as counselor, and not dealing with insurance you can charge much less than the 50k plus it costs anywhere else in the US for 90 days. You can provide better care, accomodations and continuity of care while charging less cause you aren't a corporation or non contributing owner who has to pay other people to do all these things and net an ever increasing profit for your self. Also you get cash/credit up front from patients, but a low up front investment with the ease of a mortgage (commercial, maybe residential if u live there). You don't have to hire medical billing coders or invest in building a new facility. less expensive if you want it to work so you dont have to spend money on marketing and you maintain full occupancy by price alone. The equity in the mortgage besides money after expenses is your retirement fund or business reserve. Live there to really save money ornat least till you get it running well enough at first


    Who: This idea has basically universal applicability with the need for rehab beds as well as the availablity of housing that can be used (boutique motel, camping ground). Basically anything with the minimum number lf beds/bathrooms and space to make the financials work.

    Instead of seeing yourself as wage slaves, think of how you can provide healthcare better on your own and less expensive. This could be a physical rehab facility if you're pm&r, a facility for people with end stage dementia, hospice, etc.

    By being an owner/operator and providing expensive labor that anyone else would have to pay 200k plus you get the advantage compared to others. There are also tax and other financial benefits by not having to deal with formal business structures. Any time you dont deal or take insurance you get money up front as waiting 6 months for reimbursement is what kills all small practice owners now besides no labor cost to code.

    2.6 trillion healthcare GDP, 30% of total US GDP. Physician take home 5% of that. Less than every other industrialized country. You're basically a moron if you can't make money as a physician on your own with all the business advantage and as the one labor force that drives all of healthcare spending.

    Your RX to a pharmacy (likely large corporation) to an insurance corporation (or government alternative) to a pharmaceutical corporation. And each transaction is inflated by a tax (sales, income) and wall street stock payout to the corp or if its government the guise of non-profit
  43. primadonna22274

    primadonna22274 Senior Member

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    First invite today, from Eastern Carolina/Greenville NC.
  44. michaelrack

    michaelrack All In at the wrong time SDN Advisor

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    Even assuming this is a realistic business plan, how would combined residency prepare someone for this? I think straight psych (with a heavy concentration in addiction or perhaps even an addiction fellowship) would be better preparation. Combined residency doesn't prepare a person well to be a primary counselor for this or any other group of patients.
  45. IndigoBoy0

    IndigoBoy0

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    I applied to the fm/psych programs not not Im/psych but am interested in this thread. There are only 5 such programs. I am interviewing at 3 of them.
  46. primadonna22274

    primadonna22274 Senior Member

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    Have interviews now for MUSC in Charleston and ECU in Greenville, NC. Only applied to 3--not bad :)
  47. batdoc

    batdoc

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    Did you do elective rotations at either of those two locations?

    I'm applying for the Match next year for IM/Psych and I'm also curious as to how competitive they are!
  48. primadonna22274

    primadonna22274 Senior Member

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    Nope, neither. In fact I've had very few elective rotations in which to audition before interview season as I am in an accelerated 3-yr program. I've been very pleased at the variety of community and university invites I've received.
  49. primadonna22274

    primadonna22274 Senior Member

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    So weird...I just got a VERY late invite today for Charleston, WV. I figure they must be going pretty far down their wait list to invite someone on Dec 12 for a January date. Or maybe my rockin' step 2 score got their attention lol
  50. primadonna22274

    primadonna22274 Senior Member

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    Bumping in case there might be one or two folks who can post some thoughts about their interviews. I've only kept one Med-Psych interview, at MUSC end of January. On the fence but plan to go. What I did notice is there's only one PGY1 resident this year whereas PGY2-5 have 2 or 3 each year. Wondering if that's a fluke or if folks just aren't interested.
    Thanks
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