Interviews are being offered to physicians interested in completing a newly created fellowship in addiction medicine at the University of Kansas School of Medicine-Wichita. It’s hoped the first fellow will start Aug. 1 or Sept 1.

“The program is approved for up to three fellows,” said Ashley Haynes, M.D., who is the fellowship program director and a physician practicing addiction medicine at the Robert J. Dole VA Medical Center. “We will start with one, but we’re hoping to have two or three.”

“These are doctors who have completed any residency — (such as) family medicine, internal medicine, psychiatry — who want to delve more into treating addictions, medication management and some of the therapies that are included. They will come to get that specialized training for one year.”

“A lot of the training is clinical,” Haynes added. “They’ll be treating patients from day one.”

The one-year fellowship is one of several steps the medical school is taking to better prepare physicians to treat substance use disorder and increase access to such care. The effort, called Preparing Physicians to Treat Addiction also includes increasing physician awareness and education. It’s being funded by Kansas’ share of the national opioid lawsuit settlement.

Substance use disorder has been described as an epidemic, affecting nearly 18% of Kansans 18 years and older. Nationwide, it’s believed the vast majority of cases go untreated, and one of the reasons is addiction medicine specialists are in short supply. Sedgwick County currently has four board-certified specialists in that area.

“You’re talking about serving over half a million people in Wichita with four providers,” Haynes said.

The Dole VA, where the fellows will do some of their work and clinical training, is an enthusiastic partner, having simultaneously seen the need for more treatment options.

Alexandra Flynn, M.D., M.S., Ph.D., the Dole VA’s chief of psychiatry and site psychiatry residency program director, said the facility employs “a team of exceptionally qualified physicians, specialized in psychiatry and addiction medicine. They evaluate and treat various mental health conditions and substance use disorders on a daily basis.”  

Those teaching faculty teach KU Wichita students and residents and will now also teach its new fellows. The Dole VA treats patients in its Domiciliary Substance Use Disorders Residential Treatment facility, hospital inpatient units and various outpatient clinics.

“We have identified the need to increase the local supply of physicians who have in-depth knowledge and skills in addiction medicine,” Flynn said. “There is a critical need for this service in the community and we have an opportunity to support this advanced clinical training.”

Flynn emphasized that substance use disorder has been identified as a strong risk factor for suicidal behavior among veterans and other populations. “Of course, suicide prevention is the VA’s highest priority,” she said.

Haynes said the fellowship will expose physicians to diagnoses and treatments they likely have had limited exposure to previously, covering issues such as detoxification, pharmacotherapy, various recovery models and more.

“Things like managing medications for opioid use or alcohol disorder, being able to initiate those and adjust them long-term, and then direct to additional care if that is required,” she said.

Another situation they could encounter would be a “very complicated withdrawal that doesn’t follow the textbook, where maybe we’re having to treat multiple withdrawal syndromes at one time. Having that additional training will guide expert treatment.”

Haynes said estimates of substance use disorder among veterans is similar to that of the general population. While the VA’s patients tend to be predominantly male, fellows will get experience treating adolescent, female and pregnant patients through work with other providers.

One career option for physicians who complete the fellowship would be serving as medical directors or supervisors in community-based residential treatment programs, Haynes said.

The fellowship’s curriculum and teaching plan were approved by the Accreditation Council for Graduate Medical Education. It becomes one of 106 ACGME-accredited addiction medicine fellowships in 44 states.

As for the VA, helping train physicians is nothing new for the federal agency. Over 70% of U.S. physicians do some kind of training with the VA, said Sayid Raffi, M.D., associate chief of staff for education at the Dole VA.

“As one of our four statutory missions, the Department of Veterans Affairs educates and trains health professionals to enhance the quality of and timely access to care provided to veterans within the Veterans Health Care Administration health care system,” Raffi said.

For interview or general information, contact Shelly Small, fellowship program coordinator, at ssmall2@kumc.edu or visit Addiction Medicine Fellowship Program.