Addiction Psychiatry Fellowship

Director: Karen Drexler, M.D.
Address: Substance Abuse Treatment Program (116A) Atlanta VAMC 1670 Clairmont Road, Atlanta, GA 30033
Phone/Fax: (404) 321-6111 x6900  (404) 329-4643
E-mail: karen.drexler@va.gov

Coordinator: Amy Cromwell

Phone/Fax: 404-727-3293/404-727-4746

E-mail: acromwe@emory.edu

Level: PGY-5
Positions: 2
Annual Stipend: $53,007 (2009-2010)
Accreditation: ACGME

The Addiction Psychiatry Residency Program is a one-year program. The Addiction Psychiatry resident must have satisfactorily completed an ACGME-accredited General Psychiatry residency prior to entering the program. Upon completion of the 12-month residency program, and board certification in General Psychiatry, the resident will be board eligible in Addiction Psychiatry. Training in Addiction Psychiatry that occurred during the general residency training will NOT be credited toward the one-year requirement. Training is best accomplished on a full-time basis. If it is undertaken on a part-time basis, the 12-month program must be completed within a two-year period.

To determine the appropriate level of education for a resident who is transferring from another residency program, written verification of the previous educational experiences and a statement regarding the performance evaluation of the transferring resident must be received prior to acceptance into the program.

Residents train at the Atlanta VA Medical Center and affiliated sites. Residents receive direct supervision in evaluation and treatment of men and women of different ages, ethnic and socioeconomic backgrounds with addictions to all of the major classes of addicting substances.

Residents participate in four rotations: VAMC substance abuse treatment program (6 months); Grady Memorial Hospital (3 months); a rotation at Metro Atlanta Recovery Residences (6 weeks) and one at Talbott Recovery Campus (6 weeks). Residents receive supervised training in performing patient evaluations, managing rehabilitation and detoxification, and treating psychiatric co-morbidities. They participate in clinical supervision and formal didactic training of general psychiatry residents and medical students. Residents also follow outpatients for individual psychotherapy and medication management throughout the year.

Wednesday morning seminars cover specific reading assignments based on the topic areas covered in the American Board of Psychiatry and Neurology examination and requirements of the Accreditation Council on Graduate Medical Education. Didactics address neurobiology, diagnosis and treatment of all the major classes of addicting substances, pharmacotherapy and psychotherapy, and related topics including public policy, ethics, and medications development.

A more detailed description of our program can be requested by calling Amy Cromwell, Program Coordinator, at 404-727-3293 or email: acromwe@emory.edu.

Affiliated Institutions and Rotations:

ATLANTA VETERANS AFFAIRS MEDICAL CENTER (Atlanta VAMC)

Atlanta VAMC serves over 440,000 veterans residing in metropolitan Atlanta and northern Georgia. The medical center is dedicated to providing acute medical, surgical, intermediate, and psychiatric care, and both primary and specialized outpatient services with almost all major specialties and subspecialties represented.

Atlanta VAMC is a dean’s committee, tertiary care facility comprised of 191 operating hospital beds and 100 operating nursing home care unit beds. The facility is located east of Atlanta, Georgia, on the northeast edge of Emory University’s Campus. Atlanta VAMC serves as a primary teaching hospital of the Emory University School of Medicine with a major, highly active research program.

The Substance Abuse Treatment Program (SATP) of the Atlanta VA Medical Center treats over 1,500 veterans each year with a variety of addictive disorders. In order of prevalence, they include nicotine dependence, alcohol dependence, cocaine dependence, cannabis dependence, opioid dependence, benzodiazepine dependence, and others. Over one-third of veterans in the SATP have co-occurring mental disorders including post-traumatic stress disorder, mood disorders, other anxiety disorders, and psychotic disorders.

GRADY MEMORIAL HOSPITAL

Grady Memorial Hospital has been in the heart of downtown Atlanta for over 100 years, located approximately seven miles from the Atlanta VA Medical Center and Emory University. With 1,000 inpatient beds, Grady is a primary teaching hospital of the Emory University School of Medicine and Morehouse School of Medicine. Grady Memorial is the primary hospital for inner city and medically indigent populations in the two largest counties of metro Atlanta. Construction of a $350 million renovation of the physical plant was completed in 1995. Total patient volume in the Emergency Care Center is approximately 100,000 patients per year.

Addiction Psychiatry Residents are required to participate in a full-time, three-month rotation at Grady. The residents split their time between:

• Drug Dependency Treatment Unit (DDU): the city’s largest methadone maintenance program
• Infectious Disease Program: serving HIV/AIDS patients
• Drug Court: working with drug offenders and judicial officers in the DeKalb County Superior Court
• Double Trouble: in-patient care for patients with severe mental illness exacerbated by substance abuse
• Child and Adolescent Services: treating young people, and addressing issues unique to this age group, such as school issues and families

Residents work with psychiatrists, clinical psychologists, social workers and clinical nurse specialists provide multidisciplinary clinical supervision and collaboration.

METRO ATLANTA RECOVERY RESIDENCES (MARR)

MARR, Inc., is a private, nonprofit community-based residential addiction treatment program that provides several levels of care. These include intensive outpatient/partial hospitalization, high-intensity residential, low-intensity residential, aftercare, family services, and services for recovering professionals. MARR owns and operates more than 35 recovery residences that offer a therapeutic “community” in which each patient progresses through the recovery process in a family-type environment.

The organization operates four gender-specific residential primary addiction treatment programs:

• Men’s Recovery Program
• Women’s Recovery Program
• Right Side Up, a program for women and their children
• Professional's Program

Addiction Psychiatry residents rotate through all four of these treatment programs. The main treatment and administrative facility is located in northeast metropolitan Atlanta about 10 miles from the Atlanta VAMC.

Patients include men and women with primary addictive disorders; depending on the patient population, at least half of the patients have co-occurring psychiatric disorders. The most common psychiatric diagnoses include mood disorders, anxiety disorders, and personality disorders. Treatment approaches include individual and group psychotherapy, psycho-education, 12-step facilitation, behavior modification, therapeutic community, psychopharmacology, recreation therapy, and family therapy. Residents have shared responsibility with other staff for 12-15 outpatients and have three hours per week of individual and group supervision.

TALBOTT RECOVERY CAMPUS

Talbott provides state-of-the art treatment programs designed to treat the whole pateint and family. Patients are provided comprehensive, individualized treatment of addiction (alcohol, drug use, and other addictive disorders) and its related medical, psychological, spiritual and work-related problems, along with a thorough immersion in the twelve step fellowships.

Residents rotate through these services at Talbott:

• 96 Hour Assessments - pre-admission
• Evaluations/Assessments - post admission
• Groups
• Outpatient Detoxiication
• Young Adults

One of Talbott's strengths is their success at treating professionals, such as medical doctors and airline pilots.

Didactics Curriculum

Wednesday mornings are reserved for academic activities. Residents participate in Didactics lectures ( 8:00-12:00) to include small group discussions with experts in Pharmacology, Neuroimaging, Clinical Care, and Epidemiology.

Residents are expected to complete at least one scholarly activity to include developing a lecture, writing a review paper, a research paper, or other activity approved by the Program Director.

Emory has a diverse faculty devoted to researching addiction --- from Molecular Neuroscience, to Rodent and Primate Animal Models, to Human Neuroimaging, Clinical Trials, and epidemiological studies. Residents may elect to pursue research projects in any of these areas.

 

Faculty

Addiction Psychiatry faculty currently consists of five full-time addiction psychiatrists who are certified by the American Board of Psychiatry and Neurology.  In addition, we have several addictionologists and clinical psychologists with experience in treatment of psychoactive substance use disorders. Faculty members in General Psychiatry, Child Psychiatry, Psychosomatic Medicine, and addiction research provide didactic instruction and appropriate clinical research supervision.

 

How to Apply

Applicants must complete a psychiatry residency program before beginning the addiction psychiatry residency program (PGY-5) and must obtain a Georgia Medical License.

The application form is the standard NRMP application form for PGY-2 and above. Interested applicants should send a letter of interest, the completed application, and the following materials to the coordinator:

• Curriculum vitae
• Contact information including mailing address, email, preferred phone numbers
• Evidence of qualification for a Georgia medical license (in most cases this will be a copy of a current license from a state that has reciprocity with Georgia)
• A copy of the applicant's medical school diploma
• Three letters of reference. One of these must be from the training director of the resident's general psychiatry training program documenting expected satisfactory completion of general psychiatry training.
• Medical school transcripts (may be sent by your general psychiatry training director or medical school)
• Medical school Dean’s letter (may be sent by your general psychiatry training director or medical school)
• Copies of USMLE scores from Step I, II, III
• Copy of your visa or permanent resident card if you are not a US citizen

Send all application materials to:

Amy Cromwell

Addiction Psychiatry Program Coordinator

Emory Univ SOM-Tufts House

2004 Ridgewood Dr.

Atlanta, GA 30322

 

ABPN Certification

Our goal is to prepare residents for ABPN Board Certification in Addiction Psychiatry. To that end, residents must first become certified in General Psychiatry. Each resident  takes an addiction  MCQ exam, uses a procedure logger to ensure that a minimum number of identified scenarios are handled, and takes a self-evaluation to measure comfort levels for a wide variety of cases. Site supervisors use a checklist of skills to observe and evaluate residents handling several patients. These exercises serve to measure skills and knowledge in Addiction Psychiatry while preparing the resident for ABPN certification.

 

Evaluations

Each resident is evaluated at the beginning and end of each rotation by his/her attending psychiatrists in the knowledge and practice of Addiction Psychiatry and in the six general competencies for all physicians, as outlined by the ACGME: Patient Care; Medical Knowledge; Practice-Based Learning; Interpersonal Skills; Professionalism; and Systems-Based Practice. Evaluations are based on direct observation of patient care and weekly supervision. Residents evaluate the quality of teaching by clinical attendings and lecturers.

We also use interview checklists, procedure logs, PRITE exams, mock boards, and an in-house multi-choice question exam to evaluate the fellowship.

 

Updated: August 2009