The training year is divided into two six-month blocks. The first block (“inpatient”) is comprised of a two-month rotation on the Acute Care Inpatient Psychiatry Unit at MEDVAMC, one month on the Consultation/Liaison (C/L) service at MEDVAMC, and three months at the Menninger Clinic (six weeks assigned to the Adolescent Treatment Program and 6 weeks on the Compass Young Adult Unit).

Importantly, the Menninger portion of the rotation will provide clinical training and experience in the treatment of adolescents and women suffering from addictive and complex, co-occurring disorders. During the outpatient rotations, fellows hone skills related to diagnosis and management of substance intoxication, withdrawal and detoxification as well as stabilization of substance abuse and/or mental illness among the dually diagnosed. Opportunities for teaching are provided while rotating on the C/L service, since fellows act as the “junior attending,” lead clinical rounds, and give lectures to medical students and residents on addictions-related topics.

The second block (“outpatient”) takes place at MEDVAMC, where fellows rotate in various clinical settings including the Substance Dependence Treatment Program (SDTP); Opiate Treatment Program (OTP); and Primary Care-Mental Health clinic (PC-MH).

During these rotations, fellows master the diagnosis and outpatient management of substance use and dual diagnosis disorders and provide pharmacotherapy for addictions (including methadone and buprenorphine). In addition, fellows gain experience in the psychotherapeutic treatment of substance use disorders by leading motivational enhancement therapy and Seeking Safety groups and practicing various treatment modalities (including cognitive behavioral therapy for addictions, dialectical behavioral therapy and contingency management).