Originally Posted: 2001-12-19 13:56
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Dr. Admin,
I'm a medical student debating between med/psych and internal medicine. I've found this site quite helpful! I am interested, however, in knowing how difficult it is to maintain dual board certification after completing residency. I assume that there are two entirely separate licensing systems, with different CME requirements, not to mention two vast and different bodies of literature. Have you (or other readers) found it manageable to stay current in both fields?
Thanks,
Warren Kinghorn
Great questions!
As I just finished residency in June 2001, I have not had too much trouble staying current in both fields. You are correct, that there are two different licensing boards, the American Board of Internal Medicine (ABIM) and the American Board of Psychiatry and Neurology (ABPN).
By doing the combined residency, I am board eligible in both fields. I have already taken and passed the internal medicine boards, so I am not board certified in internal medicine. I have taken the written part of the psychiatry boards, and I should hear in the next month whether I passed. Once I pass the written exam, I will then have to pass an oral psychiatry exam in order to be board certified in psychiatry.
I don't believe there is any difference between CME credits. And I'm not even sure yet what I need them for, other than to maintain my state medical license. I probably need them to keep up board certification as well, but I assume that I can use the same credits towards both fields.
For internal medicine, you now have to take a re-certification exam every 10 years. I'm not sure yet what needs to be done for psychiatry. I'll look into this one.
As for keeping current in both fields, I know it can be a challenge. As best I can tell, many people stay in an academic setting after completing a combined residency, which is one of the few venues where you can actively practice both fields. I currently work in the state system, where I can also practice both without much difficulty. VA hospitals are another option. As long as you are doing both, it is not too hard to keep current, as I find I'm always looking up things and learning more.
Another portion of graduates go on to practice one field or the other in private practice (doing both in private practice is currently very difficult due to how insurance reimbursement works, being on panels, etc). I would imagine it would be challenging to stay current in the other field, but it would depend a lot on the individual.
While the two fields are large (particularly internal medicine), most people will tend to limit their practice to some more specific population. This is also true of internal medicine alone - it is not possible to stay completely current in all of the subspecialities. If it were possible, no one would need to subspecialize.
If you provide a little more information about what you see yourself doing in the future, I can help give some more specific advice on pro's and con's of combined training versus just internal medicine.
You also should check out the Association of Medicine and Psychiatry - membership is free for students and residents and membership will provide you access to an e-mail discussion group of people interested in combined medical and psychiatric care. The website is:
There is an application on the main page.
If you don't mind me plugging a site... www.psychboards.org has a lot of useful information to help you prepare for the psychiatry side of things. Good luck. 😀
www.psychboards.org is a nice site. The forums for preparing for psychiatry board exams is a great idea. I wish you luck with the site!