Medicine-Psychiatry and Psychosomatics CPU


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The Medicine-Psychiatry and Psychosomatics Clinical Practice Unit explores the important interface between medicine and psychiatry. This includes not only the care for patients with mental health problems impacting medical conditions, but also general medical care for those with mental illness. Medicine-Psychiatry aims to integrate care for patients with illnesses that span the two fields and thereby challenges the traditional boundaries therein, often focusing on patients that have “fallen through the cracks” who require a comprehensive, holistic, approach.

Patients with heart disease and diabetes are much more likely to have mental health conditions such as depression and anxiety. On the other hand, patients with chronic mental illness lose up to 25 years of life expectancy due to early death from cardiovascular and related causes. Thus, there is a crucial need for a new approach that integrates medical and psychiatric care.

Psychosomatic clinical work includes evidence-based approaches to optimizing mental and behavioral health in both inpatient and outpatient medical settings. Medicine-Psychiatry encompasses care by dually-trained Internist-Psychiatrists who are board eligible in both disciplines and practice both Medicine and Psychiatry in some combination. Internist-Psychiatrists provide care at unique, integrated care sites such as the Duke Hospital Inpatient Medicine-Psychiatry Service and the Mental Health-Primary Care Service at DVAMC.

Duke offers a unique, integrated training program in Internal Medicine and Psychiatry – one of only 12 such programs in the country. The Duke Combined Internal Medicine and Psychiatry Residency Program is a five-year postgraduate training offered jointly by the departments of Medicine and Psychiatry. After completion of the residency program, graduates are eligible for board certification in both disciplines.

Residency training is spread over five years with equal time devoted to medicine and psychiatry through clinical rotations, continuity clinics, didactics, case conferences, and weekly journal article discussions. The weekly MedPsych Conference focuses on issues at the interface of both fields.

Faculty and trainees pursue research in areas at the interface of medicine and psychiatry, such as depression and heart disease, sleep disorders, delirium, and alcohol withdrawal.