Combined residency?

[wannabeapmr]

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I have a quick question: I have recently matched in psychiatry and really excited about it. My question is that if i wanted to do both IM/psych but there is not one at my hospital that i matched at. Is it possible for me to apporach my PD and ask him if i could somehow do a combined residency. granted it has to be approved by both departments. Has anyone done this? Please any insight on the matter would be greatly appreciated! thank you.

 

[AnnTaylor]

I have a quick question: I have recently matched in psychiatry and really excited about it.

oh.
ohh.

interesting question though...off-hand i'd say the psych pd would not be cool about it...if you matched into categorical psych, the program schedule is set up such that you are a categorical psych resident with other categorical psych co-residents. unlikely the entire program can be maneuvered around a simultaneous IM residency for one person in the program. the IM pd would likely not agree to it. there is a reason why combined programs exist...and to play devil's advocate, people who do combined residencies are not fully enthusiastic about one of two...now if it was psych/neuro, yeah, overlap...Also, apparently you run into billing issues with insurance companies if you are double boarded (I'm not sure how, guessing you can't bill under the auspice of both fields?).

 

[TexasPhysician]

Making it truly combined is probably out of the question now. I wouldn't even ask. I would go at this a different way. Maybe you can let your psych PD know that you have possible interests in persueing a career course that puts you on the psych/IM forefront. If you ask, maybe you can have a majority of your primary care months be IM related.

Assuming this works, maybe talk to the IM program director around PGY-3. Ask him/her if it might be possible to continue as an IM resident after completion of your program. If he/she is agreeable, talk to your psych PD about what you can do about getting your 4th year as close to IM as possible.

Ideally with your intern primary care experiences and 4th year experiences, maybe you can shave off some quality time on an IM residency.

I would also consider doing it this way because dual-residency programs are useless (my opinion), and it gives you time to reconsider. Psych has better hours and better pay than IM so odds are you will go into practice in psych - forgetting IM. I strongly considered psych/FM as well as psych/pedi/child psych and spoke to a few people that did the combined residencies. Every one of them quit FM/peds and focused solely on psych stuff.

I'm just saying to think about this long and hard before making any decisions.

 

[nitemagi]

TP makes good points. Also think about psychosomatic medicine fellowship.

The question is why do you want to do a combined residency? Fear of losing basic medicine skills? Interest in overlap conditions or continuity of care? Fear of specializing? Uncertainty about psych? Worry about bias against mental health?

 

[zac16125]

Did you consider doing IM/Psych combo BEFORE you matched. Judging from the NRMP stats it looks like it could have been a pretty obtainable thing.