Clinical curriculum
MultiCare Addiction Medicine Fellows will have exposure to substance use disorders across the lifespan. You will develop robust inpatient management skills through a unique hospital-based treatment program for pregnant people in addition to serving as the primary Addiction Medicine consultant for Good Samaritan Hospital. Similarly, fellows will manage a panel of patients in a continuity Addiction Medicine practice as well as a specialized Addiction/Obstetrics practice based out of East Pierce Family Medicine, work alongside experienced providers at an innovative regional methadone maintenance program, and visit multiple community Addiction Medicine practices.
Highlights
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START (Substance Treatment and Recovery Training)
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Provide wrap-around peripartum care while managing substance use treatment and mental health treatment to pregnant people with substance use disorders. It includes a weekly walk-in clinic and 26-day inpatient treatment program.
This program was featured in The News Tribune, watch the video here.
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East Pierce Addiction Medicine Clinic
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Learn to manage a panel of patients in our outpatient addiction medicine clinic. Specific skills include substance use disorder screening, diagnosis and treatment for all ages (adolescent to geriatric); use of sublingual and long-acting injectable buprenorphine; care coordination; and management of psychiatric, infectious, and medical co-morbidities.
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Hospital consults
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Gain experience diagnosing SUDs, managing withdrawal, initiating MOUDs, and coordinating post-hospital treatment in patients with complex pain and medical problems.
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Opioid Treatment Program
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Fellows will spend 1 day per week during outpatient blocks at Kent Comprehensive Treatment Center with Dr Espanol.
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Electives
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Addiction electives include work with correctional medicine, pain medicine, psychiatry, and street medicine/homeless outreach. Opportunities with adolescent medicine are being developed. Fellows also have the option of working with our residency inpatient medicine team as attending and/or managing continuity pregnancies.
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Example Block Schedule
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The fellowship year is organized as a combination of block and longitudinal learning. Fellows will alternate inpatient and outpatient blocks with electives occurring during outpatient months. Electives are typically 2-4 weeks long and may be set up as a longitudinal experience depending on rotation or interest.
Outpatient Block Elective OTP EPAM EPAM PCP Elective Elective START-C Didactics Elective Inpatient Block Inpt Inpt Inpt EPAM Inpt Inpt Inpt Inpt Didactics PCP Legend
- OTP – Opioid Treatment Program
- START-C – START Clinic
- EPAM – East Pierce Addiction Medicine Clinic
- PCP – Time in primary specialty clinic
Didactic Learning
Weekly didactics are provided in an afternoon of sessions shared with other Washington addiction fellowship programs. Fellows will also have access to the ACAAM National Addiction Medicine Didactic Curriculum.
UW ECHO (Extension for Community Health Outcomes)
Journal Club
- Fellow will participate in a weekly journal club attended by faculty and area addiction medicine providers.
- Past topics:
- Pregnancy and medication treatment for opioid use disorder
- Medication options for treating methamphetamine use disorder
- Trends in Hepatitis C
- Cannabis topics: Patterns during COVID and among adolescents
- Attitudes and disparities with peripartum MOUD use
- Substance use and breast feeding
- In-hospital substance use policies
- Neonatal opioid withdrawal syndrome
- Smoking cessation and e-cigarette use
Scholarly activities
- Past
- Peripartum mental health resource development
- Improving vaccination rates in outpatient addiction medicine practice
- Neonatal withdrawal management
- Current
- Methadone dosing among pregnant people using fentanyl