The fellowship is designed such that fellows train in a comprehensive array of treatment settings.  Each week, fellows spend approximately 50% of their time on time-limited block rotations, and 50% of their time on didactics, psychotherapy, supervision, and longitudinal rotations and experiences.  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:  Fellows work as part of the UI Health Addiction 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.

Intensive Outpatient Addiction Treatment Program Rotation: 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.

Opioid Treatment Program (OTP) Rotation:  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.  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.

Residential Addiction Treatment Program Rotation:  The Substance Abuse Residential Rehabilitation Treatment Program (SARRTP) is an 11-bed, flexible duration (typically 42 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.

Positive Sobriety Institute Partial Hospitalization Program Rotation: 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.

UIC Pain Medicine Service or the Jesse Brown VAMC Pain Clinic: Fellows will learn how to manage patients who may or may not be substance-impaired, particularly with chronic pain, using a variety of modalities. The Fellow will be working in multidisciplinary pain treatment settings where a variety of techniques such as psychoeducation, various other verbal interventions, various physical therapies, various medication therapies, and various interventional procedures are employed.

Longitudinal Experiences

Psychotherapy: This is a particular strength of our fellowship.  At any given time, fellows generally have three outpatients to whom they are providing CBT-based psychotherapy that focuses on substance use issues.  They receive in-depth experiential training in motivational interviewing.  They provide psychotherapy to adolescents with substance use issues as described further below.  They facilitate groups, including a Quit Smoking Group.  They co-facilitate the Masters Group, a process group for veterans with histories of challenges with sustaining recovery but who are now in stable recovery.  They gain experience in delivering Contingency Management for Quitting Smoking, an innovative program at the VA.  Other opportunities are available based on fellow interest.

Recovery Clinic: Fellows spend one afternoon each week working in the Recovery Clinic, an outpatient clinic in the Department of Psychiatry at UIHealth that specializes in the treatment of patients with substance use disorder that may or may not co-occur with other psychiatric conditions.  They work alongside senior psychiatry residents who are also in the clinic.  During clinic time the focus is on psychopharmacologic management of these conditions, but many of these patients will also be seen by fellows for psychotherapy at other times.

Adolescent Addiction Treatment: This rotation takes place in a special clinic at UIC’s Institute for Juvenile research (IJR)—the Urban Youth Trauma Project. This clinic provides trauma-focused addiction treatment to adolescents. Here, the fellow will treat at least one or two outpatients and their families over the course of their fellowship. 

Addiction Medicine Clinic at Mile Square FQHC: Fellows work at Mile Square Health Center (MSHC) a Federally Qualified Health Center affiliated with the UIC Department of Family Medicine. 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 manage methadone dispensation through an innovative collaboration between MSHC and Family Guidance Center, an OTP. Patients are generally 18 years old and older and 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. Fellows are supervised by primary care clinicians board certified in addiction medicine and work collaboratively with recovery support specialists, behavioral health consultants, and psychiatric nurse practitioners.

Community Outreach Intervention Projects (COIP) Rotation:  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 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.

Thresholds: Fellows work with substance use and other addiction-related issues in a community mental health center population. Here, an important emphasis will be on buprenorphine management of opioid addiction although patients with a variety of addictions and related treatment needs will be seen as well. Thresholds also has a mobile mental health component.