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How I learned integrative psychiatry during psychiatry residency

If you're like me, you probably didn't attend a residency that focused on the field of integrative psychiatry or even had an elective option like this in your residency. And guess what, that is OKAY - even if you know you want to practice integrative psychiatry after you graduate residency.

Here is what I did during residency to best prepare myself for practicing integrative psychiatry once I graduated residency:

Recognize that integrative psychiatry doesn't fit into a neat box

Be willing to understand and recognize that you can learn aspects of integrative psychiatry on any psychiatry rotation that you are on. Utilizing a bio-psycho-social model is part of integrative psychiatry and the framework is based on a holistic approach to helping people. In psychiatry, we are fortunate to have this framework as the foundation for learning to be a great psychiatrist. Other fields of medicine do not. Observe your attendings and senior residents as they interview patients and formulate treatment plans. Pay close attention to the ones who really listen to their patients, utilize informed consent, and have unconditional positive regard for their patients.

Attend Integrative Medicine Conferences

Sure, most of them aren't going to be focused specifically on psychiatry but you will find that a lot of the content is incredibly relevant to wellbeing and mental health. I started attending the Academy of Integrative Health and Medicine conferences during medical school and was able to meet lots of like-minded people. These conferences buoyed me from the world of rote memorization and the challenges of clinical rotations. I didn't attend every year since it is a lot of money to travel to conferences but would try to stay with friends/family to make it more affordable. Many integrative medicine conferences also offer student rates.

Elective Rotations and Online Programs

Since I knew 100% that I wanted to practice psychiatry using an integrative psychiatry approach and wasn't learning what I knew I needed to during my residency, I invested in a one-month elective rotation during my fourth year at the University of Arizona AND a year-long program also during my fourth year of residency through Integrative Psychiatry Institute (IPI).

These were foundational learning opportunities for me, in retrospect. I learned what labs integrative psychiatrists order in various settings, including academic outpatient and private practice. Cases were discussed and I started to learn how to actually utilize what I had learned all these years.

I used my moonlighting money to splurge on an Airbnb in Tuscon, AZ, which was a nice break from the winters of Minnesota in January. At my home residency program, I had to write a letter and fill out an application through the Graduate Medical Education Department and was thankfully approved to go to the University of Arizona for a month to learn integrative psychiatry. This was possible also because our fourth year of residency was entirely electives. The IPI fellowship was considerably less in price if you were a resident and while it was not cheap, I considered it a worthwhile investment.

What was Missing

Although I did a ton of my own learning through clinical electives, online programs, conferences, webinars, books, podcasts, I still didn't feel confident in my integrative psychiatry skills.

I didn't have mentors I could meet with longitudinally on a one-to-one basis to ask questions as they came up in my practice - and I also didn't have the time or bandwidth in my busy conventional psychiatry insurance-based outpatient psychiatry practice to use what I learned.

It wasn't until I was seeing less patients in my own private practice and could dedicate time to learning and actually putting to use what I was learning in my clinical practice.

Know that you probably will feel like you don't know enough about integrative psychiatry upon graduating from psychiatry residency - even if you went the extra mile to learn the subject matter. And that's okay. You will always be learning. And once you are out in practice (or close to graduating residency), it's helpful to have a mentor who is practicing in alignment with how you desire to be.

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