Pick an acute psychiatric disease. Now pick a severe medical disease. Now put them in the same patient. You may just have described a patient who is an appropriate patient for our inpatient unit, a resource for treating patients with an acute problem in both the psychiatric and medical domains. Herein lies the excitement in working in this interesting and invigorating environment. Any combination of problems can be seen and treated here. This unit serves the hospital and the community by specializing in the treatment of delirium, and substance intoxication and withdrawal syndromes, but also can manage patients/problems such as:

• Psychiatric syndromes associated with hyponatremia
• Schizophrenia with gastrointestinal bleeding
• Suicide attempt victims with severe body and head injuries
• Hyperthyroidism with bipolar disorder
• Anorexia nervosa, with metabolic derangements, and/or congestive heart failure
• Person with intellectual disability/agitation in patient who has swallowed a sharp object
• Serotonin syndrome
• Neuroleptic malignant syndrome
• Catatonia

The Internal Medicine-Psychiatry Unit at University of Iowa Health Care Medical Center is staffed by one to two faculty physicians (one dually-trained faculty physician or by two faculty physicians - one from internal medicine and one from psychiatry), one senior resident (internal medicine-psychiatry, internal medicine), and two junior residents (internal medicine, psychiatry, internal medicine-psychiatry, or neurology). All nurses on this unit have training in medical and psychiatric nursing, and are equipped to deal with both sets of problems.

Over the course of the residency, each trainee spends three to five months on this unit evaluating and treating patients with combined illness. Not only do they develop the skills to treat the illness in each discipline, they also develop an understanding of the complex disease relationships occurring in these patients.