Skip to main content
Log in

Supervision and Boundaries in a Combined Family Practice and Psychiatry Residency Training Program: The National Capital Consortium Experience

  • Special Article
  • Published:
Academic Psychiatry Aims and scope Submit manuscript

Abstract

Objectives

The combined discipline of family practice and psychiatry was created in 1995. There are no established guidelines for 1) teaching residents how to integrate these two specialties, 2) providing appropriate supervision, and 3) helping residents develop personal and professional boundaries. The authors share their approach and aim to stimulate dialogue and promote the establishment of standards for combined programs.

Method

The authors review some of the difficulties encountered in supervising family practice-psychiatry residents and the rationale for their approach.

Results

Providing residents with clear boundaries of practice and supervision that initially separate the two specialties during training facilitates the development of specialty knowledge and skills as well as the capacity to form clear boundaries.

Conclusion

Our experience suggests that only when residents learn the appropriate practice and boundaries of each specialty can they successfully integrate the two without boundary or role confusion.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Regier D, Narrow W, et al: The de facto US mental and addictive disorders service system: Epidemiological Catchment Area prospective 1-year prevalence rates of disorders and services. Arch Gen Psychiatry. 1993; 50: 85–94

    Article  CAS  PubMed  Google Scholar 

  2. Schurman R, Kramer P, et al: The hidden mental health network: treatment of mental illness by nonpsychiatrist physicians. Arch Gen Psychiatry 1995; 42: 89–94

    Article  Google Scholar 

  3. Chapman R, Nuovo J: Combined residency training in family practice and other specialties. Fam Med 1997; 29: 715–718

    CAS  PubMed  Google Scholar 

  4. McCahill ME, Palinkas LA: Physicians who are certified in family practice and psychiatry: who are they and how do they use their combined skills? J Am Board Fam Pract 1997; 10: 111–116

    CAS  PubMed  Google Scholar 

  5. Wulsin L, Cantor L: The current status of combined family practice and psychiatry residency programs. Fam Med 1999; 31: 606

    CAS  PubMed  Google Scholar 

  6. Doebbeling CC, Pitkin AK, Malis R, et al: Combined internal medicine-psychiatry and family medicine-psychiatry training programs, 1999–2000: program directors’ perspectives. Acad Med 2001; 76: 1247–1252

    Article  CAS  PubMed  Google Scholar 

  7. Stieble V, Schwartz CE, Physicians at the medicine/psychiatric interface: what do internests/psychiatrists do? Psychosomatics. 2001; 42: 377–381

    Article  Google Scholar 

  8. Carney CP, Pitkin AK, Malis R, et al: Combined internal medicine/Psychiatry and family practice/psychiatry training programs 1999–2000: residents’ perspectives. Acad Psychiatry 2002; 26: 110–116

    Article  PubMed  Google Scholar 

  9. Lacy TJ, Higgins MJ: Integrated care of a patient with multiple psychiatric and medical diagnoses by a combined family practice-psychiatry physician. J Am Acad Psychoanal Dynamic Psychiatr 2005; 33(4) 619–636. Acad Psychiatry 2002; 26:110–116

    Article  Google Scholar 

  10. Gabbard GO, Nadelson C: Professional boundaries in the physician-patient relationship. J the Am Med Assoc 1995; 273: 1445–1449

    Article  CAS  Google Scholar 

  11. Anfinson TJ, Bona JR: A health services perspective on delivery of psychiatric services in primary care including internal medicine. Med Clin North Am 2001; 85: 597–616

    Article  CAS  PubMed  Google Scholar 

  12. Haupt DW, Newcomer JW: Abnormalities in glucose regulation associated with mental illness and treatment. J Psychosomatic Res 2002; 53: 925–933

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lacy, T., Flynn, J. & Warren, D. Supervision and Boundaries in a Combined Family Practice and Psychiatry Residency Training Program: The National Capital Consortium Experience. Acad Psychiatry 29, 483–489 (2005). https://doi.org/10.1176/appi.ap.29.5.483

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1176/appi.ap.29.5.483

Keywords

Navigation