Underrepresented in Medicine Resident Rotation

The elective at Boston Medical Center (BMC) is a two to four week elective designed to train residents in the delivery of high-quality addiction care. For residents, from groups under-represented in medicine, which includes those racial and ethnic populations that are underrepresented in the medical profession relative to their numbers in the general population, we provide a stipend of $2100 for a two-week rotation and $4100 for a 4-week rotation to accepted residents.

Our mission is to prepare physician leaders for clinical and academic careers in Addiction Medicine who will improve the health and wellness of people who use substances through clinical care, research, education, advocacy, and public health. The program is invested in Boston Medical Center’s commitment to provide “exceptional care without exception,” which includes addressing the health and wellness inequities from racism, ethnicity, poverty, age, gender, sexual orientation, disability and stigmatizing illness.

Residents will spend most days of the rotation on the Addiction Consult Service (ACS), with weekly exposure to outpatient care settings, such as our low-barrier access clinic, affiliated methadone treatment program, office-based addiction treatment program (in adult primary care, adolescent and OB practices), and our addiction-focused academic conferences. As a member of the ACS you will provide consultation as part of a multi-disciplinary team (addiction specialist attendings, addiction fellows, nurse practitioners, social worker, wellness and recovery advocate), and will learn how to provide addiction medicine consultation to inpatients on all medical and surgical services in the hospital. The population seen on the ACS mirrors the population admitted to the inpatient services at BMC with substantial proportions of racial and ethnic minoritized and socio-economically disadvantaged patients.   Most patients are diagnosed with multiple substance use disorders, particularly alcohol, opioid, cocaine, methamphetamines and benzodiazepines. They frequently require major medical interventions related to alcohol withdrawal, opioid withdrawal, intravascular and soft tissue infections from injection drug use, chronic pain, trauma, pregnancy and post-partum care. Services provided include substance use diagnosis, psychosocial assessment, initiation of medication for substance use disorders, coordination with other medical, surgical and psychiatric disciplines, and coordination of substance use care upon discharge. Care plans are patient-centered, focusing on each patients’ care goals. Harm reduction is central to each patient encounter.

At the end of the rotation you will be able to:

  1. Take an appropriate substance use specific history
  2. Diagnose patients with substance use disorder (SUD) using the DSM-5 criteria
  3. Manage alcohol and opioid withdrawal in the hospital
  4. Appreciate the value of multi-disciplinary team rounds with physicians, advanced practice providers (APP) social workers and peers
  5. Engage patients with appropriate inpatient substance use disorder treatment resources
  6. Counsel patients using non-judgmental approach and provide harm reduction strategies, including overdose prevention and safer injection practices
  7. Counsel patients on use, risks, and benefits of medications for substance use disorders, including methadone, buprenorphine, naltrexone, acamprosate, and disulfiram.
  8. Initiate and titrate medications for substance use disorders for inpatients prior to discharge
  9. Manage acute pain in patients with concurrent opioid use disorder
  10. Effectively communicated care recommendations to social work, case management and the primary team

Subsidized Visiting Elective Program Application 2023