The Ultimate Guide to Researching Medicine-Psychiatry Residency Programs

Understanding the Landscape of Medicine-Psychiatry Residency Programs

Medicine-Psychiatry (Med Psych) is a unique combined residency that integrates internal medicine and psychiatry over a five-year training period. Because there are relatively few med psych residency programs compared with categorical internal medicine or psychiatry, researching them requires a more strategic, targeted approach.

Before you start a detailed program research strategy, ground yourself in the basics:

What is a medicine-psychiatry combined residency?

• A five-year ACGME-accredited combined program
• Graduates are eligible for board certification in both Internal Medicine and Psychiatry
• Training includes:
  • ~24 months internal medicine
  • ~24 months psychiatry
  • Integrated rotations bridging the two (C-L psychiatry, psychosomatic medicine, integrated primary care, etc.)
• Graduates often work in:
  • Academic consultation-liaison or psychosomatic medicine
  • Integrated primary care and behavioral health
  • Hospital medicine with complex psychiatric comorbidity
  • Outpatient clinics for serious mental illness with medical complexity
  • Correctional or public sector psychiatry
  • Leadership roles in integrated systems of care

Why careful program research matters even more in med psych:

• Limited number of programs (compared to categorical tracks)
• High variability in:
  • Culture and mission (e.g., public psychiatry vs research-heavy vs community-focused)
  • Balance of medicine vs psychiatry experiences
  • Strength of integrated/combined rotations
  • Protected time for research, advocacy, or education
  • Support for dual board preparation and wellness
• Smaller cohorts (often 2–4 residents per year), so personality fit and mentorship culture are crucial.

Your goal is to systematically evaluate programs to find those that genuinely match your career goals, learning style, and values—not just any program that offers medicine-psychiatry combined training.

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Step 1: Clarify Your Goals and “Fit” Before You Research Programs

Before diving into how to research residency programs, take the time to define what you need from a med psych residency. This will make evaluating residency programs more efficient and focused.

1.1 Identify Your Career Vision

Ask yourself:

• Do you see yourself primarily as:
  • An academic physician (research/teaching)?
  • A clinician-educator?
  • A community/public sector clinician?
  • A systems leader or administrator?
• Are you more drawn to:
  • Inpatient medicine and complex medical comorbidity?
  • Severe mental illness and psychotic disorders?
  • Addiction and dual diagnosis?
  • Collaborative care / integrated primary care?
  • Consultation-liaison psychiatry and psychosomatic medicine?

Write down your top 3–5 long-term aspirations. For example:

• “Direct an integrated primary care-psychiatry clinic for patients with serious mental illness.”
• “Work as a hospitalist with strong consult-psychiatry skills and teach trainees.”
• “Lead research on medical morbidity in serious mental illness.”

This clarity will guide which program features are truly non-negotiable.

1.2 Define Your Training Priorities

Next, list what you want most during residency. For med psych, common priorities might include:

• Strong inpatient internal medicine exposure (e.g., tertiary care center, medically complex patients)
• Robust training in severe mental illness across inpatient and outpatient settings
• Depth in consultation-liaison psychiatry and psychosomatic medicine
• Opportunities in addiction medicine or integrated primary care
• Consistent exposure to medically and psychiatrically complex patients (HIV, transplant, eating disorders, perinatal psychiatry, neuropsychiatry)
• Structured psychotherapy training (CBT, psychodynamic, DBT, etc.)
• Global health, advocacy, or public psychiatry components
• Research or QI infrastructure that supports dual interests

Rate each potential priority as:

• “Must have”
• “Strong plus”
• “Nice but not essential”

You’ll use this framework when evaluating residency programs and comparing them side by side.

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Step 2: Build a Structured Program Research Strategy

Now that you understand what you want, you can design a systematic approach to researching medicine psychiatry combined programs. This prevents you from getting overwhelmed and ensures you compare programs fairly.

2.1 Start With the Official Lists and Directories

For med psych residency, use:

• ACGME and NRMP program lists
  • Search for “Internal Medicine/Psychiatry” combined programs
  • Confirm ACGME accreditation and program length (5 years)
• Specialty society resources
  • Some combined programs or interest groups maintain updated lists with links
• Program websites
  • Each institution’s GME or departmental site often has the most current details on:
    • Curriculum
    • Rotations and schedules by year
    • Combined vs categorical experiences
    • Faculty leadership and mentors
    • Resident roster and alumni outcomes

Create a spreadsheet (or Notion/Excel/Google Sheet) and enter basic data for each med psych residency:

• Program name and institution
• City/state and geographic region
• Program director(s) (medicine, psychiatry, and combined if separate)
• Number of positions per year
• Application track and NRMP code (combined vs separate medicine/psychiatry)
• Visa sponsorship (if relevant)
• Key contacts (coordinator email, mentor names)

This becomes your master document for evaluating residency programs.

2.2 Use a Tiered Research Method

Instead of trying to investigate every detail at once, use a three-tier approach:

Tier 1: Broad screening (high-level fit)

Look at:

• Geographic location and lifestyle factors (city size, cost of living, support system)
• Program size and structure:
  • How many med psych residents per class?
  • How integrated is the program with the categorical medicine and psychiatry residencies?
• General mission and program description:
  • Do they emphasize integrated care, public psychiatry, research, leadership, or something else?
• Basic curriculum overview:
  • Clear med/psych balance?
  • Presence of dedicated combined rotations (C-L, integrated clinics, etc.)?

Goal: Narrow to a manageable list of “serious consideration” programs.

Tier 2: Targeted research (curriculum + culture)

For each serious program, explore:

• Detailed rotation schedule by PGY year
• Integrated clinical experiences (consultation-liaison, medical-psychiatric units, collaborative care clinics)
• Faculty interests relevant to your goals
• Presence of med psych leadership with dedicated time
• Resident wellness policies, call schedule, time off
• Academic opportunities (research, QI, teaching)

Goal: Identify ~8–15 programs that genuinely align with your goals and will likely be included on your application list.

Tier 3: Deep dive (pre-interview or post-interview)

At this stage, you’re evaluating:

• Track record of graduates (fellowships, jobs)
• Culture, support, and resident satisfaction
• Strength of mentorship in both disciplines
• Program flexibility (customizing electives, protected time, dual board prep)
• How med psych residents are perceived by medicine and psychiatry departments

Goal: Build a defensible, personalized rank list after interviews.

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Step 3: How to Research Residency Programs in Depth (Specific to Med Psych)

Once you have your preliminary list, move beyond surface details. This is where many applicants struggle, but also where you can truly differentiate programs based on your needs.

3.1 Dissect the Curriculum and Rotations

Pull up the program’s posted curriculum, and if possible, any sample block schedules. Ask:

Balance of specialties

• Is the medicine-psychiatry combined training truly integrated, or mostly sequential?
  • Example: 12 continuous months of medicine followed by 12 months of psychiatry vs alternating 3–6 month blocks.
• Are you meeting and exceeding the minimum requirements for both boards?
  • Many strong programs give residents more than the minimum in both specialties.

Integrated rotations

Look specifically for:

• Consultation-liaison psychiatry on medicine/surgery
• Medically complex psychiatric units or medical-psychiatric wards
• HIV psychiatry, transplant psychiatry, oncology/psycho-oncology
• Collaborative care in primary care clinics
• Addiction consult services and inpatient addiction medicine units

These integrated settings are often the core identity of med psych residencies and should be central in decision-making.

Outpatient vs inpatient mix

• Does the program provide robust longitudinal outpatient experiences in both medicine and psychiatry?
• Are there continuity clinics that cross traditional boundaries (e.g., primary care for patients with serious mental illness)?
• Is there a balance that reflects your interests (for example, a future hospitalist vs outpatient integrated care clinician)?

Electives and flexibility

• How many elective months are available across 5 years?
• Are electives available in:
  • Addiction medicine
  • Pain management
  • Palliative care
  • Neurology/neuropsychiatry
  • Psychotherapy subspecialties
  • Public psychiatry or community mental health
  • Correctional health
• Can you tailor your training or pursue a specialized focus (e.g., psychosomatic medicine, public psychiatry, global mental health)?

3.2 Examine Call Structure and Workload

In combined programs, call can be complex because you’re part of both departments.

Investigate:

• Call frequency on medicine, psychiatry, and integrated services
• Night float vs traditional 24-hour calls
• Weekend/holiday distribution
• Whether med psych residents share call equally with categorical residents, or have unique arrangements
• How call responsibilities evolve across PGY1–5

Use this to assess not only lifestyle but also clinical exposure and supervision. Unrealistic call burdens can adversely affect learning and wellness.

3.3 Assess Mentorship and Program Leadership

Strong med psych residency training depends heavily on leadership that understands the unique identity and needs of combined residents.

Look for:

• A clearly identified combined program director (vs only categorical PDs)
• Associate directors or core faculty with dual training or clear combined focus
• Evidence of regular combined program meetings, advising, and retreats
• Formal mentorship structure:
  • Assigned faculty mentors in medicine and psychiatry
  • Optional research mentors
  • Career development meetings focused on integrated careers

Search faculty bios:

• Are there faculty dually boarded in internal medicine and psychiatry, or in psychiatry with additional medicine expertise (and vice versa)?
• Are faculty involved in psychosomatic medicine, integrated care, or CL psychiatry?
• Do they publish or present in areas aligned with medicine-psychiatry combined care?

3.4 Consider Academic and Research Opportunities

If scholarship is part of your career goals, evaluate:

• Is there protected time for scholarly projects?
• Are med psych residents expected/encouraged to present at:
  • Academy of Consultation-Liaison Psychiatry (ACLP)
  • American Psychiatric Association (APA)
  • Society of General Internal Medicine (SGIM)
  • Other national meetings?
• Are there ongoing projects or labs working on:
  • Integrated care models
  • Medical morbidity in severe mental illness
  • Health services research
  • Quality improvement in medical-psychiatric populations?

Ask whether recent residents have:

• Completed fellowships (e.g., C-L psychiatry, addiction, public psychiatry, geriatrics, palliative care)
• Pursued MPH, MEd, or other degrees during or after residency
• Taken on leadership roles in integrated clinics or systems

This gives you a realistic picture of how the program supports your longer-term ambitions.

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Step 4: Gathering Insider Information Beyond Program Websites

Program websites tell only part of the story. To truly evaluate residency programs, especially in a niche field like med psych, you need candid, ground-level perspectives.

4.1 Talk to Current and Recent Residents

Current med psych residents are your best resource.

How to connect:

• Use the program’s listed resident email contacts.
• Ask the coordinator if they can pair you with a resident mentor or contact.
• Leverage any alumni from your medical school or rotations who matched there.
• Ask your psychiatry or medicine faculty if they know med psych residents or alumni.

Questions to ask residents:

• “What drew you to this program, and has it lived up to those expectations?”
• “How integrated do you actually feel between medicine and psychiatry?”
• “Do you ever feel like ‘half a resident’ in either department?”
• “How supportive are program leadership and faculty when scheduling conflicts arise between medicine and psychiatry?”
• “How flexible has the program been with electives or tailoring training?”
• “How do med psych graduates from this program typically structure their careers?”
• “Are there any hidden strengths or weaknesses not obvious from the website?”
• “How is the culture among the med psych cohort and among categorical residents?”

Take notes systematically so you can compare across programs later.

4.2 Seek Perspectives From Faculty Mentors

Your own mentors (especially in CL psychiatry, psychosomatic medicine, and internal medicine) may know certain programs by reputation or collaboration.

Ask:

• “What do you know about the medicine-psychiatry combined residency at X?”
• “Do you consider it clinically strong? Academically strong? Both?”
• “Do you know any alumni from that program and what they’re doing now?”
• “Are there specific programs that have a particularly strong identity in integrated care, public psychiatry, or hospital medicine?”

Mentor insight can help you interpret what you’re seeing in your research and add nuance, especially if you’re weighing programs with similar apparent strengths.

4.3 Use Conferences and Professional Organizations

If you attend conferences (APA, ACLP, SGIM, etc.), seek out:

• Combined program showcases or panels (often featured at ACLP)
• Poster sessions featuring med psych residents or faculty
• Interest group meetings on integrated care or dual training

These can be excellent networking opportunities and informal chances to ask about programs.

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Step 5: Comparing and Prioritizing Programs Objectively

After you’ve gathered all your information, you need a way to make sense of it. A structured comparison process can keep emotion and recency bias from dominating your decisions.

5.1 Create a Personal Scoring Rubric

Develop a rubric based on the priorities you identified earlier. Example categories:

1. Strength of Internal Medicine Training

   • Breadth and complexity of cases
   • ICU exposure
   • Hospitalist and subspecialty teaching quality

2. Strength of Psychiatry Training

   • Inpatient and outpatient balance
   • Severe mental illness and psychotic disorders
   • Consultation-liaison and integrated care

3. Integrated Med-Psych Identity

   • Presence and quality of combined rotations
   • Dedicated med psych leadership
   • Culture of viewing dual training as an asset, not an anomaly

4. Mentorship and Career Development

   • Access to mentors in your areas of interest
   • Support for fellowships, research, or leadership pathways

5. Workload, Wellness, and Culture

   • Call schedule and support systems
   • Resident cohesion, inclusivity, and morale

6. Location and Lifestyle

   • Cost of living
   • Proximity to support network
   • Fit with your preferences (urban vs suburban vs rural)

Rate each program (for example, 1–5 for each domain), but treat the scoring as a structured guide, not a rigid formula. Sometimes a slightly lower-scoring program may still be the best overall fit for you because of one crucial domain (e.g., integrated care opportunities).

5.2 Distinguish “Deal-Breakers” From “Negotiables”

When evaluating residency programs, especially highly specialized ones like med psych, it’s helpful to clearly define:

• Deal-breakers
  • Example: “Must have robust CL psychiatry and integrated primary care opportunities.”
  • Example: “Must be in a city where my partner can work.”
• Negotiables
  • Example: “Fewer research opportunities are okay if integrated clinical training is excellent.”
  • Example: “Location preferences can bend for outstanding training and fit.”

Explicitly naming these helps you avoid overemphasizing superficial factors like a glossy website or a single impressive elective, while missing structural mismatches.

5.3 Integrating Interview Impressions Into Your Research

Your pre-interview program research sets the foundation. Interviews and second looks refine your understanding.

After each interview day, document:

• How transparent did the program seem about challenges or limitations?
• Did residents seem genuinely supported and proud of their training?
• Did the program leadership articulate a coherent vision for medicine-psychiatry combined training?
• Were they interested in you specifically, including your integrated-care goals?

Use your spreadsheet or rubric to add qualitative notes under each category. Then, when forming your rank list, revisit both your data and your gut impressions.

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Step 6: Common Pitfalls and How to Avoid Them

When researching med psych residency programs, applicants often run into similar traps. Being aware of them can help you course-correct early.

6.1 Over-Focusing on Name Recognition Alone

Prestige can matter for certain academic career trajectories, but in med psych, the alignment of training with your desired practice often matters more.

Ask:

• Will this program prepare me well to practice in the integrated role I envision?
• Does the “big name” actually translate into stronger training in the specific niches I care about (e.g., CL, integrated primary care, SMI management)?

6.2 Ignoring the Day-to-Day Reality of Combined Training

Some programs look excellent on paper but may:

• Be administratively fragmented between departments
• Leave med psych residents feeling like outsiders in both specialties
• Have unmanageable or poorly coordinated schedules

This is why candid discussions with current residents are essential. Ask directly about:

• How often do schedule conflicts arise between medicine and psychiatry?
• How are those conflicts handled?
• Do you feel like you belong fully to both departments?

6.3 Failing to Plan for Board Preparation

Dual board eligibility is a major advantage but also a complex undertaking.

Investigate:

• How does the program structure board prep in internal medicine and psychiatry?
• Are there group review sessions, question banks, or formal curricula?
• Do recent graduates consistently pass both boards on the first attempt?

A strong med psych residency should have a clear, proactive plan for this.

6.4 Underestimating the Value of Culture and Cohort

With small combined cohorts, your immediate peers matter enormously.

Look for:

• Evidence of strong collegiality among med psych residents (photos, retreats, social events, shared projects)
• Diversity and inclusion statements backed by resident representation
• Stories of resident advocacy or program improvement initiatives

If possible, spend part of your virtual or in-person interview interacting with med psych co-residents without faculty present. Ask them how they support each other.

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Frequently Asked Questions (FAQ)

1. How many medicine-psychiatry combined programs should I apply to?

Because med psych is niche and positions are limited, most applicants cast a relatively wide net. Many competitive candidates apply to most or all existing med psych residency programs unless there are explicit geographic limitations. Use your program research strategy to identify any clear misfits, but in general, it’s prudent to err on the side of applying broadly and then narrowing through interviews and deeper research.

2. Should I also apply to categorical internal medicine or psychiatry programs?

Many applicants do apply to categorical medicine and/or psychiatry as part of a parallel plan, especially if they are open to a single-specialty career. Whether you should do this depends on:

• How committed you are to combined training
• Your competitiveness as an applicant
• Geographic constraints
• Advice from mentors who know your application well

If you choose to apply to both combined and categorical tracks, be thoughtful about how you explain your interests in each, and research those categorical programs with the same care.

3. What if a program doesn’t have dually trained faculty—should that be a red flag?

Not necessarily, but it is an important factor. Programs without many (or any) dually boarded faculty can still provide strong integrated training if:

• There are faculty in CL psychiatry, psychosomatic medicine, or integrated primary care who understand combined practice
• There is a dedicated combined program director who advocates for med psych residents
• Integrated clinical sites and combined rotations are well-developed

However, if there is minimal integrated focus, limited faculty with dual or overlapping interests, and no clear med psych identity, it may be harder to get the full benefit of combined training.

4. How can I tell if a program truly values its med psych residents?

Look for:

• Presence of med psych residents in leadership roles (chiefs, committees)
• Stories of combined residents presenting at conferences, leading QI, or developing new integrated clinics
• Clear, regularly updated web content specifically about the combined program
• Residents who speak positively and specifically about support from leadership
• Structural evidence (combined conferences, dedicated didactics, retreats, robust mentorship)

When evaluating residency programs in this niche field, those signals indicate that the institution sees medicine-psychiatry combined training as a strategic priority, not just an add-on.

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By approaching med psych residency research in a structured, intentional way—clarifying your goals, gathering detailed information, and systematically evaluating programs—you’ll be far better positioned to identify the environments where you can thrive as a future dual-trained physician.