Difference between Addiction Med vs. Addiction Psych fellowships?

[Leo Aquarius]

Does anyone have a decent understanding of the main difference between an addiction medicine fellowship and an addiction psychiatry fellowship in terms of what you learn? Also, do employers and the addiction community regard one as better training than the other? Thanks in advance.

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[vistaril]

Does anyone have a decent understanding of the main difference between an addiction medicine fellowship and an addiction psychiatry fellowship in terms of what you learn? Also, do employers and the addiction community regard one as better training than the other? Thanks in advance.

employers like to see people who go out and get real experience......if you want to work in addiction, start working in addiction after your residency.

 

[OldPsychDoc]

Well it's nice to actually *know* something too...

I think either one shows a certain commitment to getting training in the area, despite the opportunity cost of a PGY5 year. Neither is required, per se, to work in addictions. Addiction Medicine is an independent certification, open to any specialty, and not officially recognized by the Board of Medical Specialties. Addiction Psychiatry is "official", but only open to those who have completed a psychiatry residency. The content of the fellowship is pretty much equivalent. Neither is a magic path to career success, nor necessarily "better" than the other--though I could imagine that certain employers may be more or less attracted to one or the other depending on the emphases of their specific clinical populations: e.g. a methadone clinic with a lot of Hep C and HIV in their clientele may prefer an addictionist who was an internist first, where as a facility emphasizing dual-diagnoses clients might prefer a psychiatrist.

 

[vistaril]

Well it's nice to actually *know* something too...
.

if someone who knows that they want to work in addiction couldn't learn enough in 4 years of psych residency(and presumably setting up their 4th year to give them significant exposure to addiction...since they knew that's what they wanted to do) then I think that person's problems are a lot bigger than deciding whether or not to do a fellowship in anything. I suppose an exception might be if someone wanted a career in addiction research and there was an opportunity to work with someone very well funded with bunches of clout or whatever.........but to do day to day clinical addictions work(outpt suboxone, inpatient evals and detox, evals for residential, dual dx unit, oversee an iop, etc)- sheeesh stop putting off life and just get a job doing it and grow in that capacity.

 

[MacDonaldTriad]

Vistaril is right; anyone out of residency can work in addictions. The demand is enormous, and the job isn’t attractive relative to the somewhat less in demand, but very available alternative jobs in psychiatry. I also agree that if you surround yourself with appropriate mentors, and participate in lifelong learning, you can continue to grow and become as or more proficient as someone who completes the fellowship. Having said that, even if you do what it takes to get to that point, I suggest doing the fellowship and being credentialed as someone who deserves the recognition. I have heard a lot of people say that they don’t give a rat’s you know what about not having a fellowship under their belt, but “me thinks those princesses doth protest too much”.

 

[michaelrack]

I don't know if it is economically valuable to do an addictions fellowship, but I think it is clinically valuable. I ran an addictions unit at a state hospital part-time in 2007 (while also running a private practice sleep lab). Certainly an addictions fellowship isn't necessary for the med management aspect, but it is helpful if you really want to effectively work with this population, rather than just leaving all of the counseling etc up to others.

(for new readers to this forum, my background is med/psych/sleep; also certified in psychosomatics, no formal addictions training)

 

[vistaril]

I don't know if it is economically valuable to do an addictions fellowship, but I think it is clinically valuable. I ran an addictions unit at a state hospital part-time in 2007 (while also running a private practice sleep lab). Certainly an addictions fellowship isn't necessary for the med management aspect, but it is helpful if you really want to effectively work with this population, rather than just leaving all of the counseling etc up to others.

(for new readers to this forum, my background is med/psych/sleep; also certified in psychosomatics, no formal addictions training)

well a few points:

1) Presumably in a 4 year psychiatry residency one could pursue some therapy techniques that would be useful with addicts.....we still do therapy in psych residencies right??
2) If a psych/internist is spending tons of their time personally counseling their patients in their addiction job, they are probably leaving a ton of the money on the table.....another reason not to do it.

 

[slappy]

Vistaril is right

Hell doth freeze over!




Hell, that little village in Norway.

 

[F0nzie]

Inpatient rehabs prefer board certification in Addiction Medicine or Addiction Psychiatry. You will get a higher salary for the certificate and it will probably pay itself off over your career.

 

[vistaril]

Inpatient rehabs prefer board certification in Addiction Medicine or Addiction Psychiatry. You will get a higher salary for the certificate and it will probably pay itself off over your career.

I suppose it's possible some do...but a rehab headed by someone who did a 1 year fellowship in addiction isn't going to be reimbursed any more money by payers than someone who didn't. And salaries are almost always dictated by revenue/profit generated. Private pay patients aren't going to care either.

I do a little addiction moonlighting(well suboxone) on the side, but it's not really a huge interest. Honestly though if I wanted to make a career of it and someone said I could simply fill out a form and send in a thousand dollars for a board certification in addiction whatever, I'd probably pass.....not worth the thousand bucks to me.

But I mean to each their own.....

 

[HarryMTieboutMD]

I would also take a look at the differences in the philosophies of ASAM and AAAP... something to consider.