Neurology-Psychiatry Combined Residency

Welcome to Our Program!

The Basics

What is our program?

An ACGME-accredited, 6-year combined residency program conferring board eligibility in both neurology and psychiatry upon completion.

When was it approved?

In 2016, by the ABPN and ACGME.

Where are we located?

Dallas, Texas, in the medical district just northwest of downtown.

Who are our leaders?

Kathy Niu, M.D., is our Program Director, and the Associate Program Directors are Adam Brenner, M.D. and Lauren Philips, M.D.

How do I apply?

We take one to two applicants per year and use ERAS; view a list of items required in the application.

Mission Statement

Our mission is to develop clinicians, educators, and researchers who will be leaders in psychiatry, neurology, and their integration.

Vision

Many patients have complex medical histories with comorbidities spanning the fields of both neurology and psychiatry. By educating physicians in both fields, we hope to provide our graduates a unique and essential role in the future of medicine. Our goal is to foster lifelong learning, clinical excellence, proficiency in education, administrative acumen, and ethical prowess to ensure our graduates are fully prepared not only to succeed, but to become leaders who better mankind while pursuing their dreams to the fullest.

Careers

The career outlook for dual-boarded neurologist-psychiatrists is excellent. Most people who pursue this path choose to stay in academics. They often become leaders in academia, prominent researchers, or clinicians with a special niche that allows them to become experts in an area of their choice.

A large percentage of these physicians continue to practice in both specialties, and there is plenty of reason to do so. For example, in patients with epilepsy, a significant amount also suffer from psychogenic non-epileptic seizures. These patients are most often seen by practitioners of both specialties.

Another example is Multiple Sclerosis. Individuals with MS have a 50 percent chance of at least one lifetime episode of clinical depression, versus seventeen percent in the general population. They also have a two to threefold risk of being diagnosed with bipolar or psychotic disorders. In addition, some of the common treatments for MS (such as interferon) can actually exacerbate psychiatric conditions. These patients provide a clinical challenge for providers in either specialty, and may be particularly well-served by practitioners trained in both disciplines.

Future of the Field

In regard to the future of the combined approach, Dr. Joseph Martin, a neurologist and former Dean of Harvard Medical School may have said it best:

“Neurology and psychiatry have, for much of the past century, been separated by an artificial wall created by the divergence of their philosophical approaches and research and treatment methods. Scientific advances in recent decades have made it clear that this separation is arbitrary and counterproductive. Neurologic and psychiatric research are moving closer together in the tools they use, the questions they ask, and the theoretical frameworks they employ. The interests of neurology and psychiatry converge within the framework of modern neuroscience. Further progress in understanding brain diseases and behavior demands fuller collaboration and integration of these fields. Leaders in academic medicine and science must work to break down the barriers between disciplines.”

The Integration of Neurology, Psychiatry, and Neuroscience in the 21st Century
Joseph B. Martin
American Journal of Psychiatry 2002 159:5, 695-704

Program Structure

The UT Southwestern Neurology/Psychiatry Combined Residency Program (NPCRP) curriculum was primarily resident-designed, with a goal of promoting integrated education and clinical experience for both specialties in tandem.

PGY-1 comprises a preliminary year in internal medicine, but with our UT Southwestern flavor (including exposure to the emergency department, addiction, inpatient psychiatry, and a one-month Neurology Bootcamp to prepare residents for call months and the junior rotations to come). PGY-2 through PGY-6 are dedicated entirely to neurology and psychiatry.

In PGY-2 to PGY-5, there is a mix of both specialties, with more weight in neurology in PGY-2 followed by a cross-taper each year to more time in psychiatry in PGY-5. The final PGY-6 year is split 50/50 in the outpatient setting. Throughout training there will be enough consecutive time spent in each specialty to begin developing that particular specialty’s way of thinking. To balance this, every few months residents will switch and spend some time in the other specialty, fostering a dual-specialty mindset with integration throughout training.

Why is the program combined?

Historically, the fields of Neurology and Psychiatry were integrated, but have grown independently over the past several decades. However, given our ever-expanding knowledge of the brain, these specialties appear more connected than ever before (after all, they both originate in the same organ). Many physicians find themselves called to pursue both fields, and that is why we are here!

Is the combined program right for me?

Many people considering this route have wondered whether they should pursue a combined residency, a neurology residency with behavioral neurology fellowship, or a psychiatry residency followed by a neuropsychiatry fellowship. We hope to help make these distinctions a little clearer.

Combined Neurology/Psychiatry Residency

6 years:
- 1 year medicine prelim
- 5 years of combined residency

This route creates physicians boarded in both neurology and psychiatry, providing the broadest training of the options available. We are often faced with complex patients who have not read nor abide by a particular specialty’s textbook. Graduates of these programs are able to comprehensively assess patients suffering from any neurologic or psychiatric illness with the lens and tools of both specialties. They are trained in psychopharmacology, psychotherapy, behavioral emergencies, and everything else that other psychiatrists learn, including diagnosis and management of mood disorders, anxiety disorders, psychotic disorders, functional neurologic disorder, etc. In addition, they learn to interpret images of the CNS such as CT and MRI, become proficient in EEGs, and can manage neurologic conditions including epilepsy, autoimmune disorders, dementia, movement disorders, headaches, disorders of the PNS, etc. This training allows for the most flexibility in future practice options. Combined graduates may occupy any clinical space and have been shown to occupy a disproportionately high amount of leadership roles, including department chairs.

Chief Year

Residents in the NPCRP will spend their final year of residency as Chief of the combined program. The Chiefs are responsible for being a liaison for other residents in the program, working with the program directors, and helping ensure that things run smoothly in the program. This includes the development of resident schedules, working with the chiefs in the categorical neurology and psychiatry programs, helping with any disciplinary issues that arise, and fielding concerns. The Chief Year will teach administrative skills and prepare residents for future leadership roles.

Fellowships

UT Southwestern is host to a vast array of fellowships in both neurology and psychiatry. Residents who decide to pursue post-residency training will have a wide variety of options available to them.

Psychiatry Fellowships:

Addiction
Child & Adolescent
Consultation-Liaison
Forensic
Geriatric

Neurology Fellowships:

Autoimmune Disorders
Behavioral Neurology and Dementia
Clinical Neurophysiology
Epilepsy (Adult and Pediatric)
Headache Medicine
Movement Disorders
Multiple Sclerosis/Neuroimmunology/Neuro-Ophthalmology
Neurocritical Care
Neuromuscular
Neuro-Oncology
Sleep Medicine
Vascular Neurology and Stroke
Endovascular Surgical Neuroradiology/Neuroendovascular Fellowship (through Radiology)

Psychiatry Residency/Neuropsychiatry Fellowship

5-6 years:
- 4 years psychiatry residency
- 1-2 years neuropsychiatry fellowship

This route creates psychiatrists that focus on conditions that have neuropsychiatric overlay. The more behavioral aspects of these conditions are addressed symptomatically, but the underlying neurologic disorder is usually diagnosed and managed separately by a neurologist.

Neurology Residency to Behavioral Neurology Fellowship

5-6 years:
- 1 year medicine prelim
- 3 years neurology residency
- 1-2 years fellowship

This route creates neurologists that focus primarily on cognitive disorders and dementia. There are many neuropsychiatric manifestations that occur in these diseases, and patients will often have a multidisciplinary team including the behavioral neurologist, geriatric psychiatrist or neuropsychiatrist, and others. It should be noted that psychiatry residency graduates may be accepted to some Behavioral Neurology programs. We have an excellent Behavioral Neurology and Dementia Fellowship here at UT Southwestern, run by Dr. Brendan Kelley.

Some Behavioral Neurology and Neuropsychiatry Fellowships are integrated. The programs that allow a second year of fellowship generally focus on providing a significant research experience to help develop careers in academia. Graduates of residency programs in either neurology or psychiatry are encouraged to apply.

Research

Rotation Sites

The diversity of training sites at UT Southwestern is a spectacular highlight of the program. In many metropolitan areas (where diversity tends to be highest), there are higher concentrations of residency programs, and resources are often shared or monopolized. In smaller areas, diversity is often lacking.

In our program, residents train in an exceptionally broad range of environments, including:

Veteran’s Administration (VA): VA experience helps residents learn about and interact with an important population in our veterans. The VA has a unique EMR and workflow, and is a site where several attendings have chosen to practice. The patient population has its own flavor and is host to many formative rotations.
Parkland County Hospital: Working in a county hospital is a unique experience. Patients are often indigent and uninsured. Parkland hosts a substantial amount of rotations for residents, granting exposure to many pathologies and presentations more often seen in third world countries. Along with these, there are many bread and butter cases that imbue residents with the competence to adeptly handle anything that comes their way.
William P. Clements Jr. University Hospital & Zale Lipshy Pavilion—William P. Clements Jr. University Hospital: The UT Southwestern System includes the university hospitals, which endow residents with the chance to experience tertiary care facilities and privately insured patients. Zale Lipshy Pavilion is a specialty neurosciences hospital that draws complex and rare cases from all over the region and beyond. Here, residents are able to see a wide variety of pathologies that have been referred to their care for the highest level of expertise.
Metrocare Services: Metrocare Services is essentially the mental health outpatient arm of the Parkland County system, and is a representation of community medicine. Residents get exposure to outpatient psychiatry in the community setting, including working with the poor and homeless from early stages of residency. In addition, there are other available opportunities include ACT teams and research. The CEO (John Burruss, M.D.) is an expert in public psychiatry and a frequent guest speaker and lecturer for the psychiatry department.
Terrell State Hospital: Terrell State Hospital holds a variety of patients, including those awaiting psychiatric competency evaluation for trial. Residents work with Dr. Mitchell Dunn, an expert in forensic psychiatry, who teaches about competency evaluation, malpractice suits, and determining what it means to truly be not guilty by reason of insanity while walking residents through individual, real-life cases.
Lew Sterrett County Jail: Residents spend a month at the County Jail providing psychiatric care to inmates. This is a very safe rotation with standardized procedures in place and constant guard and Attending physician supervision. It provides residents a chance to interact with a population with its own challenges and pitfalls, and helps residents to see a broader spectrum of humanity.
Children’s Health Dallas: Both psychiatry and neurology have several months of required rotations involving children and adolescents. These months will be proctored by the Children's Health Dallas, adjacent to Parkland and UT Southwestern in the Dallas medical district. Children’s is one of the top children’s hospitals in the country for neurology, and also has active inpatient and consult teams in psychiatry.
Scottish Rite for Children: Residents will spend one month at Scottish Rite for Children working with children in outpatient neurology. This is yet another venue to allow residents the greatest breadth of experiences during training.

Faculty

Current Residents

Neuropsychiatry Elective for Visiting Medical Students

Interested in learning more about the UT Southwestern Combined Neurology-Psychiatry Residency?

UT Southwestern is thrilled to be one of four combined neurology-psychiatry residencies within the United States. Neuropsychiatry is a medical specialty that aims to improve the diagnosis and treatment of those living with complex brain disorders through better understanding brain-behavior relationships. Neuropsychiatrists apply a biopsychosocial approach to formulation in addition to utilizing cutting-edge advances in neuroimaging, genetics, biomarkers, and neurophysiology to provide high-quality care to patients. To help prepare our future generation of clinical neuroscientists, UT Southwestern is home to a visiting student elective for 4th-year medical students! This elective, titled “Neuropsychiatry” in the Visiting Student Learning Opportunities™ (VSLO®) online portal, is tailored to those students who are considering training in a combined neurology-psychiatry residency program. The elective will be posted on VSLO for applicant viewing beginning April 1. Applications are reviewed around the middle of April, with acceptances distributed through VSLO in late April/early May.

The Neuropsychiatry Rotation

The Neuropsychiatry visiting elective introduces students to several clinical settings at the interface of neurology and psychiatry. Students will learn with specialists in neuropsychiatry, behavioral neurology, movement disorders neurology, neuroimmunology, epileptology, and neuropsychology. There will be opportunities to learn about the diagnosis and treatment of patients living with Alzheimer’s, frontotemporal dementias, Lewy body diseases, focal and generalized epilepsy, demyelinating diseases, autoimmune encephalitides, and functional neurological disorders, to name a few. Students will rotate through outpatient clinics as well as our state-of-the-art epilepsy monitoring unit.

We strongly encourage medical students who are considering combined neurology-psychiatry residency programs to contact Dr. Chadrick Lane (chadrick.lane@utsouthwestern.edu) and Dr. Ashley Woolbert (ashley.woolbert@utsouthwestern.edu) to learn more about the medical student 4th-year elective.

To apply, students should visit the Association of American Medical Colleges (AAMC) website for Visiting Student Learning Opportunities™ (VSLO®).

AAMC VSLO APPLICATION

The UT Southwestern VSLO catalog will be viewable starting April 1.

More detailed information is available at Visiting Medical Students: Student Support Services - UT Southwestern, Dallas, TX.

Neurology-Psychiatry Combined Residency

Welcome to Our Program!

The Basics

Mission Statement

Vision

Future of the Field

Combined Neurology/Psychiatry Residency

Chief Year

Fellowships

Psychiatry Residency/Neuropsychiatry Fellowship

Neurology Residency to Behavioral Neurology Fellowship

PGY-5 – Class of 2026

PGY-4 – Class of 2027

PGY-3 – Class of 2028

PGY-2 – Class of 2029

PGY-1 – Class of 2030