Addiction Medicine Fellowship - On July 1, 2019, the Universidad Central del Caribe (UCC) established Puerto Rico’s first ACGME-approved Addiction Medicine Fellowship Program. Since its inception, the program has successfully graduated nine fellows trained as board-certified or board-eligible specialists in addiction medicine. These physicians are equipped with the necessary skills to assess, manage, and treat substance use disorders (SUDs). In 2024, the program achieved full ACGME accreditation, allowing for the opportunity to expand to three fellows annually. The proposed expansion enhances UCC’s commitment to addiction medicine training and aims to increase the number of specialists addressing SUDs in medically underserved communities. These specialists will integrate evidence-based prevention and treatment for addiction and co-occurring conditions. It will expand and establish new partnerships with clinical rotation sites that focus on integrating primary care with mental health and SUD treatment. Additionally, it will enhance fellows' ability to assist patients with referrals to legal and social systems related to their care needs. Furthermore, the program will increase awareness of addiction medicine as a subspecialty and reduce provider stigma to encourage more physicians to pursue careers in addiction medicine. Over five years, this initiative will foster a sustainable system that improves access to addiction treatment while creating a better working environment for providers. The program will be guided by a public health perspective, ensuring services reach underserved communities. Education in addiction medicine will enhance provider expertise, reduce barriers and stigma, and improve care access for vulnerable populations, including adolescents, pregnant women, and other special populations. To achieve these goals, UCC leverages partnerships with government agencies, private organizations, and community-based programs. Key collaborators include the Puerto Rico Administration of Mental Health and Anti-Addiction Services (ASSMCA), residential treatment programs, primary care behavioral health centers, and community health organizations. Additionally, the program is enhancing new partnerships with the Puerto Rico Drug Court System and juvenile programs while expanding fellow rotation sites with Rural Federally Qualified Health Centers (FQHCs) that have established Program Letters of Agreement. Puerto Rico is predominantly composed of medically underserved communities. The island's economic crisis has significantly limited government funding for addiction treatment services, disproportionately affecting low-income populations. Additionally, Puerto Rico has faced multiple natural disasters, including Hurricanes Maria and Irma, recent earthquakes, and the COVID-19 pandemic, which have exacerbated the addiction crisis. This proposal aims to address these urgent public health challenges by expanding the addiction medicine workforce and improving access to high-quality, evidence-based addiction treatment.
