Neurology-Psychiatry Combined Residency

We are thrilled to be 1 of only 4 combined neurology-psychiatry residencies in the U.S. We aim 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.

Our mission is to develop clinicians, educators, and researchers to be leaders in psychiatry, neurology, and their integration. In our experience, many patients have complex medical histories, with comorbidities spanning the fields of neurology and psychiatry. By educating physicians in both fields, we provide 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 humankind while pursuing their dreams to the fullest.

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 we receive applications?

We use ERAS; view a list of items required in the application. We accept 1 to 2 new residents per year.
Careers

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

A large percentage continue to practice in both specialties, with many reasons to do so. For example, a significant amount of patients with epilepsy are also affected by psychogenic non-epileptic seizures and most often seen by practitioners of both specialties. Also, individuals with MS have a 50% chance of at least 1 lifetime episode of clinical depression (vs. 17% in the general population) and have a 2 to 3-fold risk of diagnosed bipolar or psychotic disorders. In addition, some common treatments for MS (e.g., interferon) can actually exacerbate psychiatric conditions. Such patients provide a clinical challenge for either specialty and may be particularly well served by practitioners trained in both disciplines.

Future of the Field

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)
Program Structure
Our 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 flavor (exposure to the emergency department, addiction, inpatient psychiatry, and a 1-month Neurology Bootcamp to prepare for call months and the junior rotations. PGYs 2-6 are dedicated entirely to neurology and psychiatry.

PGYs 2-5 have 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. PGY-6 is split 50/50 in the outpatient setting. There is enough consecutive time spent in each specialty to begin developing that particular specialty’s way of thinking. To balance this, every few months residents switch and spend some time in the other specialty, fostering a dual-specialty mindset.

Why is the program combined?

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

Is a combined program right for me?

Many people 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 combined residency
This route creates physicians boarded in both neurology and psychiatry, providing the broadest training. We are often faced with complex patients who have not read nor abide by a particular specialty’s textbook. Our graduates can 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 (e.g., CT, MRI), become proficient in EEGs, and manage neurologic conditions including epilepsy, autoimmune disorders, dementia, movement disorders, headaches, and PNS disorders. This training gives the most flexibility for 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.

Our residents spend the final year of training as Chief of the combined program and are responsible for being a liaison for other residents, working with program directors, and ensuring smooth processes (e.g., developing resident schedules, working with chiefs in categorical neurology and psychiatry programs, helping with disciplinary issues, fielding concerns). They learn administrative skills and prepare for future leadership roles.

Fellowships

UT Southwestern hosts a vast array of fellowships in neurology and psychiatry for residents who decide to pursue post-residency training:

Neurology
- 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
- Addiction
- Child and Adolescent
- Consultation-Liaison
- Forensic
- Geriatric
Psychiatry Residency/Neuropsychiatry Fellowship
- 5-6 years:
  - 4 years psychiatry residency
  - 1-2 years neuropsychiatry fellowship
In this route psychiatrists focus on conditions with neuropsychiatric overlay. The more behavioral aspects of these conditions are addressed symptomatically, but the underlying neurologic disorder is usually diagnosed and managed separately by neurologists.

Neurology Residency to Behavioral Neurology Fellowship
- 5-6 years:
  - 1 year medicine prelim
  - 3 years neurology residency
  - 1-2 years fellowship
In this route neurologists focus primarily on cognitive disorders and dementia. Many neuropsychiatric manifestations occur in these diseases, and patients often have a multidisciplinary team including a behavioral neurologist, geriatric psychiatrist, neuropsychiatrist, and others. Psychiatry residency graduates may be accepted to some behavioral neurology programs. (Brendan Kelley leads an excellent behavioral neurology and dementia fellowship at UT Southwestern.)

Some behavioral neurology and neuropsychiatry fellowships, for graduates of either neurology or psychiatry residencies, are integrated and allow a second fellowship year, generally to provide a significant research experience to help develop academic careers.
Research
We are world renowned for our research prowess, with more Nobel laureates here than at any other US medical school! We receive a very high proportion of NIH funding:
- Top 20 for Neuroscience
- Top 25 for Psychiatry Research
- Top 30 for Neurology Research
In addition, we have NIH R25 grants in both Neurology and Psychiatry, giving our residents opportunities to engage in research with potential for protected research time.

We help pair residents with appropriate research mentors: example research opportunities.
Rotation Sites

Our diversity of training sites is a spectacular highlight of our program:

Dallas Veterans Affairs Medical Center

Experience at the VA Medical Center helps residents learn about and interact with an important patient population and a unique EMR and workflow with many formative rotations.

Parkland Hospital

In a county hospital, patients are often indigent and uninsured. Parkland hosts substantial rotations for residents, granting exposure to uncommon pathologies and disease presentations along with more common cases that imbue residents with competence to adeptly handle anything that comes their way.

William P. Clements Jr. University Hospital and Zale Lipshy Pavilion—William P. Clements Jr. University Hospital

The UT Southwestern System includes the university hospitals, where residents 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 see a wide variety of pathologies that have been referred to their care for the highest level of expertise.

Metrocare Services

Essentially the mental health outpatient arm of the Parkland County system, Metrocare Services is a representation of community medicine where residents get exposure to outpatient psychiatry, including working with the poor and homeless from early stages of residency. 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 cases.

Lew Sterrett County Jail

Residents spend a month providing psychiatric care to inmates. Standardized procedures are in place with a constant guard and attending physician supervision for safety. Residents interact with a population having its own challenges and pitfalls and see a broad spectrum of humanity.

Children’s Health Dallas

Both psychiatry and neurology have several months of required rotations involving children and adolescents proctored by Children's Health Dallas, adjacent to Parkland and UT Southwestern in the Dallas medical district. Children’s is one of the top hospitals in the country for neurology, with active psychiatric inpatient and consult teams.

Scottish Rite for Children

Residents will spend one month working with children in outpatient neurology, yet another venue allowing residents the greatest breadth of training experiences.
Application Process
Application Website

Use the Electronic Residency Application Service

ERAS Application Items
- Curriculum vitae
- Personal statement
- Transcripts from medical school
- Copies of USMLE or COMLEX scores, steps I, II and III (note: step III completion required)
- ECFMG certificate (if applicable)
- Three letters of recommendation from faculty supervisors
- Program Director's letter
- Program Director’s Attestation Form for Child and Adolescent Psychiatry Eligibility (program director should attach linked form to program director's letter)
Other Items Needed
- Medical school diploma
- Visa documentation (if applicable; only J-1 visas are sponsored)
Additional Information

We must receive the completed application before we will interview (we conduct virtual interviews).

GME Policies

Please note that as part of the application and interview process for a potential fellowship position in our program, we are accredited by the Accreditation Council for Graduate Medical Education and you would need to meet ACGME requirements for matriculation in our program.

Upon graduation from our training program, most of our graduates seek board certification. The process of board certification is separate from training and has additional requirements. Some board organizations require completion of all your education in an ACGME-accredited training program. Please contact the appropriate certifying board to understand your eligibility for board certification before accepting (if offered) a fellowship position at our institution.

Sample Contracts, Salaries, Benefits
Faculty
We have incredible faculty devoted to teaching, such as:
Dedicated didactic days are built into both the neurology and psychiatry programs, with psychiatry didactics on Tuesday afternoons and neurology didactics on Thursday afternoons. We ensure combined program residents may attend both sessions every week when clinical duties allow.

Grand Rounds are on Wednesdays and include experts from both fields. Hybrid and online sessions are broadcast to Parkland for those who cannot make it to an in-person venue.

Our program is in a constant state of self-evaluation. Residents are encouraged to bring any concerns or areas for improvement to the attention of program directors. Our objective is to maintain an appropriate balance of education and service, which promotes resident well-being and allows residents to have a say in their course of training.
Current Residents

PGY-5 – Class of 2026

Victoria "Vika" Ragland, M.D.

Undergraduate: University of California Los Angeles
Medical School: University of Texas Rio Grande Valley

PGY-4 – Class of 2027

Enrique Chiu Han, M.D.

Medical School: Universidad Nacional Autónoma de México

PGY-3 – Class of 2028

Adam Dinoff, M.D., M.S.

Undergraduate: Queens University
Graduate: University of Toronto
Medical School: New York Medical College

PGY-2 – Class of 2029

Jaclyn McBride, M.D.

Undergraduate: University of Nevada, Reno
Medical School: University of Nevada, Reno School of Medicine

PGY-1 – Class of 2030

Victor Liaw, M.D.

Undergraduate: University of Texas at Austin
Medical School: University of Texas Southwestern

Emma Wellington, M.D.

Undergraduate: Colgate University Medical
Medical School: George Washington University
Elective for Visiting Medical Students

The Neuropsychiatry Visiting Elective introduces students to several clinical settings at the interface of neurology and psychiatry. Students train with specialists in neuropsychiatry, behavioral neurology, movement disorders neurology, neuroimmunology, epileptology, and neuropsychology. They 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 rotate through outpatient clinics and our state-of-the-art epilepsy monitoring unit.

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

Apply through the Association of American Medical Colleges:

AAMC VSLO APPLICATION

More details: Visiting Medical Students: Student Support Services - UT Southwestern, Dallas, TX