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Internal medicine/psychiatry program blends two critical specialties

The med/psych program at KU is one of the nation's best at training doctors to treat both the mind and body.

KU Medical Center's med/psych program is one of the nation's best at training doctors to treat the mind and body.

As a medical student, there was nothing Julie Leber, D.O., loved more than piecing together the puzzle of a new patient's presentation. After completing a psychiatry rotation in her third year, she couldn't ignore the strong connection between mental and physical health.

So, Leber decided to specialize in both, and pursued a residency in the rigorous internal medicine/psychiatry program at the University of Kansas Medical Center.

"I loved the depth of internal medicine and was sure this was the right path for me. I felt like I couldn't be a good internist without a strong foundation in psychiatry," she said. "Throughout my five years of residency, I've learned to see patients with an integrated view and feel well equipped to practice this unique skill set."

That's exactly what dual-training programs in internal medicine, or in some cases family medicine, and psychiatry, are designed to do - train doctors to treat the mind and the body through a skillful blend of core expertise in both medicine and psychiatry.

A tradition of excellence
Internal medicine/psychiatry, or med/psych, programs have been around for decades, and KU Medical Center is home to one of the best in the nation. Established in 1995, it's one of the longest-running in the country. Credited with 22 alumni since its inception, the program has reliably produced at least one graduate in every year of its existence.

Anchored in both internal medicine and psychiatry, two already strong specialties at KU Medical Center with a long, ongoing history of working well together, the med/psych program here boasts one of the highest number of dually trained med/psych physicians on the faculty.

"It's played out at least as well as I'd hoped. We've had phenomenal success and great trainees who have gone on and done a lot of great things," said William F. Gabrielli, Jr., M.D., PhD, chair of Psychiatry and Behavioral Sciences and the visionary behind the thriving program. "I think we attract some of the best people in the country and I'm convinced we have a reputation among the best, and we show solidarity with cause and principles better than a lot of programs."

Only two residents are accepted annually out of about 60 who interview and the 150 to 200 who annually submit applications. Completing the postgraduate course of study leads to dual board certification in both specialties.

"These are great doctors who are very dedicated," said Teresa Long, M.D., who has been the med/psych residency director since the start of the program in 1995.

As part of the highly demanding, tightly structured program, Long said residents are expected to absorb a lifetime of knowledge in five years, compared to three years for internal medicine or four years for psychiatry, before taking their board exams and becoming practitioners who are board certified in both specialties.

Leber, a native of Conyers, Georgia, said for her, the wide range of available learning opportunities is where KU's med/psych program separates itself from others.

"We rotate not only at the University of Kansas Health System, but also at the Veterans Affairs medical centers and the Community Mental Health Clinic. We have one of the most robust programs in terms of combined trained faculty," she said. "Our academic medical center community is a great thing to be a part of, from our patients to our co-learners to our faculty. And, of course, Kansas City is a wonderful place to live!"

Leber has taken full advantage of all those learning experiences. Last year, she became the first med/psych resident from KU Medical Center to earn the Association of Medicine and Psychiatry's prestigious Martin Fenton Award as the nation's top med/psych resident. The honor, presented to Leber at the association's annual meeting Oct. 12-13 in Chicago, recognizes residents in their final year of training based on outstanding clinical performance, teaching skills, writing and/or research, service to community and leadership.

A bright future
Leber graduated in June and joined a Federally Qualified Health Center in Missouri that operates both a psychiatry and a medical clinic. There she plans to incorporate primary care into the psychiatric clinic for patients with serious and persistent mental illness.

Other alumni of the program have gone on to focus in a variety of areas such as critical care, gastroenterology, cardiology, addiction psychiatry, psychosomatic medicine, geriatric medicine, palliative care and emergency medicine.

"Whether it's community health, mental health, veterans care or a subspecialty in either psychiatry or general medicine, I think we bring a greater depth to patient issues with the dual training," Long said.

Gabrielli believes the med/psych program is well-positioned for continued success.

"Looking ahead, we will focus on enhancing an already top-notch training program by increasing the number of joint medicine and psychiatry experiences for residents and the development of an in-patient med/psych unit," he said.

Emphasizing that mental health is an important part of general medical health, Gabrielli said primary care doctors are continuing to do a lot of behavioral medicine.

"People's minds, behaviors, feelings, perceptions and brain physiology don't exist in a vacuum. It's just that we want to be the specialists in behavioral medicine and we are. That's what makes us unique," he said. "It also creates respectability for those doctors. Other colleagues see something there that's different, and that generates a confidence that ultimately results in better communication, better collaboration, and at the end of the day, better patient care."

Psychiatry and Behavioral Sciences

University of Kansas Medical Center
Psychiatry and Behavioral Sciences
Mailstop 4015
3901 Rainbow Boulevard
Kansas City, KS 66160
Phone: 913-588-6400
Fax: 913-588-6414