I'd say you have a very good chance of getting into a combined med-psych program.

First of all, remember, most people go to med school somewhere that does NOT have a combined program - there are only a handful of places that offer them. I'd say it is a small minority that attend a combined program at the same place they went to med school. I personally don't think they had an advantage because they went to that school - the few I can think of were excellent students and residents and could have gone just about anywhere.

Second, there were many unfilled slots in combined programs this past year - while some of the programs are probably fairly competitive, there are several programs that are not. Additionally, even the competitive programs may not be as competitive as you are thinking.

Third, I don't think it matters all that much where you went to medical school - there is no such thing as an "easy" medical school these days - you have to be pretty good to get into any med school.

Fourth, psych departments are struggling at MANY places, as are many other academic departments. Changes in the way medical services are being financed is really hurting medical education in this country (in my opinion at least).

Fifth, if you have strong evaluations, especially in medicine, and you wind up with a solid Dean's letter, then I think you'll be in good shape. I think that if you are good enough to get accepted to the internal medicine residency program at a place offering a combined program, you will probably be very competitive with their combined program.

Finally, as for things you can do to make yourself more competitive, I don't have too many suggestions you probably haven't though of on your own. I'd say the most important thing is to do some rotations in the summer time where you can get good evaluations. I know some of my classmates felt it was necessary to get letters from well known people within the department - in the end, I think they wound up getting letters that were not as good as if they had gotten them written by someone most other places probably haven't heard of.

You could always consider doing an externship for 1 month at a program you are considering - either in psych or medicine, or if they offer it, in a med-psych rotation (ie, inpatient unit). You better be good though, as they will also be evaluating you during that time. This will definitely give you the best feel of the particular town, program, and residents you'd be working with though.

Thanks for the information.