Rural Psychiatry Residency

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The rural track of the psychiatry residency program at Mountain Area Health Education Center (MAHEC) was created to further our belief that everyone should have equal access to healthcare. There are stark disparities in access to mental care between urban/suburban and rural areas and that is particularly true in rural and Western North Carolina, where all 16 counties have been federally designated as mental health professional shortage areas. Our mission is to train excellent psychiatrists who can work with rural, underserved populations and who are experts at providing consultation in primary care settings.

Our rural track is based out of Linville, NC, where our rural track residents will spend the majority of their time. We received initial accreditation in 2022 with the first class of four rural track residents starting in July of 2024. The Appalachian Regional Healthcare System’s Behavioral Health Services includes both an outpatient clinic as well as a brand new 27-bed inpatient behavioral health hospital that opened in November 2021.

The partnership between MAHEC, Appalachian Regional Behavioral Health Hospital, Mission Hospital, Watauga Hospital, Broughton State Hospital, and AppFamily Medicine will achieve the goal of increasing rural access to mental healthcare by having residents train in a beautiful part of the state that has developed the resources to provide an excellent graduate medical education experience.

The rural track of the MAHEC Psychiatry Residency offers an opportunity to serve an area of Western North Carolina with great need for additional mental health services. We hope you will consider applying here for this next step in your training!

Our Team

Elena Perea, MD Elena Perea, MD
Director, Psychiatry Residency Program
Director, Rural Psychiatry Residency Program
Faculty, Consultation/Liaison Fellowship

Ben Vockery Ben Vockery
Program Administrator

Contact Us

For more information or questions about our program, please contact

4th Year Medical Student Rotations

MAHEC offers a variety of student rotations in Family Medicine, Obstetrics and Gynecology, General Surgery, Rural Medicine, and Psychiatry for both in-state and out-of-state students interested in our residency programs. Learn more about our 4th year medical student rotations

Values Statement

  • Excellence: We deliver quality activities and services that our customers and partners value.
  • Diversity: We promote equity and inclusivity.
  • Integrity: We act with fairness, transparency, and the highest level of ethics.
  • Collaboration: We value partnerships and support interprofessional approaches.
  • Improvement: We continuously innovate and improve our work.

Foundational Principles

  • Civility: We treat all people with respect and kindness, all the time.
  • Inclusivity: We value the contribution of people different than ourselves and the merits of an organization that reflects differences in our teams and our community.
  • Empowerment: We value engagement, commitment, and ownership of MAHEC’s mission, work, and budget.

Our Commitment

MAHEC is committed to creating an equitable and inclusive place to work, learn, and receive care. We actively recruit physicians, staff, and students from underrepresented minorities, and we strive to implement policies and procedures that value and support diverse backgrounds and experiences. MAHEC does not discriminate on the basis of socioeconomic status, race, ethnicity, sexual orientation, gender identity or expression, spiritual practice, geography, disability, or age.


First-year residents spend the majority of their year in the Appalachian Regional Behavioral Health (ARBH) hospital doing inpatient psychiatry for a total of six months. Residents also have one month of inpatient psychiatry at Broughton State Hospital in Morganton, NC; one month of neurology at Mission Hospital in Asheville, NC; two months of inpatient medicine at the Watauga Medical Center; and three months of outpatient family medicine at AppFamily Medicine.


Second-year residents start their longitudinal continuity clinics, seeing one full day of adult and one full day of child patients at the ARBH outpatient center. In addition, residents will have one half day of psychotherapy clinic each week. Longitudinal rotations in the second year include the Lees-McRae College Student Health Department and the Crossnore Communities for Children.


Third-year residents return to the inpatient setting with more specialized psychiatry rotations including child and adolescent, geriatrics, and consultation/liaison with electroconvulsive therapy—as well as a second month of neurology—all of which take place at Mission Hospital in Asheville, NC. Residents also have a substance use disorder rotation at the Julian F. Keith Alcohol and Drug Treatment Center (ADATC). The third-year resident also returns to the general adult psychiatry inpatient unit at ARBH as a junior resident. Adult and child continuity clinics are one half day each week in addition to the one half day spent seeing psychotherapy patients. The basic requirements for residency are completed after the third year, allowing residents to fast-track into a child/adolescent fellowship if desired.


Fourth-year residents will spend a couple of months at the ARBH inpatient psychiatry unit, as well as a half day of adult clinic and a half day of psychotherapy each week. One half day per week is spent doing collaborative and integrated care consultations with rural primary care physicians as part of the Rural Health Initiative. The remainder of the fourth-year resident’s time is elective, allowing them to create a personalized curriculum as they prepare to begin their career in psychiatry.

All residents have one afternoon each week protected for didactics. This includes an ongoing Journal Club, case conference, resident presentations, research, and ongoing lectures overviewing the psychiatric field of knowledge with an emphasis on evidence-based care. Didactics will be held jointly with the Asheville-based program, and lectures for both programs are offered virtually, allowing residents to join hassle-free from their rotation site rather than trying to commute to a central location.

The rural track of the psychiatry residency is located in Linville, NC, and is just a short drive away from Boone, NC, where one of our family medicine rural tracks is located. Residents will rotate at the Watauga Medical Center alongside Boone family medicine residents, allowing for more cross-fertilization of ideas and collaboration.


Application Requirements

We invite you to apply to our program via the Electronic Residency Application Service (ERAS). We will review your application and contact you if we are able to offer you an interview. Typically, our interview season runs from October through January.

A complete ERAS application is required, including:

  • Curriculum Vitae (CV)
  • Photo
  • Personal statement
  • Three letters of recommendation from faculty who have directly supervised clinical performance (at least one letter should be from a psychiatrist)
  • Medical school transcript(s)
  • Medical Student Performance Evaluation (MSPE)
  • USMLE, COMLEX, or Canadian licensing exam completion (Step 1 or COMLEX 1 required, Step 2 or COMLEX 2 preferred)
Questions regarding the application process should be directed to the Residency Program Coordinator at

Eligibility and Selection Criteria

The Graduate Medical Education (GME) programs will select from among eligible applicants on the basis of residency program-related criteria such as their preparedness, ability, aptitude, academic credentials, communication skills, and personal qualities such as motivation and integrity.

Minimum Requirements

An applicant must meet or exceed the following minimum qualification(s) to be eligible for selection and appointment to MAHEC’s GME residency programs:

  • Be a graduate of a medical school in the United States or Canada, accredited by the Liaison Committee on Medical Education (LCME); or
  • Be a graduate of a college of osteopathic medicine in the United States, accredited by the American Osteopathic Association (AOA); or
  • Be a graduate of a non-LCME- or AOA-approved medical school who also meets one of the following additional qualifications:
    • holds a currently-valid certificate from the Educational Commission for Foreign Medical Graduates (ECFMG) prior to appointment; or
    • holds a full and unrestricted license to practice medicine in a United States licensing jurisdiction in his or her current ACGME specialty/subspecialty program; or
    • has graduated from a medical school outside the United States and has completed a Fifth Pathway program provided by a LCME-accredited medical school.
  • Passed USMLE Steps 1 and 2 or COMLEX 1 and 2 within three attempts, as required by the North Carolina Medical Board.
  • Be eligible for a NC resident training license.
  • Be eligible to work in the U.S. (citizen, permanent resident, eligible visa including J1). MAHEC does not sponsor H1B or other visas.

International Medical Graduates

Special laws and regulations apply to international medical graduates who wish to enter the United States to undertake graduate medical education. MAHEC's policies and procedures regarding graduates of international medical schools comply with federal and state laws and regulations and MAHEC's commitment to graduate medical education.

Graduates of medical schools outside the United States and Canada must have a currently valid certificate from ECFMG. Applicants must successfully pass both Step 1 (basic medical) and Step 2 (clinical knowledge and skills) of the United States Medical Licensing Examination (USMLE).

While MAHEC does not sponsor a visa, the international medical graduate applicant must also possess a current/valid visa option or other status governed by the U.S. Immigration Regulations to participate in a GME program.

Finally, the North Carolina Medical Board requires that physicians who are graduates of schools that are not accredited by the LCME or the AOA (foreign medical schools) must be individually certified by ECFMG, have successfully completed at least three years of accredited graduate medical training, and have passed the USMLE or its equivalent to be eligible for application for full licensure. An international medical graduate must complete all other application requirements required by MAHEC and the GME program.

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