Essential Questions for Med-Psych Residency: Your Complete Guide

Medicine-Psychiatry (Med-Psych) residency applicants occupy a uniquely interdisciplinary niche. You are not just asking, “Will I be trained well?” but also, “Will this program truly understand and support the dual identity I am building as an internist and psychiatrist?”

Thoughtful, strategic questions to ask programs are one of your most powerful tools during the interview season. They help you evaluate fit, clarify expectations, and signal that you understand the challenges and opportunities of medicine psychiatry combined training.

This guide provides a comprehensive, practical framework for what to ask, why it matters, who to ask, and how to adapt your questions for different Medicine-Psychiatry programs and settings.

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Understanding the Goals of Your Questions

Before you build your list, it helps to be clear on why you’re asking questions at all. In Med-Psych, every question you ask should ideally serve one or more of these goals:

1. Clarify the structure of combined training

   • How are internal medicine and psychiatry rotations integrated?
   • How will you meet board eligibility for both specialties?

2. Assess culture and support systems specific to combined residents

   • Are Med-Psych residents an afterthought or an integrated part of both departments?
   • How do they support residents juggling dual identities and requirements?

3. Evaluate how the program aligns with your future career plans

   • Academic, community, integrated care, C-L psychiatry, primary care mental health, systems leadership, etc.

4. Identify potential red flags

   • Burnout, over-reliance on Med-Psych residents as “utility players,” poor coordination between departments, or weak board pass rates.

5. Demonstrate insight into combined training

   • Asking targeted, nuanced questions shows you understand the demands of a med psych residency and are already thinking like a dual-trained clinician.

Keep these goals in mind as we go through specific question categories. You won’t ask everything on this list; instead, you’ll select the questions that help you make meaningful distinctions between programs.

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Core Questions About Program Structure and Training

These questions focus on how the medicine psychiatry combined curriculum is built, coordinated, and experienced day to day. They’re among the most important questions to ask residency programs in this specialty.

Core curriculum and rotation structure

Ask these to the program director, associate program director, or chief residents:

• “Can you walk me through the four or five years of Med-Psych training here? How are the medicine and psychiatry rotations sequenced and integrated?”

  • Follow-up: “Are there blocks that are intentionally blended (e.g., medical-psychiatry unit, C-L, integrated clinics), or is it primarily alternating between medicine and psychiatry?”

• “How closely does the combined program curriculum mirror the categorical internal medicine and categorical psychiatry programs? Where does it differ most?”

• “How much flexibility is there in elective time, and how much is constrained by board requirements for both specialties?”

• “How are night float and call responsibilities balanced between medicine and psychiatry rotations?”

These questions help you decide whether the program’s structure matches how you like to learn—e.g., alternating short blocks vs longer “immersion” blocks in each specialty.

Accreditation, board eligibility, and outcomes

Combined Medicine-Psychiatry programs must meet the requirements of both ABIM and ABPN. You want to understand how well the program does this.

• “How does the program ensure all ACGME and board eligibility requirements are met for both medicine and psychiatry?”
• “What has been your board pass rate in internal medicine and psychiatry for Med-Psych graduates over the past 5–10 years?”
• “Do Med-Psych residents ever have to do ‘make-up’ time to meet board requirements for either specialty?”

If a program hesitates or cannot clearly explain these fundamentals, consider it a mild red flag.

Integration between departments

Medicine-Psychiatry only works if internal medicine and psychiatry departments communicate and collaborate.

• “How would you describe the relationship between the internal medicine and psychiatry departments when it comes to Med-Psych residents?”
• “Who ultimately advocates for Med-Psych residents when there’s a scheduling or curriculum conflict—the Med-Psych program director, the medicine PD, the psychiatry PD, or a committee?”
• “Are Med-Psych residents included in both medicine and psychiatry educational conferences and retreats? How do you prevent us from falling through the cracks socially and academically?”

Here, you want to hear about proactive coordination, not ad hoc patchwork problem-solving.

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Questions About Clinical Experience and Integrated Care

One of the main reasons applicants choose a med psych residency is the chance to practice at the intersection of physical and mental health. Your questions should help you understand how robust that integration truly is.

Integrated clinical settings and patient populations

Ask these of current residents, faculty, and program leadership:

• “What are the core integrated or Med-Psych experiences in your program (e.g., psych-oncology, HIV psychiatry, transplant psychiatry, medical-psychiatry inpatient unit, collaborative care primary care clinics)?”

• “Are there dedicated Med-Psych inpatient units or consultation-liaison services where Med-Psych residents play a central role?”

• “On your inpatient internal medicine wards, how visible is psychiatry? And on psychiatry units, how actively are medical issues managed by the team versus automatically consulted out?”

• “Are Med-Psych residents ever the primary provider for patients’ medical and psychiatric care over time, for example in an integrated continuity clinic?”

The goal is to figure out if you’ll actually be practicing combined medicine and psychiatry, or mostly doing each separately with occasional overlap.

Supervision and role of Med-Psych residents

In some programs, Med-Psych residents become the default “bridge” for complex patients. That can be enriching or exploitative, depending on support.

• “How do attendings and teams typically use Med-Psych residents on rotations? Do we tend to become the de facto consult for complex medically or psychiatrically ill patients?”
• “When complicated multi-morbidity cases arise, do attendings model integrated thinking, or is it mostly left to Med-Psych residents to ‘figure it out’?”
• “Do Med-Psych residents receive any specialized supervision or mentoring focused specifically on integrated practice—e.g., from Med-Psych–trained faculty or dual-boarded attendings?”

You’re looking for a balance: meaningful responsibility, plus structured guidance and modeling.

Procedural skills and competence in both fields

You want to leave residency confident as a full internist and psychiatrist, not “half-trained” in each.

Questions to ask the program director and senior residents:

• “How does the program ensure Med-Psych residents achieve procedural and competency expectations comparable to categorical medicine residents (e.g., codes, ICU exposure, procedures)?”
• “On the psychiatry side, how do Med-Psych residents gain depth in areas like psychotherapy, neurostimulation (ECT/TMS), and addiction treatment?”
• “Do Med-Psych residents ever feel less prepared than categorical colleagues in either medicine or psychiatry by graduation? How does the program respond to that feedback?”

Look for honest acknowledgement of challenges, paired with concrete solutions.

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Questions About Culture, Support, and Wellness

Because Med-Psych residents straddle two worlds, support and culture matter even more. These questions help you understand the lived experience beyond the brochure.

Identity, belonging, and cohort dynamics

Ask these to current residents in a more informal setting (resident-only Zoom, social, or breakout sessions):

• “How many Med-Psych residents are there per year, and is there a sense of a distinct Med-Psych identity or cohort?”
• “Do Med-Psych residents feel fully integrated with the categorical internal medicine residents and categorical psychiatry residents, or somewhat in-between?”
• “On both services, do attendings and co-residents understand the Med-Psych training pathway and respect it?”

Follow-up example:

• “Can you share an example of when being Med-Psych was clearly seen as an asset on a team? And an example when it felt confusing or undervalued?”

You want to gauge whether Med-Psych is celebrated, tolerated, or misunderstood.

Workload, schedules, and wellness

Given the dual demands, burnout risk can be real. These are key questions to ask residency programs:

• “How does the program monitor workload and burnout specifically among Med-Psych residents?”
• “Do Med-Psych residents typically work similar hours to categorical residents on each service, or is there a trend toward higher utilization due to our dual skill set?”
• “Are there wellness resources or mentorship structures tailored to combined residents—e.g., Med-Psych support groups, retreats, or dedicated check-ins with leadership?”

Ask residents:

• “If you had to describe the culture here in one or two words (e.g., ‘supportive,’ ‘intense,’ ‘independent’), what would you say and why?”
• “Have you ever felt like expectations were unrealistic—either on medicine or psychiatry—because of being Med-Psych?”

The tone of their answers—more than the specific words—will tell you a lot.

Handling conflicts and problem-solving

Combined programs are inherently complex; issues will arise. What matters is how programs respond.

Questions for program leadership:

• “Can you share an example of a time when a Med-Psych resident was struggling with scheduling, workload, or identity conflict between the two departments? How did you address it?”
• “How easy is it for residents to give feedback, and can you share a change that was made based on Med-Psych resident feedback in the last few years?”

You’re asking: does leadership have a track record of listening and adapting, or are they defensive and rigid?

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Questions About Education, Scholarship, and Career Development

Med-Psych residents often pursue diverse careers: academic integrated care, C-L psychiatry, hospital medicine with psychiatric expertise, health systems leadership, or community-integrated models. Your questions should probe how well the program supports this.

Teaching, didactics, and interdisciplinary education

Ask program director, chiefs, or education leadership:

• “Do Med-Psych residents attend both medicine and psychiatry didactics, and is there protected time for both?”
• “Are there Med-Psych–specific conferences, case conferences, or journal clubs that focus on the interface of medical and psychiatric illness?”
• “How often do Med-Psych faculty or dual-trained physicians lead teaching sessions for residents?”

You’re looking for deliberate, structured education that bridges the two fields—not just “you can attend whatever you want.”

Research and scholarly opportunities

If scholarship matters to you:

• “What kinds of research or QI projects have recent Med-Psych residents done, and how were they supported?”
• “Are there faculty with established interests in areas like integrated care, C-L psychiatry, addiction, psychosomatic medicine, or population health who routinely mentor residents?”
• “Is there protected time for scholarly activity, and does this differ between medicine and psychiatry rotations?”

Ask residents:

• “How realistic is it to do research or QI while meeting the clinical demands of a med psych residency here?”

Career outcomes and mentorship

This is where you can get concrete about long-term trajectories.

• “Where have your recent graduates gone—fellowships, academic positions, community practice, hospital roles?”
• “Do Med-Psych graduates feel competitive for both internal medicine and psychiatry fellowships if they choose to subspecialize?”
• “Is there a formal mentorship or career planning process specifically for Med-Psych residents, including help deciding whether to practice as hospitalists, psychiatrists, integrated clinicians, etc.?”

You want to ensure that your training doesn’t pigeonhole you into a single niche unless that’s your goal.

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Strategizing: Who to Ask, How to Ask, and When

Having a list of questions is helpful, but being strategic about what to ask program directors versus residents can make your conversations more productive and candid.

What to ask program directors

Use your limited time with leadership to focus on higher-level structure, philosophy, and resources. When you think about what to ask a program director, prioritize:

• Program design and vision

  • “How do you envision the role of Med-Psych graduates in the healthcare system 5–10 years from now, and how does this program prepare us for that?”
  • “What differentiates your med psych residency from other combined programs?”

• Infrastructure and support

  • “How do you advocate for Med-Psych residents when departmental priorities conflict?”
  • “What changes or improvements are you currently working on for the Med-Psych program?”

• Outcome metrics

  • “Could you share board pass rates, graduate destinations, and any formal evaluations of the program’s effectiveness?”

These interview questions for them help you understand leadership’s priorities and transparency.

What to ask current residents

Residents are your best source for candid, on-the-ground insights. Focus on:

• Daily life

  • “What does a typical week look like on your medicine months? Psychiatry months? Integrated experiences?”
  • “How manageable is the call and night float schedule?”

• Hidden curriculum

  • “What surprised you the most after starting here that you couldn’t see from the website or interview day?”
  • “If you were choosing again, would you still pick this program—and why or why not?”

• Support and growth

  • “Can you share a moment where you felt really supported by the program? And one where you wished support had been better?”

How many questions is “enough”?

On a typical interview day, you might:

• Ask 2–3 high-yield questions in your formal interview with the program director
• Ask 2–3 questions during each breakout or small group with residents
• Ask 1–2 questions during any Q&A panel or large group session

Prioritize depth over volume. It’s better to have a meaningful back-and-forth about a few critical topics than to rush through a checklist.

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Tailoring Your Questions to Your Priorities

No two applicants have the same goals. Use the following lenses to personalize your questions.

If you’re interested in academic or research careers

Focus on:

• “What proportion of Med-Psych residents are involved in research, and in what areas?”
• “Is there structured mentorship for residents aiming for academic careers, including help with grant-writing or early publications?”
• “How supportive is the program of attending conferences and presenting work—financially and in terms of time off?”

If you’re drawn to community or underserved care

Ask:

• “What is the patient population like? Are there opportunities to work in community clinics, safety-net hospitals, or integrated primary care settings?”
• “How does the program address social determinants of health, health equity, and access to integrated care?”
• “Are there partnerships with community mental health centers, addiction programs, or public health initiatives where Med-Psych residents are actively involved?”

If you’re weighing different combined programs

When comparing multiple medicine psychiatry combined options, standardize some of your questions so you can make apples-to-apples comparisons:

• “How many months of pure internal medicine vs. pure psychiatry vs. integrated rotations do Med-Psych residents complete by graduation?”
• “How many Med-Psych graduates in the last 5 years practice primarily as internists, primarily as psychiatrists, or in explicitly integrated roles?”
• “What do you see as your program’s greatest strength and greatest limitation for Med-Psych residents?”

Document these answers immediately after interviews—they will blur together by the time you rank programs.

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Frequently Asked Questions (FAQ)

1. How many questions should I prepare for each Medicine-Psychiatry interview?

Prepare a core list of 8–12 questions, then choose 3–5 to use per program depending on what has already been covered in presentations and written materials. You don’t need to ask every question; aim for the ones that help you clarify:

• Program structure and integration
• Culture and support for Med-Psych residents
• Fit with your long-term career goals

Have a few backup questions in case your primary ones are already answered.

2. Is it okay to ask direct questions about workload, burnout, or red flags?

Yes—and you should. Phrase them professionally and curiosity-driven, not confrontational. For example:

• “How does the program monitor for and address burnout among Med-Psych residents?”
• “Have there been any recent challenges, such as duty hour concerns or faculty turnover, and how has leadership responded?”

Programs that respond transparently are generally more trustworthy than those that become defensive or evasive.

3. Should I ask the same questions to every program?

It’s useful to have a few standardized questions so you can compare programs directly, especially about:

• Rotational structure
• Board pass rates
• Graduate outcomes

But you should also tailor some questions based on each program’s unique features (e.g., a Med-Psych unit, particular research strengths). This shows you have done your homework and are genuinely interested in that program, not just any med psych residency.

4. Can I ask about fellowship or job prospects during the interview?

Absolutely. Asking about career outcomes is both appropriate and expected. Examples:

• “How well prepared do Med-Psych graduates feel for fellowships in C-L psychiatry, addiction, or other subspecialties?”
• “What kinds of positions—academic, hospital-based, community—have Med-Psych graduates obtained in recent years, and how did the program support that process?”

These questions to ask residency leadership and residents give you critical information about your long-term trajectory while signaling that you are thinking ahead in a mature, realistic way.

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Thoughtful, well-chosen questions are not just about gathering data—they are also how you present yourself as a reflective, insightful future colleague. In a Medicine-Psychiatry residency interview, your ability to ask nuanced, program-specific questions about integrated care, dual training, and career development will help you both evaluate programs and demonstrate that you are ready for the unique challenges of combined training.