Information about combined medicine/psychiatry residency programs

What is combined medicine/psychiatry?

A lot of people, even medical students and doctors, have never heard of combined medicine/psychiatry residency programs. So, what exactly is med/psych? A regular internal medicine residency program is three years; a regular psychiatry residency is 4 years. Combined medicine/psychiatry residency programs shorten this training period to a total of 5 years.

How are the two programs combined?

The two residencies can be combined without compromising the integrity of the training because much of the training overlaps between the two programs. For example, the psychiatry program at Duke University requires 4 months of internal medicine and 1 month of neurology during the first year of residency, while the entire fourth year is comprised of electives and research. Likewise, Duke's internal medicine program includes a 5.5 months of electives. Adding up all that time gives you about 2 years that are saved by combining medicine and psychiatry into an integrated training program.

How many med/psych programs are there?

The National Residency Match Program (NMRP) reports that 11 combined medicine/psychiatry programs participated in The Match in 2011:

• Charleston Area Medical Center; Charleston, WV
• Duke University; Durham, NC
• East Carolina University; Greenville, NC
• East Tennessee State University; Johnson City, TN
• Emory University; Atlanta, GA
• Medical University of South Carolina; Charleston, SC
• Southern Illinois University; Springfield, IL
• Tulane University; New Orleans, LA
• University of California, Davis; Sacramento, CA
• University of Iowa; Iowa City, IA (This program's website is especially informative and well-presented.)
• University of Kansas; Lawrence, KS

How competitive are combined med/psych programs?

I tried to get a better idea of how competitive combined medicine/psychiatry programs by looking at "Results and Data" documents published by the NRMP for the last five years, 2007 through 2011. I compiled all the Match data for med/psych programs and used those data to put together this table:


There are a lot of very interesting observations in these data:

• The average number of positions offered per year is 22 (Range 19-26) with the greatest volatility over the past two years.
• There are consistently two med/psych positions per year that are left unfilled, and those tend to be at the same institutions year after year (Kansas, East Carolina).
• The number of med/psych applicants in 2011, both US seniors and total applicants, seemed to decrease significantly from previous years.
• Med/psych applicants, both US seniors and everyone else, apply on average to about 3 programs.
• Over the past 5 years, the percentage of total med/psych applicants who were US seniors ranged from 35% (2011) to 50% (2010). Likewise, the percentage of matched med/psych applicants who were US seniors ranged from 47% (2009) to 75% (2010). There are two major points here. First, most applicants are either international students or people who took some time off after medical school. Second, US seniors have a better chance of matching to med/psych than non-US seniors.

Altogether, this is a pretty thorough presentation of what a combined medicine/psychiatry residency program actually is, what programs there are, and the Match statistics. I will likely update this with a follow-up post when I have more information, which will be sometime after I have finished interviews.

In the meantime, more information can be found on The Association of Medicine and Psychiatry website.