This program is based on the philosophy that knowledge and clinical skills are acquired through a logical progression of experiences. Over the five years of training residents will spend equal time in the two disciplines with an effort to include experiences which are integrative and overlapping.

First Year

The initial educational emphasis is on accurate collection of:

• clinical data
• assessment
• diagnosis
• mastery of procedural skills
• treatment planning

The first year experiences take place predominately on inpatient units, although emergency room and ambulatory experiences are also included.

Second & Third Year

Second and third year residents receive training in multiple settings. Emphasis is placed on supervision and teaching of Rush Medical College students and junior residents from both psychiatric and internal medicine programs. In addition to inpatient and subspecialty units, the ambulatory continuity experiences in medicine and psychiatry begin in the second year with two half-days per week under the supervision and guidance of both medical and psychiatric supervisors.

The resident assumes full responsibility for the integrated medical and psychiatric care of patients which continues throughout the remaining residency. During consultation-liaison, geriatric, forensic, women’s health and chemical dependency rotations emphasis is placed on the integration of medical and psychiatric skills and knowledge.

Third & Fourth Year

During the final three months of the third year and the first nine months of the fourth year residents are provided with a more in-depth experience with patients who present in an ambulatory psychiatric setting. Residents learn individual, marital, family, crisis, brief, and long term therapies under the careful supervision of psychiatric attending physicians.

Fine tuning of psychopharmacology skills with acute and chronic patients in an ambulatory setting is emphasized. Outpatient child and chemical dependency patients are also seen in this setting. Additionally, residents provide medical care for psychiatric outpatients with supervision. The internal medicine ambulatory experience is expanded during this year to two halfdays per week.

Fifth Year

The final year continues to provide mostly ambulatory experiences in psychiatry and medicine. Unique elective experiences include rotations in women's health, geriatrics, forensic psychiatry at the county jail, and a senior supervisory rotation on the consultation/liaison service.

The resident is also expected to develop skills and knowledge in medical-psychiatric research. Research is presently ongoing at the interface of medicine and psychiatry and numerous opportunities exist for resident participation. A two-month clinical research or combined internal medicine/psychiatry clinical experience of the residents' choice is also provided in the fifth year.

Summary

In conclusion, this program not only provides a solid base for the practice of internal medicine and psychiatry, but also is quite flexible, with the opportunity to develop each resident's clinical, teaching and research interests.

Two examples include a psychotherapy and women's health track. The psychotherapy track involves additional training in dynamic psychotherapy at the Institute of Psychoanalysis in the fourth and fifth years. The combined internal medicine/psychiatry program provides an ideal background for those interested in women's health. This track includes more intensive training in gynecology, breast pathology and those psychiatric problems specific to women.