The clinical focus of the fellowship is on acquiring skills in providing care to individuals with substances use disorders in acute medical settings, ambulatory settings, and in acute addiction treatment settings. Fellows will spend substantial time in each of these settings and will follow patients longitudinally as they move between different settings. The role of the physician as a member of an interdisciplinary care team will be emphasized in all clinical settings and encounters.

The individual aspects of the clinical program are:

• Inpatient Addiction Medicine Consultation Service – Fellows spend 18 weeks on the Addiction Medicine Consult Service at UPMC Presbyterian-Montefiore Hospital, in four to six week blocks. Over the course of their consultation service time they assume increasing responsibility for running the team and teaching learners on the service.
• Outpatient Addiction Medicine – Fellows will maintain their own outpatient addiction medicine clinic practice of one half day per week under the supervision of addiction medicine faculty, at the Primary Care and Recovery Engagement Services (PCARES) clinic, which is part of the Division of General Internal Medicine. At this clinic, fellows with evaluate new patients with opioid use disorder as well as other substance use disorders, and initiate buprenorphine and naltrexone treatment. Fellows who wish to become the primary care providers for their patients will have the opportunity to do so as part of their PCARES practice. Fellows will follow new patients longitudinally in the ambulatory setting as well as across settings if patients are admitted to the hospital or enter other treatment settings. Fellows will also rotate through the new Bridge Clinic, which provides low-barrier care of opioid use disorder and other SUDs, and spend two weeks gaining experience in managing patients with addiction or concern for opioid misuse in outpatient pain clinics. Fellows will also spend two half days on their non-consult months in the Adolescent Addiction Medicine clinic, which is part of Children’s Hospital.
• Inpatient Detoxification – Fellows will spend 20 half days over one month at the inpatient detoxification unit at UPMC Mercy, where they will assess and titrate medications for patients experiencing alcohol, benzodiazepine, and opioid withdrawal.
• Narcotics Addiction Treatment Program (NATP) – Fellows will spend 20 half-days over one month at the Narcotics Addiction Treatment Program, which is part of Western Psychiatric Institute and Clinic, which provides methadone and buprenorphine for treatment of opioid use disorder.
• Veterans Administration – Fellows will spend six weeks at the Center for Treatment of Addictive Disorders (CTAD) at the Veterans Administration. Fellow clinical activities at CTAD will include evaluations for medication treatment with buprenorphine or naltrexone, ambulatory detox assessments, and participation in the VA’s methadone maintenance program. Fellows who have a special interest in caring for veterans may spend additional elective time at the VA.
• Women’s Recovery Center (Magee-Women’s Hospital) – Fellows at the Women’s Recovery Center at Magee will gain experience caring for pregnant and non-pregnant female patients on treatment with buprenorphine as well as methadone both in the inpatient and outpatient setting.
• Elective and Supplemental Clinical Experiences – Fellows will spend 2.5 months in electives, which can include adding more time to any of the required experiences, or additional experiences in the community, Western Psychiatric Institute and Clinic, or inpatient hospital setting.
• Formal Teaching – Fellows attend all the relevant ongoing teaching conferences, including the monthly Addiction Medicine Journal Club (in which they present biannually), Addiction Medicine Grand Rounds, weekly Chief’s Conference, and the weekly didactic series hosted by the Addiction Psychiatry fellowship.

Faculty in the Addiction Medicine Fellowship Program include nationally known researchers and educators in the field, and are from disciplines including General Internal Medicine, Adolescent Medicine, Palliative Care and Pain Medicine, Psychiatry, Toxicology, and Obstetrics-Gynecology.

	Julie Childers, MD, MS Division of General Internal Medicine Program Director childersjw2@upmc.edu
	Julie A Kmiec, DO Department of Psychiatry kmiecj@upmc.edu
	Kevin L. Kraemer, MD, MSc Division of General Internal Medicine kraemerkl@upmc.edu
	Liz Krans, MD Department of Obstetrics, Gynecology & Reproductive Sciences kransee@mail.magee.edu
	Jane M. Liebschutz, MD, MPH, FACP Division of General Internal Medicine Division Chief liebschutzjm@upmc.edu
	Michael J. Lynch, MD Department of Emergency Medicine UPPEMoffice@upmc.edu
	Jessica S. Merlin, MD, PhD, MBA Division of General Internal Medicine merlinjs@upmc.edu
	Payel Roy, MD, MSc Division of General Internal Medicine Director, Addiction Medicine Consult Service payel.roy@pitt.edu
	Deanna Wilson, MD Division of General Internal Medicine Director, Adolescent Addiction Medicine wilsonjd@pitt.edu