During the first year of training, residents rotate between eight months of internal medicine and four months of psychiatry.

In internal medicine, residents spend half of their rotations on inpatient teams that service University of Iowa Health Care and the Veterans Affairs Medical Center. Rotations include general inpatient medicine, cardiology, hematology-oncology, and medicine-psychiatry. The other half of internal medicine rotations are spent on a variety of consultation teams like infectious disease, nephrology, pulmonology, and surgical co-management; in outpatient settings like allergy-immunology, endocrinology, cardiology, dermatology, gastroenterology, neurology, pulmonology, rheumatology, geriatrics, palliative care, and the emergency room; and on night internal medicine rotations.

In psychiatry, residents rotate through the inpatient psychiatry teams that cover the geriatric psychiatry unit, eating and mood disorders unit, and psychotic disorders unit at UI Health Care. Residents also cover the general inpatient unit at the Veterans Affairs Medical Center.

In addition to these rotations, residents also maintain a panel of patients in an outpatient setting through a continuity of care clinic at UI Health Care or the Veterans Affairs Medical Center. Continuity of Care Clinics are scheduled every Y week (occurring for one week between four-week-long rotations). During inpatient psychiatry rotations, residents are scheduled for one half-day per week in their Continuity of Care Clinic.

At the end of the first year of training, internal medicine-psychiatry residents will have obtained a broad experience of practice in both disciplines. They will have gained exposure to diagnosis, treatment, and management of both complex medical and psychiatric illness as well as approaches to patients with presentations at the complex intersection of both practices.

Supervision is provided by faculty physicians, fellows, and senior residents.

For a more in-depth look at each year of training, explore the following:

• First Year
• Second Year
• Third Year
• Fourth Year
• Fifth Year

The second year of training is divided evenly between internal medicine and psychiatry.

While on internal medicine rotations, second year residents are considered senior residents and rotate in the Medical Intensive Care Unit (MICU) and the Cardiovascular Intensive Care Unit. They also lead inpatient teams in general internal medicine, hematology-oncology, cardiology, and night internal medicine rotations.

While on psychiatry rotations, second year residents are still considered junior residents (a distinction primarily relevant to the call schedule) and rotate on the emergency psychiatry service, consultation-liaison psychiatry service, geriatric psychiatry unit, eating and mood disorders unit, and psychotic disorders unit.

As in the previous year, second year residents continue to follow a panel of patients in an outpatient setting through a continuity of care clinic at University of Iowa Hospitals & Clinics or the Veterans Affairs Medical Center. Continuity of Care Clinics are scheduled every Y week (occurring for one week between four-week-long rotations). During inpatient psychiatry rotations, residents are scheduled for one half-day per week in their continuity of care clinic.

For a more in-depth look at each year of training, explore the following:

• First Year
• Second Year
• Third Year
• Fourth Year
• Fifth Year

The third year of training begins with a four-month block of rotations in internal medicine, after which the residents join their categorical psychiatry counterparts in the outpatient setting for next 12 months. Residents split their time in outpatient psychiatry between the Adult Psychiatry Clinic at the University of Iowa Hospitals and Clinics and the Veterans Affairs Medical Center. Residents also spend one half-day per week at the Community Mental Health Center for Mid-Eastern Iowa.

At University of Iowa Hospitals & Clinics, residents see patients with a variety of illnesses – depression, anxiety, bipolar disorder, schizophrenia, attention deficit hyperactivity disorder, personality disorders, substance use disorders, eating disorders, adjustment disorders, etc. Appointments are generally 90 minutes in length for a diagnostic evaluation, 30 minutes for follow-up medication management, and 60 minutes for post-discharge follow-up. In an appointment, residents interview the patient, staff the case in a conference room with an attending faculty physician, and return to the patient (with the faculty physician) to finalize the treatment plan. Psychotherapy patients are also scheduled during clinic months. Residents are expected to follow three patients per week for the entirety of the 12 months in the Adult Psychiatry Clinic.

At the Veterans Affairs Medical Center, residents are exposed to a wide range of diagnoses, including a large amount of post-traumatic stress disorder cases. Appointments are the same length as those at University of Iowa Hospitals and Clinics, but there is more autonomy in the decision making process. For example, residents are not required to staff each patient and staff do not see the patients unless the resident feels there is a compelling reason. Instead, residents sit down with staff between patients or at the end of the day to discuss cases and get feedback on treatment plans.

In both locations, third year residents provide on-call support, usually once every other week. At University of Iowa Hospitals & Clinics, on-call time is spent on emergent appointments and phone calls. At the Veterans Affairs Medical Center, on-call time is spent on consults and emergency room patients.

Third year residents continue to follow a panel of patients in an outpatient setting one half-day per week through a continuity of care clinic at University of Iowa Hospitals & Clinics or the Veterans Affairs Medical Center. Unlike with the Internal Medicine rotations, Psychiatry rotation are not on a X+Y system, and consequently, there is no week-long Continuity of Care Clinic.

For a more in-depth look at each year of training, explore the following:

• First Year
• Second Year
• Third Year
• Fourth Year
• Fifth Year

The fourth year of training begins with the last four months of outpatient psychiatry rotations. At the conclusion of this outpatient experience, residents will generally move to a rotation in the child and adolescent psychiatry unit at University of Iowa Hospitals & Clinics, which includes time in both inpatient and outpatient. After a two-month rotation in child and adolescent psychiatry, residents return to internal medicine rotations for the remaining six months of the year.

Call obligations continue as in the third year according to the particular rotation, with two to three back-up calls per month on psychiatry and calls per individual rotation schedules on internal medicine.

By the beginning of this year, residents have completed the required number of continuity of care clinics to meet board certification requirements in internal medicine.

For a more in-depth look at each year of training, explore the following:

• First Year
• Second Year
• Third Year
• Fourth Year
• Fifth Year

The fifth year of training is divided evenly between internal medicine and psychiatry, usually in 3-month blocks or 6-month blocks. This year includes time to complete any remaining rotations required for board eligibility in each specialty as well as time for self-designed electives (may include research).

Call obligations continue as in the fourth year according to the particular Internal Medicine rotation, but calls are no longer required in Psychiatry rotations. 

And, as with the fourth year, residents will continue working in their Continuity of Care Clinic.

Our residents have the opportunity to serve as Internal Medicine-Psychiatry Chief Residents during their PGY-5 year to help plan and organize the program, assist in recruitment, and serve as role-models and mentors to other residents.

For a more in-depth look at each year of training, explore the following:

• First Year
• Second Year
• Third Year
• Fourth Year
• Fifth Year