Training
The UM Addiction Medicine Fellowship is divided into four 13-week blocks. Over the course of the year, fellows will participate in the following clinical/educational services and didactic experiences.
Clinical Education
Inpatient Consults
The Substance Abuse Consultation-Liaison (SACL) Service is an inpatient teaching service located at the UMMC–Downtown campus. While rotating on this service, fellows interact with staff from other disciplines including nurses, counselors and social workers.
During their consultation-liaison rotation, the fellows teach and supervise psychiatry residents and medical students co-rotating on the service. They participate in bedside rounds and case discussions with faculty and other staff.
Fellows conduct comprehensive assessment, diagnosis and treatment interventions, including:
- early/brief/harm reduction interventions and preventative counseling
- motivational interviewing
- withdrawal and pain management
- initiation of maintenance treatments
- referral to outpatient and residential services
They also help manage substance use disorders in pregnant and peripartum patients.
Chemical Dependency Service
The UMMC–Midtown Chemical Dependency Service is an inpatient teaching service. Fellows serve a dual clinical role providing medically-managed withdrawal management and substance use disorder consultation services for other hospital specialties.
Fellows provide comprehensive assessment, diagnosis and treatment interventions, including:
- alcohol, benzodiazepine and opioid withdrawal management
- counseling
- motivational interviewing
- initiation of maintenance treatments for OUD
- referral to and coordination with outpatient and residential services
While rotating on this multidisciplinary service, fellows are a key educational liaison and model for other learners including residents from the hospital’s internal medicine residency and transitional year program.
Adolescent and Young Adult Residential Treatment
Mountain Manor Treatment Center is a residential rehabilitation program for adolescents and adults. Fellows typically see one new case and two or three follow-ups weekly.
Many patients have co-occurring substance use and mental health problems. Fellows have the opportunity to manage some adolescent/young adult patients with medication assisted treatments.
The Center also serves as a site for research on novel pharmacological therapies and service delivery models targeting adolescents and young adults, such as a program offering medication assisted treatment using an assertive community outreach model for difficult to engage patients.
Outpatient Addiction Treatment
UM Addiction Treatment Programs at 1001 West Pratt is an outpatient addiction treatment setting with multiple integrated care models, including an opioid treatment program, an office-based addiction treatment program, a reverse co-located primary care and infectious disease practice, and a Deaf addictions program.
Fellows learn how to initiate and manage patients on methadone or buprenorphine maintenance and the rules, regulations and administrative issues governing treatment. They are exposed to the modalities of outpatient psychosocial interventions, work with d/Deaf patients with substance use disorders and are central to efforts to integrate addiction treatments, infectious disease screening and treatment and primary care.
Addiction Telemedicine
Fellows communicate with patients through secure video portals located on the UMMC campus. These patients originate from rural and correctional healthcare facilities, including mobile treatment units.
Well-established collaborations with nonprofit behavioral health providers, public health departments and correctional institutions across Maryland allow addiction medicine fellows to gain comfort with telemedicine platforms, provide opportunities to practice rural medicine while physically based in an urban academic institution and expose fellows to different substance use disorders and patient populations, including prisoners.
The longitudinal nature of this rotation will allow addiction medicine fellows to cultivate and maintain doctor-patient relationships throughout the yearlong course of their fellowship.
Outpatient Maintenance and Withdrawal Management
The Center for Addiction Medicine at UMMC–Midtown is an outpatient addiction treatment setting with an opioid treatment program, an office-based addiction treatment program and an ambulatory medically supervised withdrawal setting.
In addition to seeing patients in office-based settings, fellows provide ambulatory medically-managed withdrawal from alcohol, benzodiazepines and opioids.
Psychiatric Emergency Services
UMMC offers a 24/7 Psychiatric Emergency Services (PES) program for patients aged 18 or older. Fellows evaluate, diagnose and initially treat a variety of acute psychiatric diagnoses, with emphasis on initial management of intoxication and withdrawal and assessment and risk-stratification of suicidal behaviors.
Pain Medicine
University of Maryland Pain Management Center is an outpatient multimodal pain medicine practice focusing on recovery of optimal function through pharmacotherapy, imaging-guided minimally-invasive interventions and psychological interventions.
Fellows help evaluate, diagnose and manage patients' chronic pain. Through this, fellows gain knowledge and experience with surgical and other nonpharmacologic interventions for pain, understanding the strengths and limitations of evidence-based pain treatments and gaining comfort with best practices for using opioids safely for treatment of chronic pain.
Elective Time
Elective time can be tailored to a fellow's needs. Possible experiences include:
- inpatient community addiction treatment and crisis stabilization
- subspecialty care (infectious disease, hepatology, etc.)
- child and adolescent addiction treatment
- inpatient psychiatry
- research
Seminars and Research
Seminar, ECHO and Case Conferences
Fellows participate in a weekly two-hour live seminar that is led and/or attended by a fellowship faculty member. These live sessions are mapped to the American Board of Preventive Medicine (ABPM) addiction medicine exam blueprint, as well as the ACGME medical competencies.
Journal Club—led by Dr. Greenblatt and Dr. Gandhi—takes place after didactics on the second and fourth Wednesdays of the month. On other Wednesdays, this time is used for board review, research project meetings and optional office hours.
Once per month, David McDuff, MD leads case conferences/supervision prior to the seminar. Fellows also participate in the OTP Echo project, a monthly statewide interdisciplinary conference organized through the Maryland Addiction Consultation Service.
Fellows may participate in a substance use-themed book club led by Dr. Welsh. Additional required didactic activities include the pain fellowship’s afternoon case conference.
While not required, fellows are encouraged to attend the Department of Psychiatry's Grand Rounds. Asynchronous webinars are also available through the psychiatry residency’s core interviewing didactics, the American Academic of Addiction Psychiatry’s On-Demand Webinars and the Providers Clinical Support System's pain-related webinars.
Research Project
Conducting an academic project is a requirement for graduation. Fellows regularly meet with an assigned research psychologist who mentors them through the process.
Given the vitality of our division's current research, fellows are expected to analyze and formally report on a subset of data from ongoing research. This approach allows for high quality, high impact research, despite the brevity of our fellowship.
Fellows are expected to present a poster at a local, regional or national meeting. All projects are presented to the department’s Annual Research Day and to the division faculty at a meeting prior to graduation.