Addiction Psychiatry Fellowship Program
Kirk Brower, M.D.
The Addiction Psychiatry Fellowship Program is a one-year, clinical training program for psychiatrists interested in obtaining practical expertise in the diagnosis and treatment of substance use disorders. The program is accredited by the Accreditation Council for Graduate Medical Education (ACGME), and successful completion of the 1-year clinical track qualifies psychiatrists to apply for subspecialty certification in addiction psychiatry from the American Board of Psychiatry and Neurology, once they have obtained their certification in general psychiatry.
Why should I do a fellowship program in Addiction Psychiatry?
Most (at least 50% of) patients in a general psychiatry practice will have co-occurring substance use disorders. Yet, only 1 month of addiction training is required as part of general psychiatry residency programs. Thus, you and your patients will likely benefit from enhancing your knowledge, skills, and confidence in this area.
Second, the work is rewarding because treatment is effective. Moreover, with the advent of novel medications, such as buprenorphine, the role of the physician in treatment has increased.
Third, you will learn specialized skills in motivational interviewing and motivational enhancement therapy, techniques that were designed and developed for patients with substance use disorders, but have broader applicability for motivating patients with any diagnosis to make positive changes in their lives.
Fourth, the patient population is underserved, so you will be doing your part to help.
Finally, the program lasts for only 1 year, after which you will be more marketable when looking for jobs or establishing a private practice.
For more information about the subspecialty of Addiction Psychiatry, see also: American Academy of Addiction Psychiatry
Established in 1817, the University of Michigan (UM) is truly one of the world’s greatest public universities. The Medical School is consistently ranked in the top 10 and was tied for 6th place in the 2010 U.S. News and World Report issue, titled “Best Graduate Schools”. This means that fellows have the opportunity to teach very high caliber medical students, in addition to obtaining high-quality education for themselves.
The Addiction Psychiatry Fellowship Program is part of the Substance Abuse Section in the Department of Psychiatry, which is divided into clinical and research arms. The research arm, known as the University of Michigan Addiction Research Center (UMARC), was established in 1988, and was recently featured in the journal, Addiction (2010; 105:966-973). It is currently home to 15 faculty members, whose funded research portfolio includes total annual costs of almost $9 million.
UMARC also has two research training fellowships, one funded by the National Institute on Alcohol Abuse and Alcoholism for over 20 years and the other by the Fogarty International Center/NIDA funded International Research Training Program since 2001, whose focus is expanding substance abuse research training and research infrastructure development in Poland, Ukraine, Slovakia, and Latvia. Between these two programs, UMARC typically funds 8 postdoctoral research fellows and 2 pre-doctoral research fellows. Thus, addiction psychiatry fellows have the opportunity to learn alongside the research fellows during the Core Lecture Series, Journal Club, and Grand Rounds (see Didactic Program below).
Equally important, the Ann Arbor community is a great place to live as well as to work. For more highlights, please see the following links:
Finally, addiction psychiatry fellows at the University of Michigan have no overnight call responsibilities.
Approximately 50% time is spent at the University of Michigan Health System (UMHS) and 50% at the Veterans Affairs (VA) Healthcare System in Ann Arbor.
UMHS time is spent at three sites:
- The UM Addiction Treatment Services (UMATS), serves both adolescents and adults in its intensive outpatient and regular outpatient programs, including ambulatory detoxification services and buprenorphine clinics.
- Additional time is spent throughout the year rotating in (1) the high-risk obstetrics clinic treating pregnant women with substance use disorders, (2) the UM Multidisciplinary Pain Clinic providing consultations for patients either with or at risk for substance use disorders in the course of their pain management, and (3) the general hospital in a consultation-liaison role for patients with substance-related disorders.
- Fellows also rotate at the VA outpatient Substance Abuse clinic for approximately 16 hours per week.
The combination of these 2 services (UMHS and VA) offers fellows exposure to a broad range of patients with substance use disorders in a diverse patient population in both hospital and community based settings.
The didactic program includes three regular weekly events: Core Lecture Series, Journal Club, and Grand Rounds. The Core Lecture Series, presented by the faculty, focuses on epidemiology, neurobiology, and psychosocial aspects of addiction; specific drugs of abuse (alcohol, anabolic steroids, cannabis, cocaine, amphetamines and other stimulants, hallucinogens and related drugs, inhalants, nicotine, opioids, and sedative-hypnotics); assessment of substance use disorders including use of withdrawal rating scales and level of care placement criteria; urine drug screens and other laboratory tests; distinguishing substance-induced from independent co-occurring psychiatric disorders; evidence-based pharmacological and psychosocial therapies; 12-step and other mutual self-help groups; and special populations and comorbidities (e.g., adolescents, obstetrics, impaired health care professionals, chronic pain, sleep disorders). In Journal Club, a recent or classic article of interest is selected, presented, and discussed with attention to research methodology and generalizability to clinical practice. Faculty and trainees alternate in selecting articles and leading the discussion with fellows presenting once monthly. Grand Rounds is hosted by the Department of Psychiatry and highlights the work of outstanding scholars from the university and other academic institutions, related to topics across the psychiatric spectrum, including addictions. Staying current as a general psychiatrist is vital to being an excellent addiction psychiatrist.
Supervision & Mentorship
Each rotation is supervised by a faculty mentor, who provides on-site, real-time supervision. In addition, two hours per week of individual supervision are scheduled to discuss cases and readings, and to provide career guidance.
Qualified applicants will have completed (before starting the fellowship) an accredited psychiatry residency in the U.S. and have passed all necessary examinations to obtain a physician’s license in the State of Michigan. Training licenses will not be accepted. Applicants with J1 visas will be considered.
Benefits and salary levels are outlined in the House Officers Agreement which can be found at: UMHS Bargaining Agreements
One or two training slots per year are available depending on funding. The training year begins on July 1 and ends on June 30 of the following year. Applications must be received by March 1 to be considered for the July 1 term. However, training slots are filled in the order that high-quality applicants submit their materials. Therefore, there is an advantage to submitting materials early.
To apply, please complete the training program application found in the Application section of this web site and mail along with your letter of interest and background (reflective of your training and accounting for any training lapses), and 3 personal reference letters from people with whom you have had relevant, professional contact. One must be from the director of your most recent training program.
Mailing address and information contact:
Kirk Brower, M.D.
Director, Addiction Psychiatry Training Program
4250 Plymouth Rd.
Ann Arbor, MI 48109-2700