Fellowship placement at Nexus Recovery Center:
For four months, the addiction fellow will work two days a week under the supervision of the medical director (Dr. Carlos Tirado) to address the mental health needs of adolescent and adult females in residential treatment for primary addiction problems. There is a strong dual diagnosis component to the rotation and the fellow will develop skills in the diagnosis and management of women with co-occurring disorders. Nexus Recovery Center exclusively serves women and adolescent girls, so issues related to pregnancy and the post-partum, parenting, physical and sexual trauma are highly prevalent. In addition to individual psychiatric diagnosis and med management, the fellow will also lead psychoeducational groups and work with the counseling staff to provide training in topics related to substance abuse and mental health.
www.nexusrecovery.org
Fellowship placement at Homeward Bound:
Fellows from Addiction Psychiatry Training Program at UTSWMC will rotate thru Homeward Bound, Inc., a not-for-profit organization established in 1980 to offer chemical dependence treatment for the indigent population and those referred by the criminal justice system, local hospitals and private practitioners. We are funded primarily by the State of Texas (VO and DSHS). Our programs are multi-cultural and target the indigent chemically dependent adult. Our mission is to promote the development of positive behavioral health and independence for individuals and families caught up in the cycles of substance abuse and addiction, criminal behavior and mental illness. We serve the Dallas/Ft. Worth metropolitan area plus the 17 surrounding rural counties.
Physicians in the Addiction Fellowship rotation will be exposed to patients with a wide range issues related to chemical dependence (HIV, TB STD, Homelessness, and other social stressors) The tour of duty through our units will allow the Fellow to become familiar with services for a sector of the population that often fall through the cracks of hospital emergency rooms and psychiatric centers. Admission, Detoxification and assessment of immediate needs are part of the skills implemented by the fellow and supervised by the Medical Team at Homeward Bound. The Fellow will also have the opportunity to observe and participate in oriental medical approaches to relaxation and wellness.
www.homewardboundinc.org
Parkland Health and Hospital System (PHHS) Psychiatry Consult Service Rotation:
This is a required 2-month full-time (or 4-month half-time) rotation at a 900 bed tertiary care county hospital adjacent to The University of Texas Southwestern Medical Center at Dallas. The addiction psychiatry resident is responsible for performing and documenting inpatient psychiatric consultations on patients presenting with, or found secondarily to have, substance abuse problems. S/he is also responsible for providing ongoing psychotherapy and/or medication management to any of these patients for whom it is indicated. Full-time residents generally have a caseload of 5-10 patients at any one time. This includes 3-5 new inpatient consults and between 10 and 15 follow-up visits per week. The residents are responsible for performing and documenting initial evaluations. They are also responsible for providing ongoing care, in the form of therapy and/or medication management, to any of these patients for whom it is indicated.
Faculty consists of 2 full-time psychiatry attendings (one of whom is board certified in psychosomatic medicine), 2 half-time psychiatry attendings, and 2 full-time psychology attendings. Weekly, residents spend 1 hour in journal club, 1 hour in teaching conference, and 1 hour at departmental grand rounds, in addition to any addiction psychiatry didactics scheduled by the residency program. Approximately 7 hours are spent in teaching rounds weekly. Supervision is provided in the form of teaching rounds approximately 7 hours per week. Informal supervision from the attending physician is available at all times.
Other members of the consult liaison psychiatry team are: PG2 and PG4 psychiatry residents, a psychosomatic medicine resident, attending psychiatrists, attending psychologists, psychology trainees, medical students, and occasionally neurology residents and geriatric psychiatry residents.
www.parklandhospital.com
Dallas VA Medical Center:
Addiction fellowship residents rotating through the Dallas VA Medical Center participate in the diagnosis, treatment, treatment planning, and continuing care of veterans between the ages of 18-65 years. Inpatient, outpatient, and residential rehabilitation programs are all part of the direct experience for residents. The VA also provides the resident/fellow with experience in pain management under the direct supervision of qualified pain specialists. Treatment with Opioid MaintenanceTherapies, including , methadone and buprenorphine, are also part of the rotation experience. The resident/fellow responds to calls from consultation/liaison and emergency services during regular working hours in collaboration with an attending addiction psychiatrist. There is no after-hours on-call requirement. On the inpatient service, the range of experience includes detoxification (alcohol, illicit drugs, opioids, etc) as well as assessment for continuing care and appropriate placement following discharge from acute care. Supervision on the rotation is provided by medical school faculty trained and certified in addiction psychiatry and addiction medicine, with frequent contact on a daily basis between trainees and clinical teachers. In addition to the clinical work with patients, the VA has a vigorous educational program which includes weekly Grand Rounds, a monthly journal club, and supervised reading with selected faculty.
Dallas VA Medical Center
