Psychiatry as an internal medicine subspecialty: an educational model

Psychiatry has been integrated into the Department of Internal Medicine at the West Virginia University School of Medicine as a means of ameliorating the educational and patient care deficiencies engendered by the traditional mind-body dichotomy in medical education. A major project derived from this merger of clinical and teaching activities has been the transformation of the university hospital psychiatric ward in to the Conjoint Medicine Service. This service, to which patients with a variety of emotional and medical problems are admitted, is staffed by medical house officers and a general internist in a close collaborative relationship with the Department of Psychiatry. The nursing care is oriented toward patient education, exemplified by group sessions. House staff and students are trained to recognize and evaluate the underlying emotional and interrelational factors which affect each patient's health status and prognosis as a routine part of a comprehensive medical work-up. Student and patient acceptance of this integrated approach has been enthusiastic.