Addiction Medicine Fellowship - Descriptive Title: UCSF Primary Care Addiction Medicine Fellowship Program Expansion The mission of the UCSF Primary Care Addiction Medicine Fellowship Program is to prepare primary care physicians to become leaders in the care of persons with unhealthy substance use in the safety net communities of San Francisco and beyond. Through a combination of direct patient care, clinical teaching, experiential learning, and scientific inquiry embedded in public sector health care delivery systems, our one-year clinical fellowship excels in community partnerships, patient-centered communication, and evidence-based practice. The current program offers fellows outstanding opportunities to demonstrate competence in the diagnosis and management of persons from medically underserved communities (MUCs) along the spectrum of unhealthy substance use, addiction, and recovery. However, we believe we can do more. The overall goal of this proposal is to increase the number of board-certified addiction medicine physicians that serve in MUCs once trained. To achieve this workforce transformation, we propose to focus not just on the absolute number of fellows we can train, but also on enhancing the didactic curricula and clinical learning experiences that draw physicians into sustainable careers in MUCs. Specifically, over the next five years: 1. To increase the number of addiction medicine physicians trained to practice in MUCs that integrate primary care with mental health and substance use disorder (SUD) prevention and treatment services, we will execute an expansion plan to train five fellows each year over 5 years and establish community partnerships for clinical rotations in a rural and urban MUCs. 2. To increase fellows’ knowledge and ability to assist their patients with referrals to navigate the legal and social systems related to patients’ clinical needs or care, we will design an interprofessional curriculum focused on stigma reduction, social determinants of health (SDoH), and medical-legal partnerships. 3. To increase awareness of addiction medicine and reduce provider stigma so that more physicians consider addiction medicine careers, we will create clinical learning environments that facilitate influential teaching interactions between fellows and residents with support and supervision from skilled faculty. We will train 25 fellows in medically-underserved community-based settings, including new clinical rotations in rural Mendocino county and the Tenderloin neighborhood of San Francisco. Our curriculum will address the impact of stigma and SDoH on SUD prevention, treatment, and recovery, as well as evidence-based medications for addiction treatment through thoughtful near-peer training models, entrustable professional activities, and mentorship of residents by addiction medicine fellows and faculty. The success of these activities, in turn, will reduce provider stigma and foster the growth of an expanded addiction medicine workforce well qualified for rewarding lifelong ADM careers in MUCs. This proposal is eligible for Funding Priority 3 (Rural, Tribal or Underserved Communities) and Funding Preference Qualification 1 (High MUC Placement Rate).
