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Addiction Psychiatry Fellowship - looking for strong programs ..

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doctaroo

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I'm looking for strong clinical training with a focus on psychotherapy and family therapy if possible. My preference would be to stay in the East, but if there's a really great program elsewhere, I'll certainly consider it. I've heard good things about Yale and MUSC; other than that, it's been tough distinguishing one program from another. Most have quite manageable schedules from what I can tell; no malignant programs. Any tips would be much appreciated!!
 
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Blitz2006

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I've heard Yale is #1, and NYU is #2. But I'm curious to hear responses.
 
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HarryMTieboutMD

What are you really going to gain by doing an addiction psychiatry fellowship? Any decent psychiatry residency training program will teach you principles of management of intoxication/withdrawal as well as contingency management for buprenorphine. You can get practice using acamprosate/naltrexone and some of the off label things during your clinic year (not that any are particularly effective or difficult to use). And I'm sure (depending on how your program allocates funding) you could use elective time to do work in a methadone clinic. Most of the psychotherapies are a standard part of psychiatry residency anyway. Plus, most addiction psych fellowships are VA based, and addiction treatment in the VA is very different than addiction treatment in private practice or in community based settings (for a lot of reasons).

Being board certified in addiction psychiatry really just means paying more money so you can say you are board certified (and get some AAAP discounts). ASAM is the more powerful organization and offers more hospital based fellowships. But again, you probably won't learn much more in an ABAM fellowship that you couldn't realistically learn in an academic setting. Want to see DTs and learn how to dose precedex/phenobarb? Do a MICU elective. Want to learn how to use the ASAM criteria? This can be learned over the weekend in an online course.

Since you don't want to do research, by doing a fellowship you are basically losing another year of attending level income that is likely not going to expand your job/income opportunities (particularly in oversaturated areas in the northeast). There are plenty of addiction psychiatry jobs that are more than happy to hire a psychiatrist (ie, without an addiction fellowship). The only worthwhile, clinical fellowships in psychiatry are child (because competency in clinical care of child psychiatric patients actually requires 2 years of additional training) and forensics (more for political reasons than anything else). If you wanted to do addiction research, it would be a better use of time to do a T32 research fellowship with a big name researcher.

All that said, people tend to flock to Yale (most established, have VA and non VA options as well as addiction medicine), MGH/McClean, NYU with Marc Galanter (also have an ABAM fellowship), and Columbia with Herb Kleber. MUSC has some superstars (Kathleen Brady, Ray Anton), and Hugh Myrick is one of their rising stars, but the fellowship is largely in bred (ie, everyone comes from MUSC)
 
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Blitz2006

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Agree with HarryM. Not to thread jack, but with forensics, can you briefly expand on "more for political reasons than anything else"?
 

Mocaman

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I'm looking for strong clinical training with a focus on psychotherapy and family therapy if possible. I'm not too interested in research. My preference would be to stay in the East, but if there's a really great program elsewhere, I'll certainly consider it. I've heard good things about Yale and MUSC; other than that, it's been tough distinguishing one program from another. Most have quite manageable schedules from what I can tell; no malignant programs. Any tips would be much appreciated!!
Where are u currently
 

doctaroo

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Thanks for the replies! I'm in North Carolina; a resident at Duke. I am doing a fellowship for practical reasons, but also because I would like more experience in the field as I see myself working in underserved communities with limited resources for addiction treatment. Practically, I need 5 training years to get my Canadian psychiatry credentials (psychiatry training is 5 years in Canada), so one way to do this is to do a fellowship.
 

SmallBird

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Thanks for the replies! I'm in North Carolina; a resident at Duke. I am doing a fellowship for practical reasons, but also because I would like more experience in the field as I see myself working in underserved communities with limited resources for addiction treatment. Practically, I need 5 training years to get my Canadian psychiatry credentials (psychiatry training is 5 years in Canada), so one way to do this is to do a fellowship.

Thats a good reason, and for that reason I would strongly consider Yale. Besides being a great fellowship, of particular relevance to your situation is that it is a very relaxed, low-service high-education experience. Probably the best training experience available in terms of work-life balance and a very competitive salary.
 
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HarryMTieboutMD

The Canadian thing legitimizes doing a fellowship. Otherwise you are at one of the best programs in the country that should afford you ample addiction experience to learn the necessary clinical skills (see my above post). Also check out Northwestern (if you are willing to migrate westward). The fellowship has solid clinical training, and you do some private work with Dan Angres who has an appointment in the department. Nonetheless, I think for you between MUSC, Yale, NYU, MGH, and Columbia (which is 2 years btw with required research last time I checked) it comes down to where do you want to live, and how much do you want to pay to live in NYC/Boston vs New Haven vs Charleston...
 

doctaroo

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I agree! I haven't checked Northwestern, but I'll certainly dig them up now. MUSC and Yale sound appealing; New York has great programs, but I think I'd prefer New Haven or Charleston. What do you guys think of Emory and Michigan? And Dartmouth and Maryland/Sheppard Pratt? It's really tough finding out information about these places.
 

philosophize

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any recommendations on west coast addiction programs? After starting residency (a VA based one), I've really been liking my experience with addiction pts, so I've been leaning more towards addiction instead of CAP recently, but I'm hoping to get back to the west coast, specifically bay area =)
 

OldPsychDoc

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any recommendations on west coast addiction programs? After starting residency (a VA based one), I've really been liking my experience with addiction pts, so I've been leaning more towards addiction instead of CAP recently, but I'm hoping to get back to the west coast, specifically bay area =)
Can't go wrong with UCSF, if that's your goal.
 
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tennreb

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I can’t say enough good things about MUSC. It’s a great program with solid clinical experience and great faculty. Charleston offers a great lifestyle. Travel & Leisure just named it the #1 destination in the world. Doing the fellowship certainly opened up more job offers. Psychiatry is in high demand, but the pay can be considerably lower in areas popular with psychiatrists (like New York or Boston or even Charleston). Addiction Psychiatry is in high demand everywhere and offers better pay and more opportunities in many popular areas. Also, in order to see 275 Suboxone patients you have to have a fellowship. Otherwise you are limited to 100.
 
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