Addiction Medicine Fellowship

Fellows must be able to provide patient care that is patient- and family-centered, compassionate, equitable, appropriate, and effective for the treatment of health problems and the promotion of health. 

1. Fellows must demonstrate competence in: 
   1. comprehensive assessment, diagnosis, and treatment of patients with substance-related health problems and SUDs along a continuum of care, including inpatient/residential, outpatient treatments, early intervention, harm reduction, and prevention 
   2. providing care to patients in different settings, such as inpatient medically-managed withdrawal programs, SUD treatment programs, consultation services, and integrated clinics 
   3. providing care to SUD patients with diversity in age, gender, socioeconomic status, limited language proficiency or literacy, and comorbid medical and psychiatric conditions 
   4. screening, brief intervention, and motivational interviewing 
   5. working with an interdisciplinary team that includes other medical specialists, counselors, psychologists, family members, and/or other stakeholders involved in the patient’s care; and 
   6. providing continuity of care to patients
2. Fellows must be able to perform all medical, diagnostic, and surgical procedures considered essential for the area of practice. 
3. Fellows must demonstrate knowledge of established and evolving biomedical, clinical, epidemiological and social-behavioral sciences, including scientific inquiry, as well as the application of this knowledge to patient care
4. Fellows must demonstrate knowledge of: 
   1. the medical model of addiction, including a basic knowledge of neurobiology and changes in brain structures associated with addiction 
   2. pharmacology of common psychoactive substances, including alcohol, nicotine, stimulants, sedative-hypnotics, depressants, opioids, inhalants, hallucinogens, and cannabinoids
   3. epidemiology of substance use, SUDs, and the genetic and environmental influences on the development and maintenance of these disorders
   4. the impact of substance use, including psychosocial and medicolegal implications, in diverse populations and cultures, such as in women, neonates, children, adolescents, families, the elderly, sexual and gender minorities, patients with physical or mental trauma or other injuries, military personnel and dependents, health care professionals, employees, and persons involved in the criminal justice system; 
   5. common behavioral addictions
   6. prevention of SUDs, including identification of risk and protective factors
   7. screening, brief intervention strategies appropriate to substance use risk level, and referral to treatment
   8. comprehensive substance use assessment and reassessment, including diagnostic interview, use of standardized questionnaires, lab tests, imaging studies, physical examinations, mental status examinations, consultative reports and collateral information
   9. identification and treatment of common co-occurring conditions, such as medical, psychiatric, and pain conditions
   10. matching patient treatment needs with levels of intervention, including crisis services, hospitalization, and SUD treatment programs
   11. pharmacotherapy and psychosocial interventions for SUDs across the age spectrum
   12. intoxication and withdrawal management
   13. the mechanisms of action and effects of use and abuse of alcohol, sedatives, opioids, and other drugs, and the pharmacotherapies and other modalities used to treat these
   14. the safe prescribing and monitoring of controlled medications to patients with or without SUDs, including accessing and interpreting prescription drug monitoring systems; and, 
   15. the effects of substance use, intoxication, and withdrawal on pregnancy and the fetus, and the pharmacologic agents prescribed for the treatment of intoxication, withdrawal, and management, including opioid, alcohol, and sedative hypnotic withdrawal. 

Practice-based Learning and Improvement:

Fellows must demonstrate the ability to investigate and evaluate their care of patients, to appraise and assimilate scientific evidence, and to continuously improve patient care based on constant self-evaluation and lifelong learning. 

Interpersonal and Communication Skills: 

Fellows must demonstrate interpersonal and communication skills that result in the effective exchange of information and collaboration with patients, their families, and health professionals. 

Systems-based Practice:

Fellows must demonstrate an awareness of and responsiveness to the larger context and system of health care, including the structural and social determinants of health, as well as the ability to call effectively on other resources to provide optimal health care.