The Brigham and Women’s Hospital (BWH) Addiction Medicine Fellowship is a one-year, ACGME-accredited fellowship program in addiction medicine, open to physicians who have completed any ACGME-accredited residency program. Our goal is to train the next generation of leaders in the prevention, diagnosis, assessment, treatment, and recovery of those individuals with substance use disorders and related medical and psychiatric co-morbidities. The program is designed to prepare fellows for a variety of academic and clinical opportunities related to substance use disorders. Fellows completing the program will qualify to sit for the Addiction Medicine board exam from the American Board of Preventive Medicine.
We provide cutting-edge training in the treatment of substance use disorders that span the entire spectrum of treatment levels, including medically-supervised withdrawal (detoxification), inpatient addiction consultation-liaison, low-barrier and low-threshold model (Bridge Clinic), specialty addiction outpatient and partial hospital program, as well as opportunities to treat patients at the Boston Health Care for the Homeless, methadone clinic, Section 35 facility, and adolescents at Boston Children’s Hospital. Fellows will also learn from pain specialists and medical toxicologists who practice at the intersection of addiction medicine in outpatient and emergency room settings, respectively. Finally, fellows will have opportunities for scholarly activity and research collaborations.
The academic year starts with a 2-week long “Addiction Boot Camp” to help orient all of our fellows, followed by weekly didactics, fellows meeting, and monthly journal clubs. A unique aspect of the BWH program is that we provide fellows with an opportunity to gain skills in the treatment of patients with substance use disorders who have co-morbid psychiatric disorders as well as serious infectious complications related to their substance use. Fellows will gain experience by working with staff psychiatrists, collaborating with infectious disease specialists during both inpatient consult liaison and bridge clinic rotations. In addition, fellows will be encouraged to work with addiction specialists to participate in scholarly projects, present at national conferences, and become well versed in the practice of motivational interviewing.
Addiction Medicine fellows will divide their time between the inpatient and outpatient settings. The year will be divided into rotations that are two weeks in duration. The distribution of rotations is:
Fellows will join the addiction psychiatry consultation service at Brigham and Women’s Hospital provides consultation to assist with the management of hospitalized patients with known or suspected substance use disorder.
Reasons for consultation include but are not limited to: management of substance withdrawal, intoxication and toxidromes, initiation of medication treatment, management of acute and chronic pain including in patients with opioid use disorder, management of polysubstance use, diagnostic clarification, and connection to appropriate outpatient addiction services. When appropriate, fellows may choose to follow the patient after discharge at their primary clinic site to facilitate transition of care.
Each fellow will have a weekly continuity clinic at one of the two sites — the BWH Bridge Clinic and the BWFH Outpatient Addiction Recovery Program (ARP). Fellows will spend time at the other on the Outpatient Addiction Rotations.
BWH Bridge Clinic: The mission of the Brigham Health Bridge clinic is to provide rapid, low-barrier access to treatment for Substance Use Disorders with the intention of helping patients achieve stability and then “bridging” patients to longer-term programs that support ongoing recovery. The clinic is founded upon the principle of harm reduction to minimize complications of substance use disorder and to keep patients engaged in care in all stages of recovery. Fellows will work as part of a multidisciplinary team including a peer recovery coach and resource specialist to provide individualized, patient-centered care.
BWFH Outpatient Addiction Recovery Program (ARP): The Addiction Recovery Program at Brigham and Women’s Faulkner Hospital is a comprehensive outpatient program for the management of patients with substance use disorders (SUD). Patients are followed by a multidisciplinary team, including board certified addiction psychiatrists and licensed social workers (LICSW) with expertise in the treatment of SUD.
Fellows will have two-week blocks dedicated to outpatient addiction medicine. In addition to spending more time at two continuity clinic sites described above —The BWH Bridge Clinic and BWFH ARP — fellows will participate in half day or full day clinic sessions at a range of outpatient addiction sites. This will provide fellows the opportunity to see unique treatment settings and unique patient populations. The additional outpatient addiction sites include:
Health Care Resources Methadone Clinic: The Health Care Resources methadone clinic at the Lemuel Shattuck Hospital serves approximately 200 adult patients (including pregnant patients) receiving methadone maintenance treatment for opioid use disorder. This experience will provide the basic training opportunity to understand the structure of the methadone treatment programs and how to deliver multidisciplinary care within this context.
Boston Health Care for the Homeless: Addiction Consults at Medical Respite: Boston Health Care for the Homeless Program (BHCHP) provides a unique opportunity for fellows to treat patients who are homeless, marginally housed, or at high risk for homelessness. Fellows will see patients at the inpatient respite unit at Barbara McInnis House as addiction medicine consultants for homeless individuals in the respite unit.
Fellows will spend half or full days at the BWH Bridge Clinic and the BWH Outpatient ARP. Additionally, fellows will have the opportunity to learn from experts in pain management at two unique sites.
Pain Management Center at BWFH: The Pain Management program at Brigham and Women’s Faulkner Hospital specializes in the diagnosis and management of patients with acute and chronic pain. Fellows will be supervised by Dr. Mohammed Issa who is board-certified in addiction psychiatry and pain medicine and his clinical expertise is in the management of patients with pain and addiction.
Pain Management and Substance Use Disorder Treatment in Primary Care: The Pain Management and Substance Use Disorder Clinic at the Phyllis Jen Center for Primary Care (PJC) is a unique opportunity for fellows to practice at an integrated clinic in the primary care setting. PJC is a hospital-based resident/faculty practice that predominately serves patients with MassHealth and Medicare. Any patient who receives primary care at PJC with chronic pain and/or an opioid use disorder can be referred to see a pharmD with an expertise in the management of patients with chronic pain. Patients are seen for one time consultation for recommendations on management strategy for chronic pain, including patients on opioid analgesics, and some patients are followed longitudinally.
During this rotation, fellows will care for patients at the BWFH Level IV medical supervised inpatient detoxification unit. This is an eight-bed inpatient level IV detoxification unit. Patients are primarily admitted for assistance with alcohol detoxification, but some are admitted for benzodiazepine withdrawal and many patients suffer from polysubstance use disorder. Additionally, fellows will also be on call for medical toxicology consultations from the emergency department. Consultations may include assessment of chemical intoxication and/or withdrawal, evaluation for inpatient detoxification, guidance for withdrawal management, and initiation of buprenorphine in the emergency room setting. Fellows will participate in Toxicology Rounds with the toxicology and pain medicine fellows to gain additional expertise in toxicology interpretation.
Fellows will spend two weeks at the BWFH Dual Diagnosis Partial Hospital Program. The program is a short-term stabilization and treatment program that addresses the needs of patients who have both substance use and psychiatric disorders. The average length of stay is 5-7 days. Treatment is provided by a multidisciplinary team composed of psychiatrists and licensed clinical social workers.
The Adolescent Substance Use and Addiction Program (ASAP) is a national leader in the identification, diagnosis and treatment of substance use problems and disorders in children and adolescents. ASAP is part of the Division of Developmental Medicine and is staffed by developmental-behavioral trained pediatricians, licensed independent social workers and psychiatrists.
The High Point detox unit at the Lemuel Shattuck Hospital is a level 3.7 DDE; 32 bed combined ATS/CSS unit for medically monitored inpatient detox of Section 35, civilly committed women age 18 and up (including pregnant patients). The majority of women have substance use disorder, and most have psychiatric, medical social co-morbidities. Patients undergo medically supervised detoxification over the course of 6-7 days using different detox protocols including Subutex, Methadone, Clonidine, Librium, Serax and Phenobarbital. All patients undergo medical evaluation for management of SUDs, and most are started on a maintenance therapy for SUD with appropriate aftercare and medical follow-up. The program also includes group therapy, psychosocial education and case management.
Fellows will have an opportunity to access other training opportunities critical for future success as leaders in the field of addiction medicine. By leveraging resources available through Harvard Medical School and Mass General Brigham, fellows will have ample opportunities to access a broad range of training and other opportunities.
We accept applications through ERAS and by email, please plan to submit:
Timeline: Interviews will be given on a rolling basis. Applications sent before August 1, 2020 will be given priority. Once a completed application has been submitted it will be reviewed. Interviews will take place in the Fall.
To submit your application via email or with any question, please contact us at: firstname.lastname@example.org.
Director for the Division of Addiction Psychiatry
Dr. Suzuki is board-certified in both Addition Psychiatry and Addiction Medicine. His clinical role has spanned specialty addiction and general medical settings, including providing inpatient addiction consultations.
Medical Director of South Huntington BWH Primary Care and Assistant Medical Director for Substance Use Disorders
Dr. Alrakawi is a Board-Certified Addiction Medicine and Internal Medicine physician with 23+ years of experience.
Primary Care Physician and Clinician Educator
Dr. Atalay is a primary care physician and clinical educator in the Division of General Medicine and also practices at the Brigham Health Bridge clinic with an interest and expertise in the care of patients with substance use disorder.
Infectious Disease Physician and Clinician Educator
In addition to his work in the Division of Infectious Diseases, Dr. Solomon also practices at the Brigham Health Bridge Clinic where his focus is on the treatment and prevention of infectious complications of substance use disorders.
Medical Director of Addiction Services, BWFH
Dr. Rodriguez is a board-certified Addiction Psychiatrist and is the Director of addiction services at Brigham and Women's Faulkner Hospital. Her focus is to improve stigma, enhance education of providers, and improve addiction treatment across all clinical service levels.
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