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Combined Internal Medicine/Psychiatry Residency

Medical College of Wisconsin Combined Internal Medicine/Psychiatry Program

Combined IM/Psychiatry residents are dual citizens, splitting their time between both categorical programs, distilling seven years of training into five years by capitalizing on the clinical skills that overlap both disciplines. Combined residents participate in rotations and didactics of the sponsoring categorical programs as well as develop new rotations and experiences in integrated care.

We are looking for innovators, integrators, and ignitors of change.

So much is happening at MCW in the Behavioral Health integration movement – it’s the perfect time for dual-board training here.

Funded by both the Milwaukee VA and Froedtert Health, the combined program capitalizes on the strengths of both categorical programs while building its own identity with Med/Psych rotations and didactics. We have a wealth of dual-boarded faculty working in Consult-Liaison, Perioperative Medicine, Integrated Behavioral Health in Primary Care, and Psych-Oncology.

Med/Psych residents at MCW are pioneering new programs and improving existing integrated efforts at the VA while leading our new Complexity Intervention Unit at Froedtert Hospital to care for acutely comorbid patients.

New this year are our integrated Med/Psych clinics at Froedtert Hospital and Sixteenth Street Community Health Center.

Program Highlights

  • The first few classes will be piloting a new Med/Psych clinic with aspects of consultation, collaboration and continuity primary care.
  • Our combined residents will have significant leadership opportunities in program development and will be asked to provide interdisciplinary education.
  • There are ample opportunities for scholarly activity within both sponsoring departments.
  • Competitive applicants will be able to articulate how combined training will help their future patients and the health care system.

Meet Our Residents

Chart Your Future: Medical Residencies

We are grateful to the Milwaukee VA Medical Center for supporting this residency and its efforts to provide whole-person care to our veterans. Zablocki VA is a top-notch veteran’s hospital with a commitment to training the next generation of doctors to care for our those who have served our country.

Learn more about training at the Zablocki VA Medical Center

Program Requirements

Internal Medicine

Internal Medicine

  • 30 months total of internal medicine
  • 4 weeks of emergency room during years 1 or 2
  • 4 weeks of care for ICU during years 1 or 2
  • 4 weeks of care of ICU during years 3, 4, or 5
  • At least 33% (thus 10 months of 30 Medicine months) must involve ambulatory experiences
  • Continuity clinic
  • At least 4 months of subspecialty experiences (inpatient, outpatient, or a combination)
  • Significant exposure to inpatient cardiology
Learn more about the medicine curriculum
Psychiatry

Psychiatry

  • 30 months of psychiatry training
  • 2 months of neurology (1 month in either PGY1-2, and 1 month in PGY3-5)
  • Between 6 and 16 months of inpatient psychiatry
  • Inpatient geriatric, addiction, and/or forensics can count as inpatient psych months but only above an initial 6 months of general inpatient psychiatry
  • 12 months of organized, continuous, and supervised clinical experience in outpatient treatment with experience in both brief and long-term care of patients
  • 2 months of child and adolescent
  • 2 months of consultation-liaison psychiatry
  • 1 month of geriatric psychiatry (inpatient or outpatient)
  • 1 month of addiction psychiatry
  • Exposure to the evaluation of forensic issues including writing a forensic report
  • Exposure to an organized 24-hour psychiatry emergency service, a portion of which may occur in ambulatory urgent-care settings
  • Exposure to community psychiatry (community-based settings, crisis teams, public hospitals, community mental health centers)
Learn more about the psychiatry curriculum

Sample Rotation Block Grid

Frequently Asked Questions

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What will graduates of this program do?

Based on national needs for healthcare providers, we foresee that trainees completing this program will seek local and national positions combining medical and psychiatric scopes of practice. While they may seek fellowship opportunities for specialization, many enter the workforce and fill administrative roles in behavioral health integration. Graduates are ready to care for complex patients in inpatient and outpatient settings, in high acuity or chronic disease management.

Will residents in the combined program have faculty mentors?

Yes, we have a strong cadre of combined trained faculty members to serve as mentors, three dual trained in Internal Medicine/Psychiatry and one in Family Medicine/Psychiatry.

Is there a preferred number of letters of recommendation for each specialty?

We must see a letter from a psychiatrist, and one from an internist. A letter of support from a combined-trained faculty member is welcome, but not required. Candidates are expected to describe in their personal statement their reasons for applying to the combined program, and thoughts about their future career goals.

What is the process for coordinating the application process between the two departments?

Applications will be reviewed by the program director and the interview process will proceed virtually, with a sample of meetings from both departments that may be spread across multiple days.

Meet Our Program Directors

Mary Beth Alvarez, MD, MPH

Mary Beth Alvarez, MD, MPH

“I am excited to bring Med/Psych training back to Wisconsin and open doors for learners to be part of the behavioral health integration movement. We have so many enthusiastic teachers in both departments that are ready to be part of the change our health system needs to bring high-quality services to the most complex patients. It’s challenging to be the first residents in a new program, but the rewards are obvious.”

Learn more about Dr. Alvarez

Kathlyn Fletcher, MD, MA

Kathlyn Fletcher, MD, MA

"I am so excited about the prospect of having a combined internal medicine/psychiatry program at MCW! This is such an important step for our community as a whole, and I have no doubt that such a program will be a very positive influence in the categorical IM residency program. There is so much overlap between internal medicine and psychiatry because so many of our patients have comorbidities in both areas. I am personally very interested (clinically and research-wise) in the hospital care of medical patients with PTSD."

Learn more about Dr. Fletcher

Sara Brady, MD

Sara Brady, MD

"I am thrilled with this opportunity for two well-established categorial programs to collaborate and create a unique and much needed training program to develop clinicians who can deliver comprehensive and integrated care, recognizing that traditional distinctions between psychiatric and medical illness often fall short of meeting the needs of complex patients."

Learn more about Dr. Brady

Core Faculty

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Thomas W. Heinrich, MD

Professor; Vice Chair

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Jennifer Knight, MD, MS, FACLP

Professor, Psychiatry and Behavioral Medicine and Microbiology & Immunology

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Lisa Wehr Maves, MD

Assistant Professor

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