Addiction Medicine vs Addiction Psychiatry Fellowships

[nontradst]

Hello all,

I am in my 1st yr of psychiatry residency and am thinking about doing some type of addiction fellowship after residency. My home institution has an Addiction Medicine fellowship, but no Addiction Psychiatry fellowship. I have a few years to think it over, but for future job prospects, and for overall knowledge gained during that year, would there be any reason to consider going to a different institution for an addiction psych fellowship, instead of staying here for an addiction Medicine fellowship?

I know that Addiction Psychiatry is ACGME accredited, and Addiction Medicine is not. What impact could this have on me?

Thanks!

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[michaelrack]

Hello all,

I am in my 1st yr of psychiatry residency and am thinking about doing some type of addiction fellowship after residency. My home institution has an Addiction Medicine fellowship, but no Addiction Psychiatry fellowship. I have a few years to think it over, but for future job prospects, and for overall knowledge gained during that year, would there be any reason to consider going to a different institution for an addiction psych fellowship, instead of staying here for an addiction Medicine fellowship?

I know that Addiction Psychiatry is ACGME accredited, and Addiction Medicine is not. What impact could this have on me?

Thanks!

If you are going to do addiction medicine, you should do an ACGME-accredited fellowship, so you would be elgible to be certified by the American Board of Preventative Medicine

 

[nontradst]

Gotcha. How about whether I should consider looking at addiction psychiatry fellowships instead of addiction medicine fellowships? How do they differ, other than the fact that addiction medicine fellowships are available to nonpsych trained physicians and addiction psych fellowships are not?

 

[nontradst]

Bump

 

[TexasPhysician]

Addiction medicine has been absorbed by the ABPM which should result in accreditation. I’d avoid the programs which aren’t accredited by them.

While I couldn’t tell you every difference, addiction medicine would surely need to spend more time on therapy training than addition psychiatry. Other specialties do not have the training in counseling that we do.

I’m considering the grandfather process into addiction medicine.

 

[splik]

Addiction medicine has been absorbed by the ABPM which should result in accreditation. I’d avoid the programs which aren’t accredited by them.

While I couldn’t tell you every difference, addiction medicine would surely need to spend more time on therapy training than addition psychiatry. Other specialties do not have the training in counseling that we do.

I’m considering the grandfather process into addiction medicine.

boards don't accredit fellowship programs. programs are accredited by the ACGME. the ABPM will currently allow any addiction medicine fellowship to count for accreditation. these fellowships are currently in the process of moving towards ACGME accreditation.

 

[OldPsychDoc]

Addiction Psychiatrists are first and foremost, Psychiatrists.
We approach Addiction with the training and mindset of Psychiatrists.
Addiction Medicine is more of a mixed bag.
As one of my mentors said, "Addiction Psychiatrists are MY PEOPLE".

 

[nontradst]

Thanks for the replies. So I want to get back to my original question: should I do the addiction medicine fellowship at my home institution or look at doing an addiction psychiatry fellowship elsewhere? My home institution, UF, has a pretty solid addiction medicine fellowship program that was establish by our former chair, Mark Gold, one of the biggest names in addictions.

With that in mind, I’d like to know whether doing an addiction psychiatry fellowship, which as noted above, is ACGME accredited, when addiction medicine is not.

 

[TexasPhysician]

What do you want to do with your future?

 

[nontradst]

Good question. Currently I see myself starting out post residency/fellowship doing a combination of inpatient and community psychiatry work. What got me interested in addiction is the prevalence of SUD in the most ill pts. I had a chance to work with an attending on an inpatient rotation who was addiction trained, and his skill set was so practical in terms of disposition planing and counseling the pts on their substance use. I currently do not see myself doing only addictions, but you never know what you will decide to do this early on in your career. Heck, I never would have guessed that I would have gravitated towards addictions before starting residency.

The fact of the matter is, I do not want any doors closed for career opportunities. Plus, regardless of what jobs are available to me, I want to receive the best training possible.

 

[OldPsychDoc]

Good question. Currently I see myself starting out post residency/fellowship doing a combination of inpatient and community psychiatry work. What got me interested in addiction is the prevalence of SUD in the most ill pts. I had a chance to work with an attending on an inpatient rotation who was addiction trained, and his skill set was so practical in terms of disposition planing and counseling the pts on their substance use. I currently do not see myself doing only addictions, but you never know what you will decide to do this early on in your career. Heck, I never would have guessed that I would have gravitated towards addictions before starting residency.

The fact of the matter is, I do not want any doors closed for career opportunities. Plus, regardless of what jobs are available to me, I want to receive the best training possible.

Based on the paragraph above, you should train in Addiction Psychiatry.
I'd suggest trying to get to an AAAP meeting or two while still a resident. For that matter, attend an ASAM meeting as well.

 

[splik]

not all fellowships are created equal. for addiction medicine, the dept the fellowship is run out of will make the difference. it would not be a good idea for a psychiatrist to an addictions fellowship in the family medicine or internal medicine or population health department. but some addiction medicine fellowships are run by psychiatry departments (UF is one, stanford is another) and thus by that fact alone have more of a psychiatric bent. UF has a well established addiction medicine program and I see no negative impact of you doing the fellowship.

btw historically addiction medicine fellowships were at least in part a way for addicted physicians to rehabilitate themselves. the field of addiction medicine has a much higher proportion of physicians in recovery than addiction psychiatry.

 

[nontradst]

Thanks for the extra feedback! Splik, your comments are encouraging. I hear great things about our addiction medicine subdivision, but have remained slightly skeptical, as there is an obvious bias when I have only been able to hear this from faculty within our department.

 

[TexasPhysician]

Good question. Currently I see myself starting out post residency/fellowship doing a combination of inpatient and community psychiatry work. What got me interested in addiction is the prevalence of SUD in the most ill pts. I had a chance to work with an attending on an inpatient rotation who was addiction trained, and his skill set was so practical in terms of disposition planing and counseling the pts on their substance use. I currently do not see myself doing only addictions, but you never know what you will decide to do this early on in your career. Heck, I never would have guessed that I would have gravitated towards addictions before starting residency.

The fact of the matter is, I do not want any doors closed for career opportunities. Plus, regardless of what jobs are available to me, I want to receive the best training possible.

I think your program would provide fine training for inpatient/community work. If you are looking for the best training out there for academic or “prestigious” work, I’d look into the top addiction psych programs.

 

[Blitz2006]

FYI

https://www.theabpm.org/wp-content/uploads/2017/12/AddictionMedicine_D20.pdf

"The Addiction Medicine Practice Pathway and ABAM Diplomate Pathway expire in 2021. Beginning in 2022, all applicants for certification in Addiction Medicine must successfully complete an ACGME-accredited Addiction Medicine fellowship program. This subspecialty certifying exam will be given annually throughout this period"

Addiction Medicine Pathways – American Board of Preventive Medicine

" Applicants must submit documentation of a minimum of 1,920 hours in which they were engaged in the practice of Addiction Medicine at the subspecialty level"

So until 2021, you can work 1920 hours in an addiction setting and get ABPM Addiction Medicine boarded.

 

[OldPsychDoc]

FYI

https://www.theabpm.org/wp-content/uploads/2017/12/AddictionMedicine_D20.pdf

"The Addiction Medicine Practice Pathway and ABAM Diplomate Pathway expire in 2021. Beginning in 2022, all applicants for certification in Addiction Medicine must successfully complete an ACGME-accredited Addiction Medicine fellowship program. This subspecialty certifying exam will be given annually throughout this period"

Addiction Medicine Pathways – American Board of Preventive Medicine

" Applicants must submit documentation of a minimum of 1,920 hours in which they were engaged in the practice of Addiction Medicine at the subspecialty level"

So until 2021, you can work 1920 hours in an addiction setting and get ABPM Addiction Medicine boarded.

Based on this, the OP (identifying self as a PGY1) will not have this path open to them at all.

 

[michaelrack]

I think the addiction med boards r pretty strict about what qualifies for the practice pathway

 

[OldPsychDoc]

I think the addiction med boards r pretty strict about what qualifies for the practice pathway

What I have heard as well.

 

[Blitz2006]

What I have heard as well.

Good to know

 

[formerF1DO]

Thanks for the replies. So I want to get back to my original question: should I do the addiction medicine fellowship at my home institution or look at doing an addiction psychiatry fellowship elsewhere? My home institution, UF, has a pretty solid addiction medicine fellowship program that was establish by our former chair, Mark Gold, one of the biggest names in addictions.

With that in mind, I’d like to know whether doing an addiction psychiatry fellowship, which as noted above, is ACGME accredited, when addiction medicine is not.

I'm an addiction psychiatrist, board certified. I think you could do an Addiction Medicine fellowship, with or without having been a psychiatrist, and become Addiction Medicine board certified, but you essentially have to do the fellowship now.

 

[TexasPhysician]

I think the addiction med boards r pretty strict about what qualifies for the practice pathway

I’ll let you know. Just applied.

 

[psychapp121]

I’ll let you know. Just applied.

did u get it

 

[TexasPhysician]

did u get it

Board certified now. The biggest hurdle seems to be working at a dedicated addiction facility for 3/4 of the hours. Everything else was rather easy.

 

[psyguru]

Based on this, the OP (identifying self as a PGY1) will not have this path open to them at all.

There is a chance they may push the deadline back possibly due to the opioid crisis. I talked to someone who used to work for the addiction board.

 

[psyguru]

Board certified now. The biggest hurdle seems to be working at a dedicated addiction facility for 3/4 of the hours. Everything else was rather easy.

I am hoping to use my expert witness work (dui, opioid dependance in injury victim, dfsa, etc) partly to satisfy the requirements. I have yet to get a yes or a no from the board. Legislative work counts but expert witness or IME work is not expcitly stated.

 

[MaximusMDPhD]

How much medicine is asked of addiction medicine specialists? I'm a psych resident who would feel uncomfortable managing someone's cirrhosis...

 

[robellis]

How much medicine is asked of addiction medicine specialists? I'm a psych resident who would feel uncomfortable managing someone's cirrhosis...

lol no they are medically cleared before you see them on detox and usually there’s an internal medicine consultant to manage medical issues if you are uncomfortable