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VA Boston Healthcare System

 

Interprofessional Advanced Addiction Fellowship

Overview

The Interprofessional Addiction Fellowship Program at the VA Boston Healthcare System is a two-year, VA-funded fellowship that has the primary goal of training future generations of VA healthcare leaders to: 1) conduct innovative research in addictions, 2) provide evidence-based care for Veterans with substance use disorders and associated co-morbidities, and 3) manage teams, services, and/or training programs that will benefit Veterans with addiction problems.

The faculty offers training in the conduct of addiction-related research in diverse areas including basic neuroscience, psychopharmacology, treatment outcomes, and service delivery. Clinical mentorship is offered across a broad range of training sites (including both addiction and PTSD programs, as well as specialized programs for returning Veterans and female Veterans). Management training is offered at many different levels of the organization.

Fellows will spend 75% time in educational, management, and research activities, and up to 25% in direct clinical care activities. The program offers an individualized approach to training. The availability of a unique blend of scholarly and clinical opportunities ensures a high quality learning experience for each fellow. The trainee will join an academically rich and vibrant training environment for health professionals in programs affiliated with Boston University School of Medicine and Harvard Medical School.

Description of the Training Experience

Education

The educational components of the Interprofessional Advanced Addiction Fellowship in the VA Boston Healthcare System are designed to ensure that fellows develop competence to: 1) conduct scholarly research in the field of addictions; 2) provide empirically supported clinical services for Veterans with substance use disorders (SUD) and co-morbid conditions such as posttraumatic stress disorder (PTSD); and 3) learn basic leadership skills relevant to the management of clinical, training or research programs related to addiction, or other components of the VA healthcare system that impact Veterans with addictions.

Fellows acquire knowledge and skills through individually supervised training experiences. Each fellow designs an Individual Development Plan and has an opportunity to work with mentors who provide supervision in research, clinical, and management activities. Fellows participate in selected educational experiences designed to help them meet their training goals that may include courses, seminars, lectures, grand rounds, and research meetings. The fellow joins trainees from other programs including the Boston Internship in Clinical Psychology, VA Boston Psychology Postdoctoral Fellowship Training Program, VA Boston Clinical Research Postdoctoral Fellowship Program, Boston University School of Medicine (BUSM) General Psychiatry Residency Training Program and Addiction Psychiatry Residency Training Program, and Harvard South Shore (Harvard Medical School) Psychiatry Residency Training Program.

Research

The Research Service in the VA Boston Healthcare System is home to researchers in basic neuroscience, epidemiology, clinical assessment, and treatment and services outcome research. Research mentors have academic affiliations with Boston University School of Medicine and Harvard Medical School. The National Center for PTSD, a specialized center devoted to research and training in all aspects of traumatic stress is also located at VA Boston. As a result of the broad range of research interests of our faculty and vibrant academic community affiliated with the program, the Interprofessional Addiction Fellowship in Boston is able to provide training in the conduct of addiction research over a broad range of topic areas. A description of some of the general areas of research for our mentors is provided below. Additional information about other opportunities can be obtained by contacting the Fellowship Co-Directors.

Assessment/Treatment Outcomes/Technological Advances in Treating SUD

Terence Keane, Ph.D., Deborah Brief, Ph.D., Justin Enggasser, Ph.D., Amy Rubin, Ph.D., Monica Roy, Ph.D., and Marika Solhan, Ph.D. are working together on studies related to the evaluation of the efficacy of Web and mobile interventions for Veterans with problem drinking and PTSD symptoms.

Timothy O’Farrell, Ph.D. is conducting research related to the efficacy of couples and family therapy for alcohol and drug use disorders.

Grace Chang, M.D. has conducted research on identification and treatment of alcohol problems in general and specialty obstetric practices, general medical clinics, and emergency rooms, treatment utilization after residential SUD treatment, preferences among Veterans for computer versus text-based therapy, and factors involved in recidivism after detoxification.

Travis Cook, Ph.D. is conducting research focused on negative affect, urges and distress tolerance, and effects of cognition in alcohol use disorders.



Services Outcome Research

Richard Saitz, M.D. conducts research on screening and brief interventions for unhealthy alcohol and drug use, improving the integration of substance-related and general health care, such as chronic disease and care management, and improving the quality of care for people with addictions across the spectrum of use, particularly in general medical care settings.

Amy Rubin, Ph.D. is working with Steven Simon, M.D. and Richard Saitz, M.D., to evaluate specialized computer avatars to deliver screening and brief intervention for alcohol problems in primary care.



Basic neurobiological and cellular mechanisms of addiction

Gary Kaplan, M.D. is investigating the neurobiological mechanisms and treatment approaches to enhance the extinction of conditioned drug and fear responses. His research examines neuroplasticity and mechanisms of fear and drug conditioning in animal models and tests novel pharmacological and behavioral extinction learning approaches.

Michael Charness, M.D. is studying how ethanol alters nervous system development with studies focused on the characterization of a unique pharmacology for alcohol inhibition of L1 adhesion, the identification of drugs that block alcohol effects on L1 and prevent alcohol teratogenesis, the identification of an alcohol binding site on the extracellular domain of L1, and the characterization of a molecular switch that renders L1 insensitive to ethanol.

Kimberly Leite-Morris, Ph.D. is investigating the neurochemical mechanisms that underlie the anticipation, intense “craving” and repeated consumption of ethanol and substance abuse. She has established a rodent model of ethanol-self administration paired with current methods of in vivo micro-dialysis that procedurally separates and quantifies neurotransmitter levels during the different elements of the addiction process.

Marlene Oscar Berman, Ph.D. is studying brain mechanisms associated with emotional and cognitive impairments in chronic alcoholics with and without Korsakoff’s syndrome. Her research addresses abnormalities in brain centers controlling emotional perception and regulation and the impact on the course of alcoholism.



Pharmacotherapies for addiction

John Renner, M.D. is interested in the use of pharmacological interventions for opioid dependence, and ways to improve compliance with newer pharmacological agents (e.g., Buprenorphine) for the treatment of addiction.

David Osser, M.D. is conducting research focused on the interpretation and distillation of the evidence base for psychopharmacology practice into algorithms and related heuristics for clinical guidance. 



Medication development for addiction

Eric Devine, Ph.D. is conducting randomized controlled trials testing medications to treat substance use disorders. These trials are typically Phase II or Phase III multi-site studies testing medications for alcohol or cocaine use disorder. Previous studies have focused on both novel compounds and on re-purposing medications that have FDA approval for other indications.        



Clinical Training

The VA Boston Healthcare System offers a wide continuum of clinical services focused on the treatment of Veterans with substance use disorders (SUD) and prominent co-morbidities. The specialized addiction programs that are available as training sites include: 1) Mental Health Residential Rehabilitation Treatment Programs; 2) Outpatient Alcohol and Drug Treatment Programs; 3) Methadone Maintenance/office-based Buprenorphine programs; 4) Mental Health Consultation Service, which offers training on inpatient medical units; and 5) the Center for Returning Veterans and PTSD Clinics. Offering highly integrated treatment for co-morbid conditions and symptoms among Veterans with addiction problems is one of the strengths of the VA Boston Healthcare System and an approach to Veteran care that is promoted in the training.

Management Training

The VA Boston Healthcare System Advanced Fellowship Program offers fellows an opportunity to develop their leadership skills and a better understanding of the pathways to becoming a team member, manager, leader or executive. Experiences can be arranged at several levels of the organization including: 1) the Director of the Boston University School of Medicine Addiction Psychiatry Residency Training Program; 2) Medical Directors or Program Managers for the Mental Health Residential Rehabilitation Treatment Programs; 2) Section Chiefs for Substance Abuse Treatment and PTSD services; 4) Director of Residential and Rehabilitation Services; 5) Chief of Psychiatry and Deputy Director of Mental Health Services; 6) Director of Mental Health Services; and 7) Associate Chief of Staff (ACOS) for Research and Development.

Qualifications

Applicants are expected to have a primary interest in a VA career focused on developing, implementing, and managing programs, teaching, and/or conducting research to ultimately improve health care for Veterans with substance use disorders.

Physician Fellows must be a U.S. citizen or possess a current visa suitable for participation in this paid educational activity; U.S. citizens will be given priority in selection. Additional requirements for physicians include: 1) completion of an ACGME accredited residency program, 2) full and unrestricted license to practice in the U.S. or any of its territories, 3) board certified or eligible, and 4) if a graduate of a foreign medical school, ECFMG certification that is valid indefinitely.

Psychology fellows must be U.S. citizens and meet the following other requirements: 1) have completed an accredited Doctoral program and 2) completed an APA accredited internship.

Application procedures

Further information about the program and the application process can be found at: http://www.pittsburgh.va.gov/Trainee/ATF/Boston/index.asp.

 

Applicants should submit a letter of interest, CV, and three references. The letter of interest should describe an applicant’s interest in the program, a summary of educational, clinical, and research experience relevant to application, and a statement of career goals. All materials should be submitted electronically to bostonaddictionfellowship@va.gov. Please contact John Renner, M.D. (john.renner@va.gov, 617-248-1022) or Deborah Brief, Ph.D. (deborah.brief@va.gov, 857-364-4689) for further information about positions. The application deadline is January 5. Applications received after this date will be reviewed if positions are not filled.



Faculty Members

John Renner, M.D. and Deborah Brief, Ph.D., Co-Directors

 

Sharon Baker, Ph.D., Program Manager, Women’s Integrated Treatment and Recovery Program, clinical preceptor

 

Judy Bayog, Ph.D., Program Manager, Outpatient Alcohol and Drug Treatment Program, Assistant Professor of Psychology, Department of Psychiatry, Harvard Medical School, clinical preceptor

 

John Bradley, M.D., Chief of Psychiatry, Deputy Director for Mental Health VA BHS, Associate Professor of Psychiatry, Harvard Medical School, management preceptor

 

Deborah Brief, Ph.D., Director, Residential and Rehabilitation Services, Assistant Professor of Psychiatry, Boston University School of Medicine and of Psychology, Boston University, mentor, research and management preceptor

 

Aida Cajdric-Vrhovac, Ph.D., Program Manager Center for Integrated Residential Care for Addiction, Assistant Professor of Psychiatry, Boston University School of Medicine, clinical and management preceptor

 

Michael Charness, M.D., Chief of Staff, VA BHS, Professor of Neurology, Harvard Medical School and Boston University School of Medicine, Faculty Associate Dean, Harvard Medical School, and Assistant Dean, Boston University School of Medicine, research preceptor

 

Grace Chang, M.D., Director, Mental Health Consultation Service, Professor of Psychiatry, Harvard Medical School, mentor, clinical, management and research preceptor

 

Travis Cook, Ph.D., Clinical Director Intensive Outpatient Alcohol and Drug Treatment Program, clinical and research preceptor

 

Erin Daly, Ph.D., PTSD Section Co-Chief and Director, Center for Returning Veterans, Assistant Professor of Psychiatry, Boston University School of Medicine, clinical and management preceptor

 

Eric Devine, Ph.D., Director, Clinical Studies Unit, Vice Chair, Panel Blue BUMC IRB, Assistant Professor of Psychiatry, Boston University School of Medicine, research preceptor

 

Justin Enggasser, Ph.D., Section Chief for Substance Abuse Treatment Services, Assistant Professor of Psychiatry, Boston University School of Medicine, Lecturer, Harvard Medical School, mentor, clinical, management, and research preceptor

 

Gary Kaplan, M.D., Director, Mental Health Service, VA BHS; Professor of Psychiatry, Pharmacology & Experimental Therapeutics, Boston University School of Medicine, mentor, management and research preceptor

 

Terence Keane, Ph.D., Associate Chief of Staff for Research and Development, Director Behavioral Sciences Division, National Center for PTSD, Professor and Vice Chairman in Psychiatry, Boston University School of Medicine, Professor of Psychology, Boston University, mentor, management and research preceptor

 

Karen Krinsley, Ph.D., PTSD Section Co-Chief, Assistant Professor, Boston University School of Medicine, clinical and management preceptor


Leite-Morris, Ph.D.,
Assistant Professor/Research Scientist, Director of Neurochemistry Laboratory, VA BHS, Assistant Professor of Psychiatry, Brown University Medical School, research preceptor

 

Matt Lally, M.D., Medical Director SARRTP, TR Program in Boston, Clinical Instructor, Harvard Medical School, clinical and management mentor

 

Timothy O’Farrell, Ph.D., Director, Project CALM, Professor of Psychology, Department of Psychiatry, Harvard Medical School, clinical and research preceptor

 

Marlene Oscar Berman, Ph.D., Research Career Scientist at the Veterans Affairs Boston Healthcare System, Professor of Psychiatry, Neurology, Anatomy, and Neurobiology at Boston University School of Medicine, Director of the Ph.D. Program in Behavioral Neuroscience at Boston University School of Medicine, research preceptor

 

David Osser, M.D., Medical Director Homeless Domiciliary, clinical and research preceptor

 

John Renner, M.D., Associate Director of the Boston University School of Medicine Psychiatry Residency Training Program, Director of VA-BUSM Addiction Psychiatry Fellowship Program, Professor of Psychiatry BUSM, mentor, clinical, management, and research preceptor

 

Monica Roy, Ph.D., Program Manager SARRTP, Instructor, Department of Psychiatry, Boston University School of Medicine, clinical, management, and research preceptor

 

Amy Rubin, Ph.D., Research Psychologist, VA BHS, Assistant Professor, Psychiatry and Medicine, Boston University School of Medicine, research preceptor

 

Richard Saitz, M.D., MPH, FACP, FASAM, Chair, Department of Community Health Sciences. Professor of Community Health Sciences and Medicine, Boston University Schools of Public Health and Medicine, Physician, Boston Medical Center (Primary Care), research preceptor

 

Abigail Schein, M.D., Medical Director, Women’s Integrated Treatment and Recovery Program/Brockton Transitional Residence Program, Instructor in Psychiatry, Harvard Medical School, clinical and management preceptor

 

Marika Solhan, Ph.D., Program Manager Women’s Transitional Residence Program, Assistant Professor of Psychiatry, Boston University School of Medicine, clinical preceptor

 

Sean Stetson, M.D., Staff Psychiatrist, Medical Director Emergency Mental Health Services, Instructor in Psychiatry, Boston University School of Medicine and Harvard Medical School, clinical preceptor

 

Jayne Trachman, M.D., Staff Psychiatrist, Women’s Stress Disorder Treatment Team, Assistant Professor of Psychiatry, Boston University School of Medicine, clinical preceptor

 

Julie Weismoore, Ph.D., Staff Psychologist in PTSD Clinic, PTSD-SUD specialist, clinical preceptor