Addiction Psychiatry Fellowship Reviews

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Jan 2, 2013
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Hi All,
I recently finished the Addiction Psychiatry Fellowship application process and since there is limited information available on these fellowships through the usual channels (including SDN), I would like to pass along what I learned.

The first post in this thread is a general overview of the addiction psychiatry application process. Subsequent posts will be individual reviews of some of the programs I interviewed at or fellow applicants interviewed at this season. I am also happy to answer questions on the thread or via PM about the process and hope other recent fellows/applicants will take the time to chime in.

Ok, here we go:

My General Fellowship Selection Criteria:
1. Geographic location- where do I want to live during and after fellowship? Do I want to use this as a n opportunity to explore a new geographic area I might not ever live in otherwise (ie Manhattan for 1 year)

2. Home institution vs new institution- How much will I actually learn at my home institution where I've already trained for residency vs new institution with different perspective/approach towards addiction treatment? Do I want to continue training and developing my professional network at my home institution vs broaden professional network/connections by training at a new institution?

3. Established fellowship vs new fellowship- addiction fellowships in general are relatively new and some programs have new fellowships have only been around for a few years. New fellowships may have more flexibility in shaping your experience? Established fellowship will have more experience training fellows and may also have more of the kinks ironed out of the curriculum due to feedback from previous fellows?

4. Class size- programs range from 1 to 7 fellows per year. Do I want a small class size to increase personal attention or large class size for social interactions, future networking, and near peer learning? Note: class size will also relate to how many fellows have previously been through the program and thus related to consideration 3.

5. Career oportunities after fellowship- do I want to remain in academia? If so, will their be job openings in the department for me when I finish my fellowship?

6. Length of fellowship- Do I want to do a 1 year clinical fellowship (the standard)? If interested in research, some programs offer 2 year mixed clinical/research or can 1 yr clinical first then 1 yr full time research fellowship? Note: I spoke to a handful of individuals who did a two year mixed clinical and research fellowship at different programs and they recommended doing the 1 yr clinical fellowship first and then a full time research fellowship. The general feeling was in the mixed fellowships you can feel pulled in multiple directions and never able to really engage in either the clinical work or research. However, this is based of a small N, so take it with a grain of salt.

7. Patient population- Do I want a VA centric vs community psychiatry centric vs insured/higher SES fellowship experience? Does the fellowship have a well-rounded clinical experience? Basically, comes down to what patient population you like to work with
8. Salary- varies substantially, from $ 56k-95k between programs

9. Private practice and moonlighting opportunities

10. Workload- Do I want a rigorous training experience where I see as many substance users as possible while under supervision? Or am I tired from residency and want a more relaxed year to reenergize? Do I learn better from seeing lots of patients or from seeing less patients and having more time to read, attend lectures, engage in research.

11. Didactics

Additional thoughts specific to Addiction Fellowshps:
- Approximately 80 fellowship positions available annually with ~50% filling

• Not a part of the NRMP match process

• Each program has its own application requirements. Materials you may need: institution specific application, personal statement 1-2 pgs stating interest in addiction, CV, 3-5 letters of recommendation, USMLE scores, medical school transcript, medical school dean's letter, passport size photo, copy of your medical license

• In general, fellowships are no call, no nights, and no weekends

• I found most valuable information comes from current/previous fellows or current residents at that institution also applying to addiction fellowship. If internal residents have historically gone to other institutions to complete their addiction fellowship may be a red flag

• Aside from selecting your ideal fellowship, the interview season is also a great opportunity to network with leaders in the field of Addiction Psychiatry and meet your future colleagues on the interview trail. This is a good reason for going on multiple interviews.

• The American Psychiatry of Addiction Psychiatry ( is an excellent meeting to learn more about Addiction Psychiatry and a large number of the fellowship training directors attend. Annual travel awards for $1300 are available and deadline is typically September 1st. 2013 Annual Meeting is in Scottsdale, AZ December 5th-8th

• Addiction Medicine is in the process of becoming an ACGME board certified fellowship. If this occurs it is unclear what effect this will have on Addiction Psychiatry. Arguments have been made that it will help increase the legitimacy of treatment of addiction as a medical disorder/disease and will bring increased research and clinical funding to the field. Arguments have also been made that the market may be more saturate and thus competitive, especially in private practice. I tend to agree more with the former.

Application timeline:
• Most programs start accepting applications July 1st

• Interview season starts August-November

• Offers made September-December

• Note: you will likely be made time sensitive offers (ie this offer expires within x amount of days) when you still haven't heard back from other programs. This can be uncomfortable. An ideal strategy is to get all application in July 1st and interview as early in the season as possible, so you can minimize this. If put in this situation, you have to have a clear idea of what your rank list is and chance of getting into programs higher on your rank list than your current offer. I ended up turning down offers even when I did not know for sure I would have a better offer, obviously this is scary.

Do I need to do an addiction fellowship to be an addiction psychiatrist?

• Easy answer is no

• More complicated answer is it depends. If you are interested in running an addiction psychiatry fellowship or addiction psychiatry department in the future will likely make you more competitive applicant. If you are interested primarily in addiction research or private practice answer is largely based on your previous experience/training and your current job opportunities outside of a fellowship. Also, are you the type of person who will learn more through supervision with leaders in the field or on your own in clinical practice? If you are really financially savvy and money is of the utmost importance to you, there is a good argument for not doing a fellowship. However, there is also a good argument for not being a psychiatrist and getting a job at a hedge fund.

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thank you.
so we have acgme approved programs, but no acgme approved board exam?
ah, that's what i thought. i misread the o.p.
thank you.
so we have acgme approved programs, but no acgme approved board exam?

It's actually ABMS (American board of medical specialties) that accredits programs to be official medical specialties/subspecialties. Addiction psychiatry is an official ABMS accredited medical specialty, whereas addiction medicine is not.