|
Rotation |
Amount of Time |
|---|---|
|
Inpatient Experiences IP |
|
|
Substance Use Intervention Team Consultation-Liaison at Rush University Medical Center; RUMC |
2 blocks |
|
Rush University Medical Center Palliative Medicine & Advanced Pain Management Rotation; RUMC Site 1 (A 2 Wk Rotation) |
½ block |
|
Rush University Medical Center Hepatology Department’s Rotation; RUMC Site 1 ( A 2 Wk Rotation) |
½ block |
|
Inpatient Community Addiction Medicine at West Suburban Medical Center; WSMC Site 2 |
1 block |
|
Outpatient Experiences OP |
|
|
Outpatient Addiction Medicine Clinic at Rush University Medical Center; RUMC Site 1 |
2 blocks |
|
Rush Addiction Medicine Program Outpatient Clinic for Person’s with Co-Occurring Disorders *; RUMC Site 1 |
1 block |
|
Rush University Medical Center Behavioral Therapy Rotation; RUMC Site 1 (A 2 Wk Rotation) |
½ block |
|
Outpatient Community Addiction Medicine at PCC Community Wellness Center; Site 2 PCC 2 |
1 block |
|
Opioid Treatment Program at Family Guidance Center, Inc. Rotation; FGC Site 3 (A 2 Wk Rotation) |
1/2 block |
|
Elective, Research, Education and Scholarship, Longitudinal Learning |
1 block |
|
Elective, Research, Education and Scholarship, Longitudinal Learning |
1 block |
|
Vacation |
1 block |
The Substance Use Intervention Team Consultation-Liaison at Rush University Medical Center is a team-based inpatient consultation service for medical and surgical patients. Directed by Dr. Jenna Nikolaides and overseen by Elisabeth Ramsey, LCSW; this multidisciplinary team consists of addiction medicine trained physicians, advanced practice nurses, registered nurses, licensed clinical social workers, pharmacists, recovery support specialists, residents, and students working together to identify and treat patients at risk for opioids and other substances. Fellows work collaboratively as consultants and as team leaders. As consultants, fellows oversee the comprehensive assessment, diagnosis, and treatment of patients with substance-related health problems and SUDs along a continuum of care, including inpatient treatments, early intervention, harm reduction, and prevention. The fellows’ participation in SUIT affords repeated opportunities for screening, brief intervention with medical treatments including inpatient medically-managed withdrawal and motivational interviewing, and referral of patients to specialized clinics/treatment centers (SBIRT) depending on the level of need. Fellows develop competence in effectively conducting inpatient interviews with Rush’s socio-culturally diverse patients and families, including those with limited language proficiency, literacy, hearing, or sight Fellows may continue the patient’s care on an outpatient basis at either outpatient addiction service locations offering the opportunity to develop an appreciation for addiction as a chronic disease process. Fellows participate in discussions and may lead the dialogue in daily rounds as well as the SUIT huddle, a multidisciplinary conference focused on complex patients. Fellows are directly overseen by the team.
Fellows rotate through Rush University Medical Center’s Palliative Medicine and Advanced Pain Management Rotation for two weeks. The Palliative Inpatient Consultation Service sees patients through RUMC to assist in the evaluation and management of any or all of the following issues: pain and symptom management for patients facing serious, life-limiting illnesses and provide clarification of goals of care, transitions in care to comfort-focused therapies, intensive comfort care for patients being withdrawn from life-sustaining treatments. Palliative Medicine offers a multidisciplinary approach. Fellows assess patients with chronic pain for substance use, addictive disorders, substance-related health problems, and co-occurring psychiatric illness. Fellows may taper prescription opioids to safe doses, prescribe naloxone, initiate buprenorphine-naloxone, or refer to a community methadone/buprenorphine clinic, as appropriate. The fellow is directly supervised by the palliative care physician attendings and functions as an integral member of the interdisciplinary team during this two-week elective. Upon completing this elective, the fellow gains confidence in their skills in advanced pain management and in teaching the REMS Safe Opioid Prescribing Course offered through the American Society of Addiction Medicine, an opportunity available through the Illinois Society of Addiction Medicine for fellows interested in pursuing educational opportunities.
Fellows rotate through Rush University Medical Center Hepatology Department for two weeks. This immersive experience integrates the fellow with an interdisciplinary team and enhances the fellow’s knowledge of advanced liver disease related to alcohol use disorder and viral hepatitis. Included in this rotation is extensive didactic (both self-directed and with the Section Chief of Hepatology) on gaining confidence in the treatment of Hepatitis C, as many addiction medicine clinicians choose to address viral hepatitis in their future clinical practice. The elective also includes participating with the liver transplantation care team and playing an active role in bolstering continuity of care for patients with advanced alcohol use disorders at RUMC.
Fellows rotate longitudinally in a community addiction medicine experience on the West side of Chicago, providing culturally sensitive inpatient and outpatient care to a vulnerable patient population. PCC Community Wellness Center’s Outpatient Addiction Medicine Clinic (a Federally Qualified Health Center) and West Suburban Medical Center (a Safety Net Hospital) are co-located in the Austin neighborhood of Chicago.
For their inpatient experience, fellows rotate on the inpatient addiction medicine consult service at West Suburban Medical Center and gain expertise in caring for pregnant and parenting persons with SUD, providing care for infants affected by perinatal substance exposure, and integrating SUD treatment with the treatment of Hepatitis C. Fellows work with family medicine residents and family medicine maternal child health fellows in conjunction with the Addiction Medicine Team that the Family Medicine Department directs. Fellows are directly supervised by the Associate Program Director, Dr. Ruchi Fitzgerald, and the Site Director, Dr. Kathleen McDonough.
Fellows oversee the comprehensive assessment, diagnosis, and treatment of patients with substance-related health problems and SUDs along a continuum of care, including outpatient treatments, early intervention, harm reduction, and prevention. During this longitudinal experience, fellows conduct comprehensive assessments for persons with substance use, addictive disorders, and substance-related health problems. Fellows may prescribe buprenorphine and other medications for addiction treatment, enhance their motivational interviewing skills, and learn to understand the impact of the social determinants of health. Fellows manage SUD across the adult age spectrum, see continuity patients and same-day patients in this clinic model. Fellows have substantial opportunities to teach and supervise medical students, residents, and other learners during this clinic. The Substance Use Intervention Team (SUIT) facilitates the Addiction Medicine Outpatient SUIT Clinic; fellows are directly by Dr. Jenna Nikolaides and Dr. Nicholas Chien.
Fellows rotate longitudinally in a community addiction medicine experience on the West side of Chicago, providing culturally sensitive inpatient and outpatient care to a vulnerable patient population. PCC Community Wellness Center’s Outpatient Addiction Medicine Clinic (a Federally Qualified Health Center) and West Suburban Medical Center (a Safety Net Hospital) are co-located in the Austin neighborhood of Chicago.
For their outpatient experience, fellows have numerous opportunities to design a longitudinal experience at PCC Community Wellness Center, a hub-and-spoke model for addiction treatment. PCC Community Wellness Center (PCC) began in 1980 as the Parent-Child Center, a three-room clinic that offered prenatal, postpartum, and infant care for Chicago’s underserved Austin Community. Fellows work alongside family medicine residents and family medicine maternal child health fellows in conjunction with the Addiction Medicine Team that the Family Medicine Department directs. Fellows are directly supervised by the Associate Program Director, Dr. Ruchi Fitzgerald, the Site Director, Dr. Kathleen McDonough, and Dr. Francesco Tani.
Rush Addiction Medicine Program’s Outpatient Clinic for Persons with Co-Occurring Disorders Outpatient affords fellows a longitudinal setting to identify and treat common co-occurring conditions, such as substance use and addictive-related disorders, substance-related health problems, pain, and mental illness. Fellows gain confidence in treating SMI (serious mental illness) along with SUDs in this continuity clinic while working collaboratively with the program director. Fellows manage SUD across the adult age spectrums, SUD in the pregnant patient, and SUD in the medical professional.
Fellows interact with a multidisciplinary team of administrative and clinical professionals including nurse practitioners, social workers, and medical assistants. Fellows work collaboratively with other RUMC departments to care for RAMP patients and create comprehensive treatment plans in a shared decision-making process with patients affected by SMI and SUD. Fellows take the lead role in educating psychiatry residents and medical students and serve as role models.
During their year-long outpatient experience in RAMP, fellows work in private offices equipped with computers and text books and have administrative and technological support available. Telemedicine is incorporated into the RAMP experience. Dr. Gail Basch provides direct on-site supervision and offers a senior clinician’s perspective. She is the Program Director and Director of the Outpatient Rush Addiction Medicine Program; Dr Basch has over thirty years of experience in psychiatry and twenty years of experience in addiction medicine.
During the Rush University Medical Center two-week Behavioral Therapy Rotation, fellows enhance their knowledge of the role of various behavioral therapies in the addiction treatment process.
They learn basic principles of cognitive behavioral therapy, relapse prevention therapy and acceptance and commitment therapy. In addition, they learn the basic principles of Motivational Interviewing, its use in brief interventions, and its application with persons with substance use and addictive related disorders.
Fellows observe the implementation of behavioral therapies by observing and facilitating psychotherapy sessions. On the inpatient consultation service, they observe and practice Motivational Interviewing skills, and receive real-time coaching and feedback to reinforce Motivational Interviewing principles and practices. Fellows complete an online course in Motivational Interviewing for persons with substance use and addictive related disorders.
Fellows develop an understanding of the function of peer support groups. They attend three peer support meetings such as 12 step meeting, Smart Recovery or Refuge Recovery. In observed patient interactions, fellows integrate new knowledge about peer support in collaborative treatment planning with patients.
Fellows learn the impact of social determinants of health on the addiction recovery process.
They assess for various case management needs such as housing, transportation, food insecurity and access to health services.
They develop knowledge of resources in the community to address social determinants of health concerns and develop treatment plans that integrate this knowledge. They demonstrate an understanding of how to work within an interdisciplinary team to address these concerns, including proactive involvement of case managers and recovery support specialists.
Fellows rotate through the Opioid Treatment Program (OTP) at Family Guidance Centers Inc, (FGC) an outpatient medical clinic facility that aids persons with substance use and addiction related disorders while providing comprehensive behavioral health solutions. FGC is recognized as one of the most accessed Opioid Treatment Programs in the Chicago area and has multiple locations throughout the state. Fellows are directly supervised by the site director, Dr. Hilton Gordon. Traveling with Dr. Gordon to several of Chicago’s inpatient facilities for detoxification (Thorek, Methodist, and St. Bernard’s) broadens the fellows’ experience.
Fellows work with low-income, indigent, and unstably housed patients who may also have co-occurring mood or medical illnesses and engage in detoxification intakes, physical exams, and medication for addiction treatment (MAT) clinics. They gain educational experience in delivering harm reduction, trauma-informed care, motivational interviewing, healthcare for the homeless, and integrative approaches to addiction medicine. Fellows improve awareness of why patients choose methadone, buprenorphine, or extended-release naltrexone. They work with their patients on setting and achieving recovery goals. Fellows gain knowledge of the use of methadone for the treatment of OUD by learning the systems of care in an OTP and how an underserved population accesses methadone. Fellows work closely with the lead physician and lead nurses/counselors in an interdisciplinary team during this rotation and have ample opportunities for bidirectional learning. Traveling with Dr. Gordon to several of Chicago’s inpatient facilities for detoxification (Thorek, Methodist, and St. Bernard’s) broadens the fellows’ experience.
Professor Napier Professor T. Celeste Napier is the Fellowship’s Director of Education and Research Training; she provides mentorship in survey data evaluation, interpretation, and public dissemination. Under her tutelage, fellows improve skills in biomedical teaching, including content, organization and delivery of materials, curriculum development, outcomes (attitudinal and behavioral) analysis, experimental design and statistical evaluations, scientific presentations, and publications. Dr. Napier meets with the fellows at least twice monthly. She offers guidance and direct supervision to the fellows as they develop and deliver lectures for Psychiatry Residents, as well as their annual national ACAAM didactic lecture.
Dr. Napier is the Training Program Mentor for Dr. Neeral Sheth’s Educational Scholars Program award (supported by the Assoc of Directors of Med Ed in Psychiatry). Dr. Sheth is the Director, Medical Education in Psychiatry, and the Division Chief, Medical College Educational Programs at Rush University. The fellows work with Drs. Napier and Sheth in data analysis, interpretation, and dissemination to the public domain
The leadership of the addiction medicine program is committed to advancing the research and scholarship interests of the addiction medicine fellows. Each fellow will pursue scholarly activities in addiction medicine in alignment with the American Academy of Addiction Medicine goals and the ACGME objectives for the addiction medicine fellow. Fellows are encouraged to pursue scholarly activity in addiction medicine. Fellows participate in the Rush University Research and Compliance Online Courses before engaging in a research project to write a research proposal and submit a project for IRB approval. Fellows are matched to mentors within RUMC (including meeting the physicians in the department of their primary board specialty) and the community based on their specific interests.
Fellows have numerous opportunities to formally teach other clinicians (through the Illinois Society of Addiction Medicine) and medical students and gain confidence in teaching the buprenorphine waiver course and the REMS safe opioid prescribing course. Should Fellows express interest in grant writing or other academic interests, they will be directed to the appropriate mentoring pathways available at Rush University.