Addiction Medicine Fellowship - Program Purpose: The University of California San Diego (UCSD) Addiction Psychiatry Fellowship (APF) Expansion to Meet Community Addiction Treatment Needs (EMCATN) program aims to significantly enhance addiction psychiatry training and service delivery within San Diego and Imperial Counties, with a specific focus on rural populations and community-based settings. This initiative continues the expansion of the UCSD APF by (1) the provision of 3.0 annual fellow stipends (expanding on the original 1.0 fellow funding previously secured for a total of 4.0 stipends), (2) developing new rural, telehealth, and medical-legal partnership rotations/experiences and expanding existing clinical rotations in community-based settings, and (3) reducing stigma and increasing awareness of addiction psychiatry through the provision of clinical rotations that expose medical residents to the field. This expansion seeks to bolster the addiction medicine workforce, recruiting and producing highly knowledgeable and skilled specialists capable of integrating mental health and substance use disorder (SUD) prevention and treatment services with other medical care. Program Goals: The UCSD APF EMCATN aligns with Health Resources and Services Administration (HRSA) grant objectives by fostering robust clinical training for addiction psychiatry physicians in medically underserved, community-based, and rural environments. Program Objectives: The UCSD APF EMCATN program will: (1) Increase the number of board-certified addiction psychiatry sub-specialists serving San Diego and Imperial County, particularly in rural and underserved communities. (2) Establish new formal partnerships with community centers serving rural populations, integrating in person training experience with provision of telehealthcare. (3) Enhance existing partnerships from prior HRSA funding, improving training for UCSD APF fellows and strengthening the capacity of collaborating sites to deliver integrated SUD treatment. (4) Equip fellows with the knowledge and skills to assist patients in navigating legal and social systems related to their clinical and SUD treatment needs, through a new medical-legal partnership rotation. (5) Develop and enhance training for providers at collaborating community, rural, telehealth, and medical-legal partnership sites, creating a sustainable infrastructure for inter-professional SUD training. (6) Reduce provider stigma and elevate addiction psychiatry as a valuable specialty through high-quality training, mentorship, and exposure of medical residents to the field, fostering future physician leaders. Training and Approach: The UCSD APF EMCATN will offer multifaceted training, leveraging the strengths of a teaching health center with expert addiction faculty. This fellowship will encompass: (I) Dissemination of academic center training through expanded rotations in community and rural clinics providing direct patient care in diverse settings. (II) Development of a novel telehealth training rotation, including an in-person orientation and hands-on experience with a mobile van delivering SUD treatment to remote rural locations. This rotation will address access barriers by utilizing technology to extend care to underserved areas. (III) Implementation of a collaborative learning experience with a medical-legal partnership group, focusing on underserved veterans with SUDs. This rotation will provide critical skills in addressing the intersection of legal, social, and medical needs. By integrating these diverse training experiences, the UCSD APF EMCATN will equip future addiction psychiatrists with the skills, knowledge, and experience necessary to effectively address the complex needs of rural and underserved populations, thereby expanding access to high-quality SUD care and reducing health disparities. This program will serve as a model for developing and sustaining a robust addiction psychiatry workforce in regions with significant unmet needs.
