Combined Neurology & Psychiatry Residency Training Program

"To know the brain…is equivalent to ascertaining the material course of thought and will, to discovering the intimate history of life in its perpetual duel with external forces.” - Santiago Ramon y Caja

Welcome to MUSC Neurology/Psychiatry!

Why both neurology and psychiatry? It’s a question all of us are familiar with, and it’s not unwarranted; combining both does add two years to residency. While all of us have different interests and reasons why we have chosen this path, we all agree that having a comprehensive understanding of the brain will improve care for patients and better lead to advancements in neuroscience.

Our residents and graduates have tackled this in various ways. Prior graduates have gone on to use their combined skills in movement disorders/DBS, epilepsy/treatment of nonepileptic events, and brain stimulation, as well as more general psychiatry or neurology. Others have gone into education or research. Graduates of this program are eligible to become board certified in both neurology and psychiatry, and have a unique skill set that can open doors to a variety of career paths.

What does our program look like?

While our graduates complete the equivalent of full residency training in both neurology and psychiatry, our goal is to integrate the two fields throughout the 6 years so that our trainees always feel part of each. Residents will be on rotations and participate in didactics with their categorical neurology and psychiatry peers and also have some experiences unique to the combined residents. Additional information on the Neurology Residency Program and Psychiatry Residency Programs is available online.

Intern Year

During their first year, residents complete 8 months of internal medicine which is an ACGME requirement for neurology. The remaining 4 months are split between neurology and psychiatry so that residents able to start building their foundation in each field.

Second and Third Year

Over these two years, residents alternate between neurology and psychiatry every 3 months. During this time, residents complete similar rotations to the junior PGY-2 Neurology and Psychiatry residents, including inpatient and outpatient rotations. Residents also start their weekly neurology continuity clinic in the PGY-2 year which continues through PGY-4. One week a month, this clinic is a combined neurology/psychiatry clinic with attendings from both specialties.

Fourth Year

This year is primarily spent being a senior resident on both the neurology and psychiatry inpatient services with some additional outpatient elective time included.

This is also the year most residents apply for the DART program.

Fifth and Sixth Year

During these years of training, residents shift to a fully outpatient schedule. There will be a mix of neurology and psychiatry clinics fulfilling both requirements and allowing for additional electives. In addition, there is more intensive training in psychotherapy, including dedicated didactics and supervision for psychodynamics and CBT-style therapies (including CBT, DBT, ACT, etc), as well as an expectation to see several longitudinal psychotherapy patients which can be tailored to resident interest. As long as there is a balance of psychiatry/neurology clinics to fulfill graduation requirements, elective options are fairly open. In the past, residents have participated in consult services, DBS implantation/planning, running TBI or nonepileptic event specific clinics, or doing more intensive training in Movement or Cognitive disorders. If a resident is participating in DART, protected time for research and didactics is provided.

Education Opportunities

We participate in lectures depending on which department we are working with. Neurology has daily protected noon conference lectures. Psychiatry has one didactic half-day a week in PGY-1 through PGY-4 as well as PGY-6, with two half-days in PGY-5 focused on psychotherapy, psychopharmacology, and general lectures. After starting outpatient psychiatry, there are two half-days of supervision as well.

We also offer neuro-psych specific education. The first hour of the monthly combined neuro/psych clinic is a didactic session with a rotating schedule. Categories of topics include clinical neuropsychiatry, brain-behavioral relationships, review of new research publications, and career planning where we invite a former graduate (from our or another program) to talk about their career path. We are planning this year to expand this conference from once a month to every other week. We also have a monthly neuro/psych case series. During this didactic, we discuss an interesting overlap case with faculty and residents from both the neurology and psychiatry departments, allowing for collaboration and learning across the fields. We also have developed collaborations with other programs, including “combined” journal clubs during which we discuss topics with other combined neuro-psych programs across the country. There are several protected didactic days in the Fall to allow for neuro-psych specific training.

All of our residents are members of ANPA, the national neuropsych organization. We encourage submission of abstracts to the yearly ANPA meeting as well as travel to the meeting. For this meeting (and others), there is departmental support from both Neurology and Psychiatry to cover travel costs, especially if presenting a poster or oral presentation.

Social Life

All of the combined residents stay close throughout training, and with the schedule shifting every three months shifts between Neurology and Psychiatry, there is frequent interaction on the inpatient units as well as at the monthly clinic. The three month schedule also allows for strong connections to build with both the categorical psychiatry and categorical neurology residents, as one is never “off service” for more than three months at a time. Residents typically participate in many of the categorical resident social events (which are usually two to three times monthly) and help “bridge the gap” between both programs.

Additionally, we have monthly get-togethers specifically for combined residents that significant others and families are welcome to join. These are informal and typically held at the chief resident’s home, with program directors at times joining as well. We have yearly (sometimes bi-yearly) “retreats” held at the beach to discuss the future of the program and address any concerns. Combined residents also participate in the categorical yearly retreats.