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Perceptions and Practices of Graduates of Combined Family Medicine-Psychiatry Residency Programs: A Nationwide Survey

Received February 1, 2006; revised July 15, 2006; accepted September 5, 2006. Dr. Warner is affiliated with the Third Infantry Division, Fort Stewart, Georgia, and the Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin. Dr. Morganstein is affiliated with the Department of Psychiatry, Malcolm Grow Medical Center, Andrews Air Force Base, Maryland. Dr. Rachal is affiliated with the Department of Psychiatry, Ehrling Berquist Hospital, Offutt Air Force Base, Nebraska. Dr. Lacy is affiliated with the Department of Psychiatry, Malcolm Grow Medical Center, Andrews Air Force Base, Maryland. Address correspondence to Dr. Warner, Winn Army Hospital, Department of Psychiatry, 373 Steeple Chase Lane, Richmond Hill, GA 31324; christopher.h.warner{at}us.army.mil (e-mail).

OBJECTIVE: The authors evaluate the current practices and perceptions of graduates of combined family medicine-psychiatry residency programs in the following areas: preparation for practice, boundary formation, and integration of skills sets. METHOD: The authors conducted an electronic cross-sectional survey of all nationwide combined family medicine-psychiatry training graduates in the spring of 2005. RESULTS: Twenty-seven (62.8%) graduates participated. Nearly 30% worked in positions designed specifically for combined trained physicians, though only 11.1% participated in fully integrated practice. The mean time spent practicing psychiatry and family medicine is 70% and 16%, respectively. CONCLUSIONS: Combined trained graduates felt well prepared for practice in both specialties but somewhat less comfortable providing integrated care. Most are in positions that underutilize their ability to integrate family medicine and psychiatry in one practice. Contributing factors may include limited preparation for integration during residency training and lack of integrated job opportunities. Enhancing combined residents’ training in the provision of integrated services may optimize their utilization.

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