Curriculum

Outpatient Month (6 months of the year, alternates)

^SUD clinic with Dr. Ellie Grossman- outpatient clinic for patients with SUDs (in internal medicine clinic)
*SUD clinic with Dr. Liz Davis- outpatient clinic for patients with SUDs + complex mental health comorbidities (in internal medicine/psych clinic)
#PASS (Pain and Addiction Support Services) Consult Service- interdisciplinary consult service of primary care physicians, pharmacists, palliative care, psychiatrists, psychologists, addiction experts, social workers- we review charts/provide recommendations to PCPs referring patients with complex pain, addiction, mental health; Fellows help present patients and write up reccs
+PACC clinic- outpatient clinic for patient with pain and/or SUDs embedded in Family Medicine residency clinic; run by Fellows and Fellowship faculty
!Suboxone group visits- this is our area of expertise! Fellows run group visits (supported by physician, addiction nurse, recovery coach, admin coordinator; oversee residents) for patients with OUD and AUD on Suboxone, Subloade, and Vivitrol (~ 25 patients)
%E-consults- Fellows work with psychiatrist to provide e-consults for patients with addiction and mental health dx (includes discussion of core primary care behavioral health topics)

Note:
-3 months of outpatient clinic month include time at our Intensive Outpatient Program (IOP) for patients with SUDs
-1 month of outpatient clinic month includes time at the ASAP (Adolescent Substance Abuse Program) at Boston Children’s Hospital

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Inpatient Month (6 months of the year, alternates)

Elective Opportunities - clinical, teaching, community engagement, research, oh my!

Clinical

• Bridge Clinic - Fellow see patients who are not plugged into recovery services, start them on medications (for OUD, AUD, StUD) and bridge them to long-term support services
• Mobile Unit - Fellows deliver addiction care to patients in the community via our mobile van and help plug them into longer-term recovery resources
• Perinatal SUD rotation - Fellows will have the opportunity to see patients for prenatal and postpartum care who are prescribed Buprenorphine for OUD before, during, and after pregnancy. Fellows will also participate chart review and interdisciplinary team discussions with physician, nurses, peer moms/recovery coaches, and behavioral health clinicians to collaboratively manage their care, especially as it relates to harm reduction, behavioral health supports, medicolegal aspects of care, and interfacing with the Department of Children and Families
• Center for Mindfulness and Compassion - Fellows will participate in group-based therapy that focuses on in-depth teaching around mindfulness among patients struggling with substance use disorders, mental health disorders, chronic pain, and/or desiring coping strategies for managing stress. Fellows will have the opportunity to observe, co-lead groups, and obtain additional training in mindfulness-based techniques, based on their interest levels.

More info here: https://www.chacmc.org/

Teaching

• Teaching residents & students! Fellows will have lots of opportunities to teach FM, IM, Psych residents and Tufts medical students (teaching is highly encouraged and Fellows will get support/training on evidence-based teaching approaches); when you can teach something, you really know it well!
• Masters in Medical Education work - Fellows will have the opportunity to participate in coursework and small group discussions with other fellows who are enrolled in a Masters in Medical Education fellowship at our Malden Family Medicine Center site. Course work content from the University of Dundee Masters in Medical Education Program and is facilitated by Dr. Allen Shaughnessy. Topics relate to Teaching and Learning, Curriculum Planning, Principles of Assessment, Education Management and Leadership, and Medical Education Research.

More info here: https://www.challiance.org/academic/family-medicine-master-teacher-fellowship

Community Engagement

• Bridge Recovery Center (BRC)
  The BRC is a community-run center to support patients with addiction located 1 block from our family medicine clinic. It is a safe space for patients with a h/o SUDs (and their families) to come, engage in social connections, attend groups, get help with job applications, kick back/play pool and foosball, and join Friday night speakers and game nights. Other periodic programming is offered (such as sports activities, holiday parties, and trainings). The Fellows can develop a longitudinal community-based project that could support the clients there, including teaching about addiction or health-related topics (MOUD, Hep C, birth control, HIV/PrEP, smoking cessation, harm reduction, healthy eating, exercise, sleep hygiene, managing anxiety/stress, etc) or connecting them to primary care/psych services or providing other needed health services. The spirit of the project is to understand the center, its clients’ assets and needs, and offer ongoing collaborative support to enhance the clients’ health.
• Drug Story Theater
  Fellows will join Adolescent Substance Abuse groups that support adolescents struggling with various SUDs by empowering them to lead theatrical productions about drugs with high school and college students.
  More info here: https://www.drugstorytheater.org/
• Malden High School
  Malden High School is located about ½ a mile from our Family Medicine Clinic. Fellows will help support high school students with behavioral health and substance use-related issues.

Research Projects

These are ever-evolving across our institution, based on what faculty are currently working on. Some current examples include:

1. Qualitative Research project on “Best practices for setting up Addiction Training within FM residency programs across the country” (Fellows will learn qualitative research analysis with InVivo software)
2. Prospective Chart review- starting patients “in the field” on Bup after narcan reversal for opioid overdose (led by Emergency Medicine and EMS staff)
3. Retrospective Chart review on “Iatrogenic effect of benzos used to treat inpatient alcohol medically managed withdrawal”

Other opportunities

• more concentrated experience with Hep C treatment
• more concentrated experience in chronic pain management by working with our pain pharmacy specialists to perform comprehensive biopsychosocial assessments and make recommendations for patients with chronic pain and potential SUD and mental health co-morbidities
• Choose your own adventure! (We are here to support your passions!)