Mastering Research During Residency: A Guide for Med-Psych Trainees

Understanding Research During Medicine-Psychiatry Residency

Research during residency can feel intimidating, especially in a demanding combined program like med psych residency. Long clinical hours, complex dual training requirements, and high expectations can make research seem like “extra work” that’s hard to fit in. Yet for Medicine-Psychiatry trainees, engaging in research is one of the most powerful ways to shape your career, deepen your understanding of both fields, and advance integrated care.

This guide focuses on research during residency specifically within Medicine-Psychiatry combined programs—how to get started, realistic project types, how to balance time, and how to leverage opportunities such as an academic residency track. Whether you’re a medical student planning ahead or a current resident trying to orient yourself, this article will give you a practical roadmap.

Why Research Matters in Medicine-Psychiatry

Medicine-Psychiatry combined training sits at the interface of physical and mental health. Many important questions in this space are still unanswered or underexplored. Research allows you to:

• Improve care for complex medically and psychiatrically ill patients
• Challenge fragmented systems that separate “medical” and “psychiatric” care
• Build an academic niche that spans two specialties
• Develop skills in critical appraisal, data analysis, and quality improvement
• Become more competitive for fellowships and faculty positions

Examples of impactful Medicine-Psychiatry research questions include:

• What models of integrated care reduce hospital readmissions for patients with severe mental illness and heart failure?
• How does delirium risk differ in patients with serious mental illness compared to the general medical population?
• Which brief interventions best address substance use in medically hospitalized patients with co-occurring depression?
• What are the outcomes of collaborative care models in primary care for patients with multiple chronic medical conditions and bipolar disorder?

In a combined med psych residency, research is not just a “nice extra”—it can be a key part of your professional identity.

---

Types of Research Projects That Fit Medicine-Psychiatry Training

Not all research needs to be an R01-level randomized controlled trial. Within a Medicine-Psychiatry residency, many meaningful resident research projects are small, focused, and directly tied to your clinical work.

1. Clinical Research

Clinical research is often the most intuitive option, especially if you’re passionate about patient care.

Common clinical research designs in Med-Psych:

• Retrospective chart reviews
  • Example: Reviewing outcomes of patients with schizophrenia admitted to a general medical floor after implementing a proactive psychiatry consult protocol.
• Prospective cohort or observational studies
  • Example: Following a cohort of patients with diabetes and major depressive disorder in an integrated primary care clinic to assess changes in HbA1c and PHQ-9 scores over 12 months.
• Cross-sectional studies
  • Example: Surveying hospitalized medical patients about barriers to psychiatric follow-up after discharge.

Why it fits residents well:

• Often feasible within a single institution
• Leverages routinely collected clinical data
• Can be nested within existing rotations (e.g., inpatient medicine-psychiatry unit, CL service, primary care clinic)

2. Quality Improvement (QI) and Implementation Projects

Many combined med psych residency programs emphasize systems-level work, making QI a natural fit. QI is often more flexible, has fewer regulatory hurdles, and can show concretely improved outcomes in your own practice environment.

Examples tailored to Medicine-Psychiatry:

• Implementing routine depression screening on a chronic heart failure inpatient service and tracking referral follow-through to outpatient psychiatry
• Standardizing antipsychotic metabolic monitoring for inpatients on medical floors
• Creating a protocol for managing agitation and delirium in patients with advanced liver disease on the medicine service
• Developing a liaison model where a Med-Psych team reviews all readmissions for patients with serious mental illness

Why QI is attractive:

• Shorter timelines than many traditional research studies
• Often aligns with hospital priorities (e.g., readmissions, seclusion/restraint reduction)
• Easier to integrate into duty hours and existing rotations
• Highly valued for academic careers in systems-based practice and healthcare delivery science

3. Health Services and Integrated Care Research

This type of research examines how care is organized, delivered, and financed—perfect for Medicine-Psychiatry combined trainees.

Potential projects:

• Evaluating outcomes of a collaborative care model for patients with chronic pain and depression in a primary care setting
• Studying patterns of emergency department utilization among patients with co-occurring severe mental illness and COPD
• Comparing length of stay and readmission rates for Med-Psych vs traditional medical or psychiatric units
• Analyzing barriers to physical health screening (e.g., lipid panels, A1c) in community mental health center patients

These projects can position you to pursue a career in population health, health policy, or integrated care systems.

4. Education and Curriculum Research

As a med psych resident, you’re often teaching peers and teams about the intersection of medicine and psychiatry. Turning these efforts into scholarship can be highly rewarding.

Examples:

• Designing and evaluating a curriculum on managing psychotropic medications in medically complex patients for internal medicine residents
• Studying the impact of a delirium and capacity assessment workshop for psychiatry residents on consultation-liaison rotations
• Creating simulation scenarios that combine acute medical and psychiatric crises (e.g., sepsis with suicidal ideation) and assessing learner outcomes

Education research projects can yield conference presentations and publications that are highly relevant if you’re considering an academic residency track and eventual clinician-educator role.

5. Case Reports and Case Series

In med psych residency, you will encounter rare and complex cases that perfectly illustrate the interface of medicine and psychiatry.

Examples include:

• Neuropsychiatric presentations of autoimmune disease (e.g., lupus psychosis)
• Unusual medication interactions (e.g., serotonin syndrome in a patient on multiple serotonergic agents for medical and psychiatric indications)
• Challenging capacity evaluations in patients with fluctuating delirium and chronic psychosis

Case reports and small case series:

• Are manageable early in residency
• Help you learn the publication process
• Build your CV and show genuine engagement in scholarship

---

Finding the Right Research Environment and Mentors

A key decision during med psych residency is where and with whom you’ll do your research. Combined training means you have access to both medicine and psychiatry departments—this is an asset but can also feel overwhelming.

Identifying Your Interests

Before hunting for a mentor, spend time clarifying what genuinely interests you. Ask yourself:

• Do I gravitate more toward inpatient or outpatient work?
• Which patient populations excite me (e.g., SMI with chronic medical disease, addiction, geriatrics, psychosomatic medicine)?
• Do I like systems-level and policy questions, or symptom-level/clinical questions?
• Do I see myself in an academic career long-term?

Knowing your interests helps you narrow down potential projects and mentors.

Finding Mentors in a Combined Program

Aim for a mentorship team rather than one person:

• Primary mentor: Could be in medicine, psychiatry, or a combined-trained faculty member (ideal if available)
• Content expert: E.g., someone in addiction, psychosomatic medicine, cardiology, or health services research
• Methodological mentor: A biostatistician, epidemiologist, or QI expert
• Career mentor: Often a program director or senior faculty who understands the Medicine-Psychiatry combined training landscape

Where to look:

• Departmental research directories on your institution’s website
• Your med psych residency program leadership—they often know which faculty enjoy mentoring residents
• Grand rounds speakers or faculty who present on integration topics
• Med-Psych units, CL services, collaborative care clinics, and primary care-psychiatry integration programs

When you approach a potential mentor, come prepared with:

• A brief description of your interests (1–2 sentences)
• Your stage in training and schedule constraints
• Openness to working on an existing project or developing a new one
• A realistic timeline (e.g., “I’d like to have a poster ready for next year’s Academy of Consultation-Liaison Psychiatry meeting”)

Evaluating a Potential Mentor

Ask yourself:

• Do they respond to emails relatively promptly?
• Have they successfully mentored residents before?
• Do they have ongoing projects with realistic roles for you?
• Are their expectations clear and compatible with your workload?
• Do they respect duty hours and resident wellness?

A supportive mentor is usually more important than the “perfect” topic.

---

Balancing Clinical Demands and Research Time

One of the biggest challenges in med psych residency is time. Balancing research during residency with demanding rotations requires careful planning and honest self-assessment.

Understand Your Program’s Structure

Start by clarifying:

• Which rotations are lighter (e.g., outpatient clinics, electives, some consult months) versus heavy (e.g., ICU, night float, busy inpatient months)
• When dedicated research or scholarly time is available, if at all
• Whether there is an academic residency track with protected research time, and what the application process involves

Many combined programs offer:

• Longitudinal half-day research clinics (e.g., ½ day/week in PGY-3 or PGY-4)
• Capstone scholarly projects required for graduation
• Optional academic tracks with additional protected time and mentorship

If your program has an academic residency track, explore it early (PGY-1 or PGY-2) so you can plan your timeline and build the necessary relationships.

Time Management Strategies

1. Front-load the groundwork on lighter rotations
   Use outpatient or elective months to:

   • Conduct literature reviews
   • Draft IRB submissions
   • Build databases and data collection tools

2. Match projects to your year of training

   • PGY-1: Focus on clinical foundation; identify interests; maybe start case reports.
   • PGY-2: Connect with mentors; join an existing project; complete IRB; start small QI projects.
   • PGY-3: Major data collection and analysis; first abstracts and posters.
   • PGY-4–5 (if applicable): Manuscript writing; more independent projects; leadership roles in research/QI.

3. Use micro-time effectively

   • 20–30 minutes between admissions or clinic sessions can be enough to update a data spreadsheet or edit a paragraph.
   • Keep a running “micro-task” list (e.g., 3–5 citations to find, 2 data points to double-check).

4. Be realistic about project size A well-completed, smaller project is far more valuable than an overly ambitious study that never gets finished. Start with:

   • Clear, narrow research questions
   • Limited variables for chart reviews
   • QI cycles that can be completed in months, not years

5. Negotiate protected time thoughtfully If you’re on an academic track or have flexibility in electives:

   • Plan research electives after your project’s groundwork is laid (IRB approved, data collection process defined) so you can use the time for high-yield work.
   • Coordinate with co-residents to manage coverage so your protected time is respected.

---

Making Your Work Count: From Idea to Publication

A key challenge for residents is not just doing research during residency, but turning it into tangible outputs—abstracts, posters, presentations, and publications.

Step 1: Refining the Research Question

Use the FINER criteria: Feasible, Interesting, Novel, Ethical, Relevant.

For Medicine-Psychiatry specifically, consider:

• Does it address both medical and psychiatric dimensions?
• Could it influence integrated care models or policies?
• Is the question clear enough that a non–med psych physician would understand its importance?

Example refinement:

• Too broad: “Do psychiatric comorbidities affect heart failure outcomes?”
• Better: “Among adults hospitalized for acute decompensated heart failure, does a co-occurring diagnosis of major depressive disorder predict 30-day readmission after controlling for comorbidities?”

Step 2: IRB and Regulatory Considerations

Your mentor and institution’s research office can guide you, but in general:

• Many QI projects may be exempt from full IRB review, but you must still confirm.
• Chart reviews usually need IRB approval, even if minimal risk.
• Prospective studies involving patient contact require more detailed protocols.

Tips:

• Use IRB templates and examples of previously approved studies.
• Emphasize minimal risk and de-identified data whenever appropriate.
• Build extra time into your timeline for IRB review and potential revisions.

Step 3: Data Collection and Management

Organize your data from day one:

• Use standardized data collection forms (REDCap, Excel, or institutional tools).
• Define each variable explicitly (e.g., what counts as “psychiatric diagnosis”—ICD-10 codes, chart documentation, etc.).
• Keep a data dictionary so future you (and reviewers) know exactly what you did.

For med psych projects, carefully consider:

• Capturing both medical and psychiatric variables (e.g., comorbidities, lab values, psychotropic medications, symptom ratings).
• Socio-demographic and social determinants of health, which often play a major role in dual-diagnosis populations.

Step 4: Analysis and Interpretation

You don’t need to be a statistician, but you should:

• Understand basic statistical concepts (means, medians, confidence intervals, p-values).
• Know which tests are generally used for which kinds of data (t-tests, chi-square, logistic regression).
• Work closely with a biostatistician or experienced mentor for anything beyond basic descriptive analysis.

A common strength in Medicine-Psychiatry resident research is nuanced clinical interpretation:

• You can contextualize findings with your real-world experiences across both specialties.
• You can highlight limitations related to stigma, fragmented care, and diagnostic uncertainty that others may overlook.

Step 5: Abstracts, Posters, and Presentations

Turn your project into scholarly products early and often:

• Abstracts: Submit to relevant meetings such as:
  • Academy of Consultation-Liaison Psychiatry (ACLP)
  • American Psychiatric Association (APA)
  • Society of General Internal Medicine (SGIM)
  • American College of Physicians (ACP)
  • Association of Medicine and Psychiatry
• Posters: Great for networking and receiving feedback; can often be converted into a manuscript.
• Oral presentations: Start with local departmental or institution-wide research days, then move to regional/national meetings.

Pay attention to:

• Target audiences: A CL psychiatry meeting will appreciate different angles than a general medicine conference.
• Messaging: Emphasize integration and cross-disciplinary implications—this is your strength as a med psych resident.

Step 6: Manuscript Writing

For many residents, writing the full paper is the most challenging—but also the most rewarding—stage.

Strategies:

• Break it down: Draft Methods and Results first; then Introduction and Discussion.
• Use your abstract as a skeleton for the paper.
• Block protected “writing hours,” even if it’s just 1–2 hours weekly.
• Share drafts incrementally with mentors, not only at the very end.

Consider aiming for journals that value integrated care, psychosomatics, and health services research:

• Psychosomatics
• Journal of Psychosomatic Research
• General hospital psychiatry journals
• Primary care or general internal medicine journals with behavioral health interests
• Journals focused on healthcare delivery and population health

---

Strategically Leveraging Research for Your Future Career

Your work in research during residency should align with your long-term goals. Combined med psych training opens many paths; research helps you clarify and pursue them.

Building a Coherent Scholarly Narrative

Ask: If someone reads my CV, what story does it tell?

Examples of coherent narratives:

• “Resident focusing on integrated care models for patients with serious mental illness and cardiovascular disease.”
• “Physician-investigator interested in health services research at the intersection of addiction, chronic pain, and mood disorders.”
• “Educator developing curricula on managing psychiatric comorbidity in primary care for internal medicine physicians.”

You don’t need all of your projects to be identical, but some thematic consistency helps when you later apply for fellowships or faculty roles.

Academic Residency Track and Beyond

If your program offers an academic residency track:

• Use it to secure dedicated time, mentoring, and sometimes formal coursework (e.g., epidemiology, biostatistics).
• Consider pursuing a certificate or master’s degree (MPH, MS in Clinical Investigation, health services research) if feasible and aligned with your goals.
• Seek leadership roles on research or QI committees within your department.

Long-term, your resident research projects can evolve into:

• Pilot data for larger grants
• Foundations for a K-award or other early-career funding
• Content expertise for an academic job in CL psychiatry, internal medicine, primary care, or population health

For Applicants and Early Trainees

If you are still in medical school or the early phase of residency preparation:

• Participate in resident research projects as a medical student, ideally in integrated care or CL settings.
• Ask to help analyze data, prepare posters, or co-author manuscripts.
• Document your contributions clearly on your CV, emphasizing roles like data collection, literature review, or first-author abstracts.

This will show Medicine-Psychiatry combined programs that you are serious about scholarly work and prepared to use the program’s academic opportunities.

---

Frequently Asked Questions (FAQ)

1. Do I need research experience to match into a Medicine-Psychiatry combined residency?

Strong research experience is not an absolute requirement, but it can be a differentiator. Programs value curiosity, critical thinking, and a commitment to integrated care. If you have prior research—especially related to psychiatry, internal medicine, or health services—it strengthens your application. However, meaningful clinical experiences and a clear rationale for choosing Medicine-Psychiatry are just as important.

2. How much research should I realistically aim to complete during residency?

Quality matters more than quantity. For many med psych residents, a realistic portfolio by graduation might include:

• 1–2 completed QI or clinical projects
• 1–3 posters or oral presentations at regional or national meetings
• 1–2 manuscripts (submitted or published), sometimes including case reports

If you’re planning a heavily research-focused career, you may aim for more, but even then, depth in a coherent area of interest is more valuable than many disconnected projects.

3. Can I still pursue a research career if my residency doesn’t have a formal academic track?

Yes. While an academic residency track can make things easier by providing structure and time, many successful physician-researchers developed their paths in programs without formal tracks. Key steps include:

• Proactively finding engaged mentors
• Starting with feasible, focused projects
• Using electives creatively for research and coursework
• Seeking external opportunities (multi-site collaborations, national committees, or online research training)

4. How do I choose between medicine-focused, psychiatry-focused, or integrated research topics?

As a med psych resident, you don’t have to limit yourself to exclusively “integrated” projects, but choosing topics that leverage your dual training can be especially powerful. Consider a balanced portfolio:

• One or two projects clearly at the medicine-psychiatry interface
• Possibly one project more squarely in internal medicine or psychiatry but enriched by your cross-disciplinary perspective

When in doubt, prioritize projects where your combined training gives you unique insight or where the work could directly improve care for patients with co-occurring medical and psychiatric conditions.

---

Research during residency in Medicine-Psychiatry is demanding but deeply rewarding. By choosing feasible projects, cultivating strong mentorship, using your time strategically, and aligning your work with your long-term goals, you can turn residency into a launching pad for a career that blends clinical care, scholarship, and system-level impact at the crossroads of medicine and psychiatry.