Fellows will be exposed to a wide variety of treatment modalities. These include methadone maintenance, buprenorphine treatment, inpatient detox, psychotropic medications (antidepressants, mood stabilizers, non-habit-forming sedatives), Medication Assisted Treatments (MAT) for recovery, individual/group/family counseling, psychotherapy, 12-step groups, and primary-care treatment including HIV and HCV. Management of MICA patients with a wide range of co-occurring psychiatric and medical illnesses is a key component of the training experience.
Overall Objectives of the Training Program
- The overarching objective of the program is to recruit, train, and graduate outstanding psychiatrists in the field of Addiction Psychiatry.
- We will expose our trainees to a broad variety of patients with problems associated with addiction; inpatients, outpatients, younger patients, older patients, patients with intercurrent medical illnesses (whether drug-related or not), patients with concomitant non-substance related psychiatric disorders, patients from all socioeconomic groups, patients of all races/religions/countries of origin/sexual orientations, patients with mild as well as patients with florid multi-drug addictions, and so on. In each clinical site, we will endeavor to triage as many different types of patients, from a multitude of backgrounds, to our trainees.
- We will expect our trainees to rigorously master the written knowledge of Addiction Psychiatry; to include books (past and recent) and the medical/psychological/sociological literature. The clinical literature is paramount, but not in itself sufficient. The neurobiology literature, the epidemiologic literature, the historical literature, and the literature addressing the sociologic and historical context in which addiction occurs is also to be our curriculum.
- We will expect our trainees to develop a sophisticated appreciation for the ethics attendant to the treatment of our patients: Issues of confidentiality, informed consent, refusal of treatment(s), suicidal and/or homicidal urgencies, voluntariness vs. coercion, the duty to warn, the duty to intervene when child abuse or neglect is suspected, the complexity and need for clinician sensitivity to violence and/or spouse abuse.
- We will expect our trainees to develop expertise in the diagnosis of addictions, singular or mixed addictions, addictions masked by intercurrent psychiatric or medical disorders, mild to severe addictions both to illicit or prescribed substances.
- We will expect our trainees to develop expertise in the use of the treatments of addictions, including pharmacological, psychological, group, and family/couple systems interventions.
- We will expect our trainees to work expertly with colleagues of all disciplines, well-versed in the multidisciplinary and team models of treatment; and to appreciate that being a physician is not automatically synonymous with greater knowledge or authority in all treatment settings.
- We will expect our trainees to develop an appreciation for basic and clinical research in addiction, to gain research experience through participation in an ongoing research project of their choice, and to become familiar with new and recent research findings in addiction and the potential impact of such findings on the clinical treatment of substance-related disorders.
Participation in Research
Fellows are required to spend 5-10% of the fellowship year doing an independent clinical or basic science research or independent study project of their choice. Those with a greater interest in research may opt for a half time clinical half term research position that will extend over 2 years.
Trainees are encouraged to make a presentation of their research at a relevant meeting or to produce a scholarly paper on their research. All fellows will present a clinical or research lecture during their rotations, participate in journal clubs, and present their final project to the research group.
Available Library Resources
- Medical Library at the Albert Einstein College of Medicine
Hours: Mon-Thurs 8:30 am - Midnight, Fri 8:30 am - 5:00 pm, Sat Closed, Sun 10:30 am - 10:30 pm.
- Medical Library at Moses Division of Montefiore Medical Center
Hours: Mon-Fri 9:00 am - 8:45 pm, Sat 9:00 am - 4:45 pm, Sun Closed.
- Journals and periodicals available at the DoSA Resource library:
- The Journal of Public Health Policy
- Drug and Alcohol Dependence
- Journal of Substance Abuse Treatment
- NEDS/National Evaluation Data Service
- Annals of Internal Medicine
- New England Journal of Medicine
- Alcohol and other Drug Screening of hospitalized Trauma Patients
- Screening and Assessment of Alcohol and other Drugs Abuse Adolescents
- The Tuberculosis Epidemic
- The Lancet
- Other Journals available in Dr. Merrill Herman's office:
- American Journal on Addictions
- American Journal of Psychiatry
- Journal of Addictive Diseases
- Journal of Maintenance in the Addictions
- Substance Abuse - Journal of The Association for Medical Education and Research in Substance Abuse
- Addictive Disorders and Their Treatment
Supervision
Trainees receive 2 hours of individual supervision weekly and clinical supervision at sites. This includes off site supervision by the Program Director, Merrill Herman, MD, which includes clinical case presentations, supervision on psychotherapy and pharmacotherapeutic modalities. On-Site supervision includes directly observed interviews with patients.