The program devotes equal time to medicine and psychiatry training. Weekly continuity clinics in medicine take place throughout each year of the residency; continuity clinics in psychiatry start during the third year of training.
Rotations take place primarily at Duke University Hospital, Duke Regional Hospital, and Durham Veterans Administration Medical Center. Psychiatry training also occurs at Central Regional Hospital, a state psychiatric facility. Residents also may participate in internal medicine and psychiatry electives at Lincoln Community Health Center and other community clinics. There are opportunities for global health elective rotations in the final year of training.
Integrated Med-Psych Clinical Experiences
Integrated Med-Psych experiences occur throughout training. A highlight of training at Duke is the inpatient combined Med-Psych service, known as “Gen Med 12.” Patients on the Gen Med 12 rounding team are hospitalized on the general medicine floor and present with medical illness and complicating psychiatric or behavioral features.
The Gen Med 12 team consists of an attending physician (combined-trained internist-psychiatrist), at least one first-year psychiatry or medicine-psychiatry trainee, a pharmacist, and other learners.
All Med-Psych residents rotate on Gen Med 12 annually to practice combined and holistic care while working closely with combined-trained faculty, enabling them to forge relationships for formal and informal mentorship. During these rotations, our upper-level Med-Psych residents teach the interns, learn about various ways in which psychiatric and physical health impact each other, and take on increasing leadership on the team.
Several outpatient integrated Med-Psych clinic experiences are also available throughout the five years of the program but concentrated in PGY4-5, including Integrated Med-Psych care at the Duke Outpatient Clinic, VA Mental Health Primary Care clinic, primary care at the Lincoln Healthcare for the Homeless clinic, transplant psychiatry, psycho-oncology, and IMPACT model collaborative care.
Rotations by Training Year
This year is comprised mostly of rotations in internal medicine. The internal medicine internship is completed after this year. Continuity clinic in medicine occurs throughout the year.
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During this year, trainees complete second-year rotations in medicine and are junior assistant residents in medicine. They complete a combination of first and second-year rotations in psychiatry. Trainees rotate between the two departments with six months in each. Continuity clinic in medicine occurs throughout the year.
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During this year, trainees complete all second-year rotations in medicine and in psychiatry, spending eight months in medicine and four months in psychiatry. Continuity clinic in each specialty occurs throughout the year. Trainees may apply for a one-month elective in study design and evidence-based medicine that occurs during medicine training.
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This year is comprised of 10 months of continuous training in outpatient psychiatry, with a focus on core psychotherapy skills. Trainees begin their time as senior assistant residents in medicine in the spring and complete two months of medicine rotations.
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*Includes general psychiatry clinics at Duke and Durham VA, CBT or related therapies, Child and Family Studies, and electives.
**Includes integrated med-psych care at the Duke Outpatient Clinic, VA Mental Health Primary Care clinic, primary care at the Lincoln Healthcare for the Homeless clinic, transplant psychiatry, psycho-oncology, or IMPACT model collaborative care.
Trainees complete six months of outpatient psychiatry and six months of medicine. Trainees often spend time in leadership positions, such as assistant chief resident in Medicine or chief resident in Medicine-Psychiatry. Trainees may apply for a two- to three-month experience in global health in medicine. Dedicated research time is also a possibility.
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*Includes general clinics and electives, including:
- Electroconvulsive therapy
- Psycho-oncology
- Psychotherapy electives
- Collaborative care
- Pain medicine
- Sleep medicine
- Transplant psychiatry
- Community psychiatry
- Integrated med-psych clinics
**Includes integrated med-psych care at the Duke Outpatient Clinic and VA Mental Health Primary Care clinic, primary care at the Lincoln Healthcare for the Homeless clinic, transplant psychiatry, psycho-oncology, or IMPACT model collaborative care.