Addiction Psychiatry Fellowship

About the Fellowship

Since 1999, the Mass General Brigham Addiction Psychiatry Fellowship has trained fellows to pursue the critical and exciting field of addiction psychiatry. We provide an outstanding learning environment for the professional growth and development of our fellows; our faculty includes national leaders in the field of addiction psychiatry. The fellowship provides clinical rotations at multiple Harvard Medical School teaching hospitals including:

• Massachusetts General Hospital
• McLean Hospital
• Brigham and Women’s Hospital

Fellows engage in individual supervision and small tutorial style didactic seminars with Harvard Medical School faculty, as well as faculty members elsewhere in the city of Boston. Fellows are expected to gain competence and excellence in the practice of addiction psychiatry in public, private, academic and community-based settings with a wide variety of patient populations. Fellows learn evidence-based treatments and enjoy increasing opportunities to participate in the development of the field’s knowledge base through research and writing. We place a special emphasis on fellows’ active participation in their own education, and welcome their input not only in formal committees, but also informally.

The primary goal of the one-year, full-time Mass General Brigham Addiction Psychiatry Fellowship is to train outstanding psychiatrists who will become experts in the field of addiction psychiatry. Graduates of the fellowship may pursue careers in the clinical care of individuals with substance use disorders and their families, addiction research, education, policy or a combination of these activities. Graduates of the program often receive multiple job offers, individual mentorship and career planning are important components of the program.

Mass General Brigham offers two tracks:

1. One-year full-time clinical fellowship
2. Half-time, 2-year fellowship. Most frequently, fellows whose research interests match up with a mentor at Harvard Medical School complement their the half-time clinical fellowship with a half-time research position. Other options for the other half-time are available, however, such as only working half-time.

Fellows receive benefits through Mass General. More information on policies for vacation time, sick leave, holidays, educational leave, family and medical leave act, bereavement time, moonlighting, health and other benefits can be found on the Mass General benefits website.

Curriculum

Program

This one-year, full-time fellowship in addiction psychiatry is for graduates of accredited psychiatry residencies While it is usually taken during the PGY–5 year, some fellows join the program after completing a child psychiatry fellowship, i.e. during their PGY-6 year. The fellowship is designed to meet the objectives of the Accreditation Council for Graduate Medical Education (ACGME). In 1999, the program received full accreditation from the ACGME Residency Review Committee and has been re-certified ever since that time. Psychiatrists completing the fellowship are eligible to take the ABPN exam for Added Qualifications in Addiction Psychiatry.

We also offer a two-year, half-time option for fellows who are interested. Some fellows have used the other half-time to pursue research interests.

Training Sites

Clinical training is based at four sites:

• Massachusetts General Hospital
• Brigham and Women’s Hospital
• McLean Hospital
• North Charles Foundation (an opioid treatment program, where fellows learn methadone treatment)
• MGH Chelsea Healthcare Center (a community-based health center)

Training Experience

Core training includes an overview of the field of addiction psychiatry, with an emphasis on identification, screening, assessment, diagnosis and evidence-based treatment. Training is provided in individual, group and family therapy using a variety of techniques, including:

• Motivational interviewing
• Psychoeducation
• Cognitive behavioral therapy
• Relapse prevention
• Psychopharmacology
• Treatment of patients with co-occurring medical and psychiatric illness
• Dynamic psychotherapy
• Twelve-step facilitation

Training is provided across the spectrum of levels of clinical care including:

• Inpatient
• Residential
• Partial hospital
• Intensive outpatient
• Outpatient
• Residential treatment for first responders
• Hospital consultation-liaison
• Methadone maintenance treatments
• Community-based health center

Fellows are exposed to a range of twelve-step and other mutual-help programs and learn about integrating these peer support programs into the overall treatment program for individual patients. Fellows receive exposure to a heterogeneous urban and suburban population from diverse socioeconomic, racial, ethnic and cultural backgrounds; they see patients with a range of substance use disorders, as well as co-occurring psychiatric and medical disorders. Specialized populations (e.g., law enforcement officers and other first responders, physicians and other health care personnel) are also seen. Fellows learn to work in a team model with other professionals including counselors, social workers, nurses, psychologists and physicians from a variety of specialties.

Didactic seminars occur on Wednesday afternoons on core topics in addiction psychiatry with Harvard faculty and other experts from around the Boston area. The fellows meet as a group weekly with the program director and associate program director to review complicated cases, discuss topics not covered in the Wednesday seminars, read and discuss pivotal studies in the field and give academic presentations on topics of interest.

Clinical experience

Core Clinical Sites

• Massachusetts General Hospital
• Brigham and Women’s Hospital
• McLean Hospital
• North Charles Foundation
• MGH Chelsea Healthcare Center

Clinical Rotations

• Inpatient, Partial Hospital and Residential Treatment Rotation
  Alcohol, Drug, and Addiction Treatment Program
  McLean Hospital
  40% for 6 months
• Addiction General Hospital Consultation Liaison Rotation
  Brigham & Women’s Hospital
  40% for 6 months
• Outpatient Rotation
  Alcohol, Drug, and Addiction Treatment Program, McLean Hospital
  OR
  West End Clinic, Mass General Hospital
  40% all year
• Outpatient Opioid Treatment Program Rotation
  (Methadone and buprenorphine Treatment)
  The North Charles Foundation Inc.
  10% for 6 months
• Outpatient Cognitive Behavioral Therapy Rotation
  West End Clinic, Mass General
  10% all year
• Outpatient Mass General Chelsea Health Center (community health center)
  Mass General Chelsea Health Center
  40% for 1 month

Health Resources and Services Administration (HRSA) Grant

In 2020, our fellowship program received a grant from the HRSA to expand our fellowship size from three to four fellows, with an emphasis on treating those in underserved communities. We welcome applications from those who are interested in treatment of patients in underserved communities.

Educational Activities

Seminars

Weekly seminars, which take place in tutorial style, cover core topics in addiction psychiatry. Seminar leaders assign additional readings as appropriate to their topics. Faculty conducting the seminars include leading clinicians, educators and researchers across Harvard Medical School’s teaching hospitals as well as faculty from other institutions such as Boston University and Brandeis University.

Examples of Seminar Topics

• Epidemiology of substance use disorders
• The initial interview: making a diagnosis and beginning treatment at the same time
• Neuroimaging and addiction
• Neuropharmacology of addiction
• Psychosocial treatment modalities such as psychodynamic psychotherapy, cognitive behavioral therapy, motivational interviewing, relapse prevention
• Mutual help groups such as Alcoholics Anonymous and SMART Recovery
• Pharmacotherapy of substance use disorders
• Detoxification
• Specific substances, including alcohol and other CNS depressants, methamphetamine, cocaine, opioids, hallucinogens, cannabis, club drugs, and nicotine
• Treatment of substance use disorders and co-occurring psychiatric disorders
• Treatment of substance use disorders and co-occurring medical disorders
• Gambling
• Substance use in special populations such as adolescents, women and geriatric patients
• Treatment of substance use disorder and chronic pain
• Cross-cultural addiction psychiatry
• Research design
• State regulations and confidentiality
• Screening for drug and alcohol use disorders and use of urine drug screening
• Treating physicians and other healthcare professionals with substance use disorders
• HIV, hepatitis C and substance use disorders
• Treating patients who want to cut down rather than abstain
• Working with family members of individuals with substance use disorders

Individual Supervision

Individual Supervision is, for many trainees, the most important and powerful component of their fellowship. It is individualized, personal, immediate and clinically based. Optimally, it is a forum to discuss all clinically relevant material with highly experienced and expert clinicians.

Fellows have regularly scheduled supervision, which is usually divided as follows:

• 1 hour/week individually with rotation supervisor
• 1 hour/week with program director, associate program director and other fellows
• 2 hours/week with additional faculty

Rotation-based Clinical Rounds

Rotation-based clinical rounds provide rotation-based opportunities to discuss clinical cases and receive supervision.

Clinical rounds cover topics in addiction treatment and promote effective treatment.

North Charles Seminar

The North Charles Seminar takes place weekly during the fellows' methadone maintenance and outpatient opioid treatment rotation.

Grand Rounds

The Mass General and McLean Departments of Psychiatry sponsor Grand Rounds from September through June. At McLean Hospital, these are held on Thursday 12-1 and at Mass General on Friday 8:30-9:30.

Nationally and internationally known speakers are invited for formal presentations to the hospital community. These rounds are an excellent opportunity to meet and hear from some of the most well-known individuals in the field. While most of the presentations are oriented to general psychiatry, addiction psychiatry topics are generally included in the course of the year.

Fellows' Meeting

Fellows’ Meeting occurs weekly, in which all of the fellows meet with the program director and the associate program director. In these meetings, complicated cases are reviewed, and common clinical scenarios are discussed (e.g., What if a patient lies to you? Do you need to get urine tests? How do you know when treatment is over?) Fellows give talks in these meetings and are given feedback on their presentation; optimal use of Power Point slides is emphasized. Major studies in the field are reviewed; both the results and advances in research design are discussed. Fellows are taught how to review different types of articles and how to use the information from the articles in clinical practice.

McLean Hospital Alcohol, Drug, and Addiction Treatment Program Research Seminar

The McLean Hospital Alcohol, Drug and Addiction Treatment Program Research Seminar takes place monthly. Faculty present their current research at these seminars; fellows often present findings from research that they have conducted or are currently working on.

Academic Opportunities

In addition to the 2-year, half-time clinical/half-time research fellowship, fellows in the one-year clinical fellowship engage in academic activities as well. Fellows are commonly involved in writing projects, such as book chapters or review papers. Fellows are often asked to review journal article submissions in conjunction with the Program Director, to learn how to critically evaluate scientific articles. Some fellows have participated in the Research in Addiction Medicine Scholars (RAMS) program sponsored by the National Institute on Drug Abuse.  

Additional Opportunities

A variety of other educational opportunities are available. The Mass General Brigham Graduate Medical Education Office sponsors seminars and retreats during the year. Fellows attend the American Academy of Addiction Psychiatry annual meeting in December, paid for by the fellowship. The McLean Hospital/Harvard Medical School continuing medical education office sponsors a two-day conference on Addiction in May each year featuring international experts in the field; this provides another opportunity for high-quality education.

In recent years, fellows in our program have been given the opportunity to attend meetings of the Clinical Advisory Committee of the Massachusetts Medical Society Physician Health Service (PHS). Among its other services, the PHS supports and monitors physicians with substance use disorders. Fellows who have attended these meetings have found them to be highly educational.

Faculty

Roger D. Weiss, MD
Director, Mass General Brigham Addiction Psychiatry Fellowship
Chief, Division of Alcohol, Drugs, and Addiction, McLean Hospital
Professor of Psychiatry, Harvard Medical School

Olivera Bogunovic, MD
Associate Program Director, Mass General Brigham Addiction Psychiatry Fellowship
Medical Director of Ambulatory Services, Alcohol, Drug, and Addiction Treatment Program, McLean Hospital
Assistant Professor of Psychiatry, Harvard Medical School

Mark Albanese, MD
Medical Director Addiction Treatment Services, North Charles Foundation, Inc.
Assistant Professor of Psychiatry, Harvard Medical School

Craig Boyajian, MD
Psychiatrist-in-Charge, Inpatient Program
Alcohol, Drug, and Addiction Treatment Program, McLean Hospital
Assistant Professor of Psychiatry, Harvard Medical School

Hilary Smith Connery, MD, PhD
Clinical Director, Alcohol, Drug, and Addiction Treatment Program, McLean Hospital
Division of Alcohol, Drugs, and Addiction
Assistant Professor of Psychiatry, Harvard Medical School

A. Eden Evins, MD, MPH
Director, Center for Addiction Medicine, Massachusetts General Hospital
William Cox Family Professor of Psychiatry in the Field of Addiction Medicine, Harvard Medical School

Michael A. Fiori, MD
Medical Director, Alcohol, Drug, and Addiction Inpatient Program, McLean Hospital
Instructor in Psychiatry, Harvard Medical School

Shelly Greenfield, MD, MPH
Chief Academic Officer, Chief of the Division of Women’s Mental Health, McLean Hospital
Director of Clinical and Health Services Research and Education in the Division of Alcohol, Drugs, and Addiction, McLean Hospital
Kristine M Trustey Endowed Professor of Psychiatry, Harvard Medical School

David B. Hathaway, MD
Associate Psychiatrist, Brigham and Women’s Hospital
Instructor in Psychiatry, Harvard Medical School

Martha T. Kane, PhD
Clinical Director, Substance Use Disorders Initiative
Unit Chief, Behavioral Health, MGH Charlestown Health Center
Massachusetts General Hospital
Instructor in Psychiatry, Harvard Medical School

Janice F. Kauffman, RN, MPH, CAS, LADC 1
Vice President, Addiction Treatment Services, North Charles Foundation, Inc.
Director, Addiction Consultation, Cambridge Health Alliance
Assistant Professor of Psychiatry, Harvard Medical School

Vinod Rao, MD, PhD
Medical Director, West End Clinic, Massachusetts General Hospital
Instructor in Psychiatry, Harvard Medical School

Amanda Sedgewick, DO
Psychiatrist in Charge, Alcohol, Drug, and Addiction Inpatient Program, McLean Hospital
Instructor in Psychiatry, Harvard Medical School

Rachel Steere, DO
Psychiatrist, Massachusetts General Hospital
Instructor in Psychiatry, Harvard Medical School

Joji Suzuki, MD
Medical Director, Addiction Psychiatry Service, Department of Psychiatry, Brigham and Women's Hospital
Assistant Professor of Psychiatry, Harvard Medical School

Claire Twark, MD
Associate Psychiatrist, Brigham and Women's Hospital
Instructor in Psychiatry, Harvard Medical School

How to Apply

Eligibility

Eligible candidates will have completed an ACGME–accredited psychiatry residency program prior to start date of the fellowship.

Submitting Your Application

Our program uses the Electronic Residency Application Service (ERAS) to process applications. Visit the ERAS website to learn more.

Applicants may begin applying on July 7, 2021, via ERAS for our 2022-2023 fellowship class. We encourage applicants to apply as early as possible starting July 7. Interviews will occur on a rolling admissions process beginning in mid-July. Offers will be made beginning September 20.

Note: We strongly advise that applicants begin the process of applications for the full licensure in the state of Massachusetts by January 1 of their potential training year if they anticipate moving to the state. If there are documents from previous positions or schools where you have trained that you think may be difficult to obtain, we suggest that you begin this process as soon as possible.