Addiction Medicine Fellowship - Established in 2020, the ACGME-accredited MAHEC Addiction Medicine Fellowship (AMF) addresses the critical need for addiction specialists in rural Western North Carolina (WNC), a region in which all counties are HRSA-designated Mental Health Professional Shortage Areas (HPSA). MAHEC’s AMF Program seeks to address a regional workforce gap by training fellows in rural settings. From MAHEC’s family medicine residency program, 56% of residents went on to practice within 100 miles of their residency training site positions, demonstrating that MAHEC is in a key position to make a difference in health outcomes in rural WNC communities. Five of the program’s eight graduates have remained in WNC, and three are currently serving in rural areas. This program supports MAHEC’s mission of “training to serve,” emphasizing community-oriented rural practices that help address barriers and concerns specific to the medical care landscape of this underserved region. MAHEC’s patient population is unique, and the region faces distinct challenges in addressing SUDs and opioid use disorder (OUD). In rural WNC, an average of 54% of residents report that their life has been negatively affected by substance abuse, their own or someone else’s.[2] To access treatment, individuals often must travel to Asheville, NC, which can be a two to three-hour drive on mountainous rural roads. Most fellowship rotation sites are located in Buncombe or Haywood Counties, with mental health HPSA scores of 17 or above, and at least one additional rural Graham County rotation site is expected in 2025. As an established AMF program, our plan is to maintain the program from our Asheville location in collaboration with satellite and rural rotation sites, supporting four fellows over five years. To achieve the goal of expanding the number of board-certified addiction medicine specialists serving in medically underserved, community-based settings, including rural areas, our program will implement a comprehensive, structured approach focused on three key objectives: 1. Increase the Number of Addiction Medicine Specialists in Medically Underserved Areas 2. Enhance Fellows’ Ability to Navigate Legal and Social Systems Related to Patient Care 3. Increase Awareness of Addiction Medicine as a Specialty and Reduce Provider Stigma To ensure compliance with program requirements, grant activities, and deliverables, the AMF Program Director, Dr. Nathan Mullins, will dedicate 20 percent of his time to this program. The core elements of our work plan include consistent reporting to the Accreditation Council for Graduate Medical Education (ACGME) and the Sponsoring Institution to ensure compliance with accreditation standards. The program must maintain accreditation by meeting or exceeding these standards, which requires regular evaluation and quality improvement efforts through our GME structure and Program Evaluation Committees.
