Addiction Medicine Fellowship

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The fellowship is designed such that fellows train in a comprehensive array of treatment settings.  Each week, fellows spend approximately 60% of their time on time-limited block rotations, and 30% of their time on longer-term, longitudinal rotations.  Most of the rotation sites are rich learning environments with trainees from many disciplines including medical students, residents, and trainees in psychology, social work, pharmacy, and nursing.  Fellows will learn alongside and provide supervised teaching of other trainees.  Based on a fellow’s background and interests, customization is available for the experience, including electives.



Block Rotations:

Addiction Medicine Consult Rotations (4 months):  Fellows work as part of the UI Health Psychiatry Consult Service and the Jesse Brown VA Medical Center (JBVAMC) Addiction Consult Service to provide a range of services to patients with substance use, misuse, and use disorders.  They provide care in a variety of hospital settings, including inpatient medical and surgical units as well as within the emergency department and on obstetric units.  In doing so, they gain competence in these settings in various aspects of substance use disorder treatment, including diagnosis, assessment, brief interventions, pharmacotherapy, and referral to treatment.   Some examples include diagnosing and managing the intoxication and withdrawal phenomenon of addictive substances, performing motivational interviewing, initiating buprenorphine treatment for opioid use disorders, and facilitating appropriate referrals for substance use disorder treatment.

Residential Addiction Treatment Program Rotation (2 months):  The Substance Abuse Residential Rehabilitation Treatment Program (SARRTP) is a 20-bed, flexible duration (typically 35 days), “open” residential addiction treatment program located at JBVAMC. It provides treatment to adult veterans of all age groups requiring intensive substance use disorder treatment in a 24-hour/day monitored setting. Patients have a wide range of co-occurring psychiatric and medical issues across the full continuum of severity. Fellows perform comprehensive evaluations of the majority of patients who are admitted during their rotation, follow them regularly throughout their stay, and are actively involved in discharge planning. In doing so, they will provide pharmacotherapy, brief targeted interventions, and tobacco cessation efforts. Fellows participate in selected groups based on fellow need and interest. Fellows will play an active role in interdisciplinary team meetings and at times lead the discussion.

Opioid Treatment Program (OTP) Rotation (2 months):  Located at JBVAMC, the Drug Dependency Treatment Center (DDTC) is a multidisciplinary and interdisciplinary clinic that provides treatment to patients with opioid use disorder primarily and multiple medical and psychiatric comorbidities.  It is one of the largest VA OTPs with about 350 patients.  Fellows become knowledgeable in all phases of pharmacotherapy for opioid use disorders, including buprenorphine, methadone, and long-acting injectable naltrexone induction.  They also learn about the psychosocial, administrative, and regulatory aspects of federally licensed opioid treatment programs.

Positive Sobriety Institute Partial Hospitalization Program Rotation (1.5 months): The Positive Sobriety Institute (PSI) is a high quality and cutting-edge addiction treatment program that specializes in the treatment of health care professionals, including physicians.  PSI offers an invaluable experience for fellows to gain competence in providing assessment and treatment of substance use and co-occurring medical and psychiatric disorders to health care and other professionals in an intensive outpatient setting. 

Intensive Outpatient Addiction Treatment Program Rotation (1.5 months): The Addiction Treatment Program (ATP) at JBVAMC is a comprehensive intensive outpatient addiction treatment program that treats veterans with substance use disorders.  A multitude of evidence-based treatments are deployed in individual and group modalities, including contingency management, cognitive behavioral therapy, and twelve step facilitation.    In addition to providing direct individual patient care, fellows participate in groups based on fellow need and interest.  They also attend and play an active role in family meetings and team meetings.

Pain Medicine Clinic Rotation (1 months):  Fellows will rotate in the pain medicine clinic at JBVAMC.  They will perform intake evaluations and follow-up visits of patients presenting with acute and/or chronic pain. The clinic takes a comprehensive, multi-modal approach to the management of pain, and fellows will gain a strong understanding in the various treatments available and in working with patients in collaboratively developing and following robust and effective treatment plans. Fellows will spend time learning how to diagnose substance use issues in this setting and how to integrate addiction assessments into the clinic workflow. They will work with an interdisciplinary team including attending physicians, clinical psychologists, advanced practice nurses, nurses, pain medicine fellows, residents, and medical students.  The fellows will also attend the clinic “Pain School” for patients, which is a weekly, 1-hour educational presentation by various Pain Clinic staff on various topics relevant to the diagnosis and treatment of painful conditions.  In doing so, they will gain further knowledge of multi-modal approaches to pain management at a “patient level,” such that they can incorporate it into their education of their patients in other contexts.


Longitudinal Rotations:

Addiction Medicine Clinic Rotation (two half-day clinics weekly for 12 months): Fellows will work at Mile Square Health Center (MSHC) a Federally Qualified Health Center affiliated with the UIC Department of Family Medicine. Its main site is located adjacent to the UIC COM/UI Health campus. This is an outpatient setting where fellows will be responsible for screening, evaluating, and treating patients with substance use disorders. In addition to providing office-based pharmacotherapy for opioid use disorder, fellows will also be able to manage methadone dispensation through an innovative collaboration between MSHC and Family Guidance Center, an OTP. Patients will generally be 18 years and older and will include patients with pregnancy and co-occurring disorders. Patients are self-referred, referred from local community hospitals, follow-up from recent hospitalization/detox/emergency department visits, and the Cook County Sheriff's Office for returning citizens. The program is also staffed by additional primary care clinicians with experience in substance use disorder treatment, a recovery support specialist, behavioral health consultants, and psychiatry nurse practitioners. Fellows will also be trained in telehealth as MSHC Main site provides virtual behavioral health and addiction care for the outreach sites.

Community Outreach Intervention Projects (COIP) Rotation (one half-day clinic weekly for 6 months):  COIP was founded in 1986 to address the HIV/AIDS epidemic among people who inject drugs. COIP utilizes the Indigenous Leader Outreach Model to employ people who previously used drugs to deliver community services and harm reduction around substance use disorders. COIP has multiple syringe exchanges located on the west and south sides of Chicago, as well as a Mobile Van unit that provides syringe exchange services. In addition to primary care, the COIP West Side clinic offers a variety of services including a Hepatitis C treatment program, wound care, and medications for opioid use disorder. Fellows will provide screening, evaluation, and treatment of opioid use disorder for patients in the COIP clinic, as well as learn to treat common issues that affect people who inject drugs, such as basic care of chronic injection-related wounds. As part of this experience, fellows will also have the opportunity to accompany outreach workers on the COIP Mobile Van unit. When fellows are on the van, they will be available to provide counseling and brief intervention services to clients who utilize the van.