Rotations
Core Rotations
ACTS Clinic
This clinic is the home of the fellows’ continuity clinic for both psychopharmacology, as well as short-term psychotherapy for substance use disorders and co-occurring disorders. Fellows will gain expertise in medication-assisted treatment modalities, such as buprenorphine and naltrexone.
Addiction Consult Service
Fellows will serve on the consultation team in a 750-bed hospital providing addiction expertise for medical and surgical patients.
Adcare
This hospital is a Level 4 acute detoxification facility with 114 beds for both detox and rehab units, as well as daily medical rounds, and 24 hours monitoring. Fellows will evaluate and follow patients over the course of their in-patient hospitalization.
Motivating Youth Recovery
This unit treats adolescents between the ages of 13 and 18 who require detoxification as well as clinical stabilization from substance use.
Spectrum Health Systems
Fellows will evaluate patients seeking treatment for opioid use disorder, and they will observe as patients are induced on methadone and as the dose is titrated to a maintenance level.
Bedford VA
Fellows will practice addiction psychiatry in ASAM levels of care, from clinically managed intensive inpatient services and high-intensity residential services, to Intensive Outpatient services. They will get comprehensive experience in evaluating patients and administering medications for opioid use disorder, providing group therapies, and learning about other psychosocial interventions such as Motivational Interviewing and Contingency Management. They will also be responsible for providing addition psychiatry consults to the rest of our hospital, including our robust geriatric patient population in nursing home and geriatric psychiatric unit.
Teleaddiction Consultation
Fellows will utilize telepsychiatry to provide addiction consultation to other treatment facilities within the UMass system, such as community mental health centers and the state hospital.
Additional Rotations
Substance Use Disorders in the Pregnant and Postpartum Patient
Fellows will rotate in the Karen W Green Clinic for Pregnancy and Recovery. This multi-disciplinary clinic serves pregnant or recently delivered women who also have a variety of Substance Use Disorders. Medication considerations in pregnancy, legal and ethical issues regarding pregnancy and parenting, and pain management plans around labor will be reviewed.
Forensic Addiction Psychiatry
Massachusetts allows for the involuntary hospitalization of people with substance use that is putting them at imminent risk of harm to themselves, and fellows will be able to observe the legal process that leads to this type of hospitalization. They will also be able to attend and observe the proceedings of drug courts.
Medical Toxicology
During the consult service rotation, fellows will have the option to attend rounds for the medical toxicology service that covers both the emergency department as well as the in-patient units.
Liver Clinic
Fellows will provide addiction consultation for a clinic that treats patients with alcoholic liver disease.
Pain Clinic
Fellows will observe a pain specialist in the evaluation and management of patients with chronic pain.
Novel Treatments for Mood Disorders
There is growing use of hallucinogens such as ketamine and psilocybin for treatment-resistant depression. As the use of these medications expands, there will be a need for Addiction Psychiatrists to be able to provide expertise on safe and appropriate use. Fellows will rotate in a newly established esketamine clinic, evaluating new patients and monitoring patients in active treatment.