The Kaiser Permanente Northern California Addiction Medicine Fellowship offers a one-year clinical track with an optional second year focused upon clinical research. Our addiction medicine fellowship is uniquely nested within an integrated health plan offering tailored prevention, assessment, and treatment of substance use disorders for more than 3 million members in Northern California Kaiser Permanente Health Plans. This is a busy, challenging training environment offering 1:1 mentorship by board certified addiction specialty faculty physicians working in multidisciplinary treatment teams in hospitals and clinics. Fellows will be equipped to be physician leaders, teachers, and expert clinicians in the rapidly expanding medical specialty of Addiction Medicine.
Clinical rotation sites for the fellow are located throughout the San Francisco Bay Area and include the Kaiser Permanente multidisciplinary outpatient “Addiction Medicine Recovery Service” programs, the Kaiser Hospital Addiction Medicine Consultation/Liaison Service Team and Follow Up Clinic, an Addiction Psychiatry led hospital Psychiatry Consultation & Liaison team, and an Inpatient Residential Treatment Program. Electives include experiences in an Opioid Treatment Program, a large public hospital buprenorphine medication clinic, a Kaiser multidisciplinary Chronic Pain Clinic, and the opportunity to treat patients in a Kaiser hospital Medical Psychiatric Unit.
In the US, only 1 in 10 people with addiction receive adequate treatment of their substance use disorder. 12 million emergency department visits involved a behavioral health and/or substance use disorder (SUD). This is one out of every eight ED visits. These visits were two and a half times more likely to result in hospital admissions.
Traditionally, only stabilization of intoxication, withdrawal or medical complications of SUD is available to patients. Individuals in crisis are not offered treatment of their addiction; others are lost in complicated, fragmented systems of medical and psychiatric care.
Kaiser Permanente offers integrated, comprehensive, multidisciplinary treatment by addiction physician specialists. The Addiction Medicine Fellow will learn to assess and treat SUD within physician led teams in inpatient and outpatient settings.
We have found a new model for treatment of patients with substance use disorders in the ED and throughout the hospital. Appropriate clinical diagnosis and treatment by an Addiction Medicine physician in the team setting improves patient satisfaction, shortens length of stay, decreases return ED visits, and increases follow up to outpatient assessment and treatment of SUD.
Fellows will participate in the monthly Addiction Medicine Journal Club with addiction medicine and addiction psychiatry fellows from UCSF, San Mateo, and Stanford Programs. With the assistance of the faculty, the fellow will be responsible for presenting one manuscript during the year.
The core curriculum includes educational lectures on assessment and treatment of patients with substance use disorders in the inpatient and outpatient setting, development of critical assessment of the literature, clinical leadership skills, and experience providing treatment in the interdisciplinary setting. To gain an understanding of the fundamentals, fellows will participate in the “Addiction Boot Camp”, with the same group of addiction medicine and addiction psychiatry fellows, in the first 6 weeks of the fellowship followed by monthly case discussions in this group. Fellowship Faculty from Kaiser Permanente offer an Addiction Medicine Board Review Course to physicians preparing for the American Board of Preventive Medicine Examination. The fellow will participate in this review course. In addition, due to the multidisciplinary approach to treatment of SUD there are daily case discussions of treatment plans for patients in every clinical setting of the fellowship.
Supervision and Mentoring
The fellow will be mentored in clinical rotations 1:1 by addiction specialist physicians, from addiction medicine and addiction psychiatry, throughout the year. She/he will meet with the Program director weekly for mentoring throughout the fellowship. The fellow will be encouraged to select a topic within addiction medicine and conduct a review of the literature with the goal of presenting a “Grand Rounds” to the Addiction Medicine physicians throughout Northern California Kaiser Permanente. The fellow will be encouraged to prepare and submit a manuscript for publication on this review topic.