Locally developed training will enhance addiction medicine
A collaboration between VHC, PHC and UBC has resulted in a new medical fellowship program that uses locally developed curriculum for specialized training in addiction medicine.
About the fellowship
The St. Paul’s Hospital Goldcorp Fellowship in Addiction Medicine is interdisciplinary and allows for a one-year specialty training for physicians from family practice, internal medicine and psychiatry. Fellows will get exciting clinical experience in key areas of the field including inpatient and outpatient detoxification protocols and procedures, addiction medicine consultation service, youth addiction and mental health, residential treatment focused on women, chronic pain management, and longitudinal community based addiction treatment. In addition, they will obtain excellent academic training in the science of addiction medicine through academic half days, journal clubs, and conference attendance. The fellows will explore ways to impact public policy, and do advocacy and research projects. The fellowship has now received accreditation from the American Board of Addiction Medicine and full details regarding the fellowship and how to apply are available through the fellowship website at: www.addictionmedicinefellowship.org.
The fellowship was made possible through a $5 million gift from Goldcorp. A portion of the Goldcorp gift is going to support the successful Assertive Community Treatment program at VCH.
The VCH ACT program
The VCH ACT program is a unique 24/7 service delivery approach for people who live on the DTES, or previously lived on the DTES, struggling with the most serious and persistent mental illnesses and addiction and are unable to access or maintain involvement with traditional services. ACT was funded through a one-time federal grant which is set to expire in 2012. The grant was created specifically to help treat people living on the DTES who are high users of health and emergency services (hospital psychiatric units, emergency departments, correctional facilities, etc) because of their disorders. Round-the-clock service for a small caseload may seem expensive but it is estimated that it costs between $70 and $75 per day, per person for ACT services versus $160 for an emergency room visit or $450 per day for an acute bed.
ACT has been in operation for more than a year now and has proven to be very successful in reducing the length and frequency of hospitalization and in improving a person’s ability to live on their own. There are some truly moving stories of success to come from ACT – desperately ill people who have gone from living on the street with little or no hope for the future, to having a clean, safe home, a job, and purpose in their lives.
Benefits of collaboration
Through ACT, addiction medicine Fellows will have the opportunity to regularly engage with patients with addiction. This is a model of care that has occurred in other specialties (i.e. cardiology, internal medicine, etc) for a long time, but has been a challenge for addiction medicine, not just here in Vancouver but across British Columbia. The vision is for each fellow to participate directly in the work that the ACT team is doing as part of his or her rotation or elective.
Fellows are also expected to spend between 25% and 50 % of their time conducting research to further improve the system of care. The ACT program will be of tremendous benefit in this regard as well with an already established and growing database of rich clinical information. Fellows will be able to use this data for their research and what they learn will help influence how care is provided to people in need here in British Columbia and beyond.
Continuity of care is another important benefit that comes by bringing these two programs together. Although ACT is successful in reducing the number of hospital visits by clients, it does not eliminate them. Having specialized addiction physicians who are linked to ACT and are familiarized with these clients – who know and understand their unique struggles and backgrounds – will help to foster an atmosphere of trust and, ultimately, improve care.