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The addiction medicine curriculum includes core clinical rotations in a variety of sites that will lay the foundation for a strong knowledge base in addiction medicine. The electives available will allow fellows the opportunity to add some specialized areas to their training for development of unique expertise in more niche areas of addiction medicine.
Fellows will have a required, part-time experience in consultation liaison services. Consultation will be provided for the wards and emergency departments within Community Health Network at Community Hospital East. The clinical population will be heterogeneous with regard to sex, ethnic, cultural, and economic background, reflective of the large, multi-site hospital network that spans both urban and suburban areas.
Educational methods will involve patient assessment, subsequent recommendations/treatment, and follow-up if indicated. The clinical experience will require assessment of all available clinical information, liaison with referring treatment providers and treatment teams, collateral contact with support systems, and careful assessment of the patient. Treatment modalities to be used will include pharmacologic, psychotherapeutic, crisis intervention and educational. Fellows will also actively participate in the daily staffing of patients.
The faculty supervisor will review all consultation write-ups and be available for consultation as needed. Clinical discussion points will be emphasized during supervision, and fellows will be assigned pertinent reading material.
Fellows will have a required 3-month part-time addiction medicine rotation. A portion of this rotation will consist of daily rounding at Community Fairbanks Recovery Center on the Community Hospital North campus. The Community Fairbanks inpatient unit focuses on complex drug and alcohol detoxification while also treating co-occurring physical and mental illness diagnoses. Patients include adults seeking voluntary treatment, as well as those leveraged into treatment through legal status (i.e., probation, drug treatment court, impaired professional programs, etc.).
Treatment modalities used include medical detoxification and stabilization of patients with substance use disorders, daily treatment team staffing, residential staffing and medication supervision, case management services to assist with sober housing placement, and 12-step education and facilitation. Fellows will be able to prescribe buprenorphine and naltrexone/vivitrol as well as other FDA and off-label substance use disorder treatments and may supervise residents.
Educational methods will involve supervised evaluation and clinical management of patients with substance abuse/dependence problems and will include dual diagnosis. Cases will be staffed with supervising faculty. Fellows will learn and utilize various addiction treatment modalities including detoxification, management of overdose, maintenance pharmacotherapy, group/individual therapies, self-help groups, and therapeutic techniques that address the psychological and social consequences of addiction.
Fellows will have a required part-time outpatient addiction medicine experience during their entire fellowship. Fellows will see patients carrying diagnoses of all major substances of abuse. Fellows will work with board certified family medicine physicians, board certified addiction psychiatrists, licensed clinical social workers, licensed mental health counselors, nurses, learners (residents and medical students) and other team members to treat co-occurring illness and will have direct supervision of all patient care from a board certified physician. Fellows will be able to prescribe buprenorphine and naltrexone/vivitrol as well as other FDA and off-label substance use disorder treatments and may supervise residents.
Continuity clinic for treating patients with substance use disorders, including prescribing buprenorphine, naltrexone and other pharmacology in a family medicine setting. Option to supervise residents. Generally will be a half-day per week for the entire 12 months.
Fellows will work independently on a QI project or other operational project alongside a relevant supervising faculty member. They can participate in the behavioral health addictions council with clinical and administrative leaders if they choose to do an operational improvement project. They will present their project at the annual regional Multidisciplinary Scholarly Activity Symposium (MSAS) held in May.
A maximum of three months should be spent on fellow electives or scholarly activity.
Rotate in the Emergency Department at Community Hospital East to evaluate patients after opioid overdose or seeking emergent care for drug intoxication or withdrawal syndromes. Facilitate establishing treatment with buprenorphine and/or appropriate referral to an outpatient setting. Potential to work alongside a peer recovery coach.
Work in an OB-GYN office with pregnant women diagnosed with substance use disorders (see CHOICE Program). Observe inpatient inductions on buprenorphine. Participate in and/or co-facilitate group psychotherapy with pregnant and postpartum moms with substance use disorders.
Work in a multidisciplinary outpatient sports medicine and/or pain clinic to see how the modalities used to manage patients with complex diagnoses often including opioid use disorders. The focus of the program is non-pharmacologic modalities for treatment of pain.
