Over 10 million Americans suffer from comorbid chronic illnesses, making the need to properly evaluate, diagnose, and treat such individuals a major public health mandate and priority. Psychosomatic medicine (PM) focuses on the diagnosis and treatment of psychiatric disorders and symptoms in complex medically ill patients. PM will be a critical resource in integrated and collaborative care under health care reform.
There are many ways a specialist in PM can help patients with comorbid psychiatric and physical conditions and their care providers. Some examples include: treatment of delirium tremens in an elderly woman with unsuspected alcohol dependence who just received coronary artery bypass surgery; consultation to an outpatient HIV/AIDS clinic to help manage psychotropic medications for a patient about to begin a new antiretroviral regimen; co-treatment with the Maternal and Fetal Medicine Service of a young woman with bipolar disorder who is taking lithium for mania prophylaxis and who wishes to become pregnant; and inpatient consultation to the Oncology Service for a depressed middle-aged man with newly diagnosed, widespread pancreatic cancer. PM physicians often work in primary care and outpatient specialty clinics (such as diabetes or women's clinics) and have key roles in developing population-based collaborative care models for patients with depression and anxiety and other mental health conditions.
Psychosomatic medicine gives you the opportunity to “hold on to” a great deal of your medical and surgical training and to use it effectively. In addition, it provides the opportunity to work more closely with medical and surgical colleagues than is typically the case for most psychiatrists. It is a great way to make a big difference in the lives of patients with complicated medical or surgical conditions who are suffering emotionally and to help our colleagues who care for them.
Considering a Fellowship Training in Psychosomatic Medicine?
Psychosomatic medicine (PM) is the branch of psychiatry that deals with the understanding and advancement of medical science, education, and the provision of healthcare for persons with comorbid psychiatric and general medical conditions. This is also referred to as consultation-liaison (C-L) psychiatry or hospital psychiatry. Training in PM follows completion of a general psychiatry residency training program. PM fellows typically spend one additional year in training, although some training programs include an optional additional year during which fellows may get more involved in research or take on a more administrative role. There are now more than 50 ACGME-accredited PM fellowship training programs, with numbers steadily increasing. Satisfactory completion of a PM fellowship qualifies each graduate to sit for the subspecialty board examination in PM administered by the American Board of Psychiatry and Neurology.
APA's Council on Psychosomatic Medicine
The Council on Psychosomatic Medicine (Consultation-Liaison Psychiatry) focuses on psychiatric care of persons who are medically ill and thus stands at the interface of psychiatry with other medical specialties. It recognizes that integration of biopsychosocial care is vital to the well-being of patients and that full membership in the house of medicine is essential to the well-being of our profession. It accomplishes its goals by initiatives related to research, clinical care, education, and health care policy. Learn more about the council.