Originally Posted: 2001-10-27 16:17
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I received an e-mail recently with a few more questions about combined programs. I've included the questions here, along with the answers:
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1. How is the comdined course per se in terms of your experience and practise?
Answer: It is different for everyone. I originally thought I would practice primary care internal medicine and have a patient population with a lot of mild psychiatric illness, but I found out during residency that I liked the practice of psychiatry much more than internal medicine. I wound up taking a job at a state psychiatric hospital where I am doing mostly psychiatry, but also managing some of the medical issues for the long term patients. For example, I have several mentally retarded or psychotic patients with diabetes where I am (attempting to) manage their diabetes. Also, I am working on developing a weekly meeting with psychiatry residents where we discuss all of their new admissions to review any potential medical complications that they may not have thought of.
2. Can it give you an opportunity to pursue say a fellowship in an internal medicine field?
Answer: Yes, you can do a fellowship fterwards, exactly as if you had done either residency separately.
3. And during the 5 years how taxing or personally draining is it? Do you get time to do other stuff like develop your other talents or you just do not have time top breathe? Did you find the program personally challenging in terms of patient care and now do you feel like you can do more for any patient than if you had done one alone?
Answer: I selected Iowa's program because I knew I would have a lot of elective time
my last year, and there were several people who I wanted to do research with. My last year was extremely nice because of the 6 months of time I had set aside for research. There was a time in the middle of residency where I was very burnt out and seriously considering switching to just finish the psychiatry residency. I was very frustrated with the way the internal medicine department was running my outpatient clinic and I felt I had little control to change it. Fortunately, the program changed for the better and things were smoother after that. If you are motivated, you can definitely "make" time to develop other talents. Many people choose to use their "extra" time to moonlight and earn extra money. I did some moonlighting my last two years, but also did some research after hours. Some people took classes in the college, but that is more difficult to work out.
I didn't find the patient care responsibilities to be excessive, but other residents did. I did not like my medicine clinic because the patient population was difficult and the clinic was not equiped to handle them. I wanted to spend more time with the patients to sort things out, but we weren't given time to do that. I needed to learn to be more efficient and I never did, so that aspect was difficult.
Overall, now, I think I am well prepared to deal with most basic medical and psychiatric problems, but I think I have a much better understanding of the interplay of the two. I think there are some internal medicine residents who were perceptive enough to learn similar skills in dealing with patients, so you don't need to do a psychiatry residency to be a good internist, but I think some of the skills are very helpful with difficult patients. I feel extremely comfortable with my skills as a psychiatrist, even though I think I am more aware than most of my limitations.
4. Could you possibly tell me approximately when most programs give interviews to applicants esp. foreign med grads. after completing the ERAS? This is important since I am currently trying to complete my step two. I did my step 1 a couple of weeks ago.
Answer: I have no idea on this one. If no one posts a reply to this on the forum in the next week, I'll send out another message to the email list.
5. What sort of stuff do they usually look for in particular, or consider important, like letters of recommendation and so on?
Answer: Foreign medical grads definitely have it rough when it comes to getting US residency slots. I think solid letters of recommendation would be the most helpful thing. I know that some programs make an arbitrary cut-off for board scores and then consider applicants above that for interviews. Because of the huge number of foreign applicants, it can be very difficult.
Solid, detailed letters from US doctors would be helpful, especially if they explain specifis about your strengths. If the doctors are in an academic setting, it is appropriate (and can be very helpful) to have them call the program director for a program you are very interested in. Have the US doctor explain that you've expressed a lot of interest and if they can say very good things about you, you will have a much better chance. Also, that doctor may be able to get a feel of your chances so you can plan accordingly.
6. Are there particular programs that favour foreign med grads?
Answer: Again, others can answer this better than I can.
Rick