Rotation Schedules for 1 Year Addiction Medicine Fellowship:
6 Months 3 days/week Be Well Texas Outpatient
12 Months ½ day/week Be Well Texas Continuity
6 Months 3 days/week Villa Serena Residential
3 Months 1 day/week UH/VA Consultation Liaison
3 Months ½ day/week UH/VA Pain Clinic
6 Weeks ½ day/week UH Obstetrics
6 Weeks ½ day/week VA Intensive Outpatient Program
6 Weeks ½ day week Bexar County JDC Child and Adolescent
6 Weeks ½ day/week CHCS Methadone Clinic
12 Months ½ day/week Elective/Scholarly Activity Elective
Didactics:
- didactics is held every Tuesday afternoon from 1:00pm – 5:00pm
- fellows are invited to participate in faculty development day which is held twice a year and in education day which is hosted by the general program
Be Well Clinic – Adult and Adolescent Addiction
· This rotation is located in the Pinnacle building, which is close to campus.
· The clinic offers standard outpatient substance use treatment, which includes medical management, psychotherapy, and case management. It serves patients from various socio-economic backgrounds across Texas, both in person and via telemedicine.
· BWT treats both adults and a rapidly growing number of adolescent patients in the Youth Clinic (ages 11 to young adult). The Youth Clinic is led by Dr. Chaudhary, a trained physician specializing in adolescent addiction medicine who supervises this clinic.
South Texas VA – Villa Serena Residential Rehabilitation Program
· This is a 66-bed facility which is primarily a Substance Use Disorder program – residential treatment is variable length, usually 4 to 6 weeks. This program also offers a homeless/unemployment track, and we are scheduled to offer a PTSD track along with primary focus on SUD. Fellows will spend 20+ hours per week, for a six-month rotation, at this facility. Experiences will include new-patient evaluations; admission, follow-up, and discharge from the residential program; and outpatient visits with patients taking buprenorphine.
· Fellows will usually see one new evaluation, one admission, and approximately 3 follow-up patients during an 8-hour shift. Fellows are responsible for thoroughly assessing patients and formulating diagnostic and management plans with the on-site supervisor.
· Fellows have regular, on-site supervision. Nearly all patients are seen with the on-site faculty. D. General psychiatry residents (PGY-2) also rotate through this facility.
· Fellows have opportunity to provide supervision to general psychiatry residents. Fellows also have the opportunity to participate in telemedicine appointments.
· Fellows improve their skills in communicating and working collaboratively with an interdisciplinary team, and especially in teaching nursing and support staff on this relatively long term, intermediate care service.
University Hospital
-10 weeks minimal experience primarily during the CAP 1 year
-Pediatric specific Consult and Liaison work at the only pediatric level 1 trauma center in San Antonio, TX
-Interaction with a plethora of services to include pediatrics, trauma surgery, general surgery, hematology/oncology, OBGYN, and transplant medicine
-Large diversity of both patient demographics and pathology
Psychotherapy Clinic/Supervision
-Dedicated half-day weekly for psychotherapy with emphasis on long term psychotherapy
-Reserved for child and adolescent-aged patients
-Weekly engage in both individual and group psychotherapy supervision alongside longitudinal supervisor and co-fellows, respectively
-Psychotherapy specific didactics given by experienced providers and psychologists
CHCS Methadone Clinic
· CHCS Methadone Clinic is a county-funded Substance Use treatment clinic focused on patients with severe Opioid Use Disorder. Fellows have the option to spend four hours per week for 1-2 months evaluating and prescribing Medication Assisted Treatment for these patients, under the supervision of the clinic medical director.
· All cases are discussed with and/or seen with the supervising faculty.
· Fellows improve their skills in communicating and working collaboratively with the counseling staff and nurses at the clinic.
Bridge Outpatient Clinic
-A part of the Community rotation in the CAP 1 year
-Classic outpatient child and adolescent psychiatric care
-Multisystem care model with embedded therapy and other resources (financial, food, etc)
School Consults
-Updating
Pediatric Neurology Outpatient Clinic
– ½ day per week experience as part of Community rotation in CAP 1year
– Gain valuable experience with common neurological conditions in childhood
– Work with seasoned attending whom we often share patients that have comorbid neuropsychiatric illness
UT Health San Antonio CAP Outpatient (ADVANCE) Clinic
– Work side-by-side with Department Chair to provide psychiatric care for a unique patient population
– Experience a high-paced “private-practice style” environment within an academic setting
– A part of the Community rotation in the CAP 1 year
Cyndi Taylor Krier Juvenile Detention Center:
– The Cindi Taylor Krier Juvenile Detention Center is a long term correctional facility for minors in Bexar County.
– Our fellowship program provides psychiatric services to the population there with the goal of mental health recovery and improved behavioral functioning.
– Our fellows rotate at this clinic during the Community rotation of CAP 1 year.
Bexar County Juvenile Detention Center:
– This rotation is located at the Bexar County Juvenile Detention Center where minors are awaiting trial or long term correctional placement.
– The clinic provides psychiatric care through the duration of the detainees stay for a large gambit of psychiatric conditions.
– Our fellows rotate at this clinic during the Community rotation of CAP 1 year.
Trauma Clinic:
– This clinic is embedded in the University Hospital Trauma Surgery clinic for children and adolescents needing evaluation for PTSD in the aftermath of various emergency trauma situations.
– The clinic also provides treatment with pharmacotherapy and trauma focused CBT. Our fellows rotate at this clinic during the Community rotation of CAP 1 year.
Bridge Emergency Shelter
– Part of Roy Maas Youth Alternatives programs
– 24/7 shelter for vulnerable minors (runaways, victims of sex traffic, etc)
– Provides medical, dental, financial, academic needs for the residents up to 90 days
– This is a CAP 2 longitudinal rotation
– Very high rates of hx of abuse, neglect and criminal activity
– Allows a lot of autonomy and unique “outpatient” rotation in inpatient setting
Meadowlands Group Homes
– Part of Roy Maas Youth Alternatives programs
– Group home setting for children (age 6-18) with chronic placement issues
– Very high rates of hx of abuse, neglect, and criminal activity
– Another very unique “outpatient” rotation in inpatient setting
– A part of the Community rotation in the CAP 1
Community Telepsychiatry at Gulf Bend or Hill Country:
-This is one of the primary rotations during CAP 2 year, consisting of 1.5 days weekly of telepsychiatry work with various rural clinics
-Unique telepsychiatry experience that allows for us to provided access to care for much of South and Central Texas communities
– Current clinic include:
– Gulf Bend
– Boerne
– Canyon Lake
– Del Rio
– Fredericksburg
– Hondo
– Junction
– Kerrville
– Llano
– New Braunfels
