New Application: Addiction Psychiatry
Review Committee for Psychiatry
ACGME
515 North State Street, Suite 2000 Chicago, Illinois 60654  312.755.5000  www.acgme.org
INSTITUTIONS - PARTICIPATING SITES
Indicate whether ACGME-accredited programs in the following specialties are available at each
participating site. [PR I.B.4.]
Family medicine
Internal medicine
Neurology
Physical medicine and rehabilitation
Site #1
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Site #2
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Site #3
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Site #4
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PROGRAM PERSONNEL AND RESOURCES
Faculty
1. List the designated site director at each participating site who is responsible for the day-to-day
activities of the program at that site, with overall coordination by the program director. [PR II.B.1.b)]
Site
#1
#2
#3
#4
Designated Site Director
Name
Name
Name
Name
2. Describe faculty members’ participation in organized clinical discussions, rounds, journal clubs, and
conferences. [PR II.B.6.]
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Other Program Personnel
1. List the professional personnel that will be available to the program from those clinical disciplines
necessary for the accomplishment of clinical training and the educational goals of the program. [PR
II.C.1.]
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2. Will substance abuse counselors and, where appropriate, teachers, be available to the program?
[PR II.C.3.] ................................................................................................................... ☐ YES ☐ NO
If “NO,” explain.
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3. Will there be a designated program coordinator? [PR II.C.4.] ....................................... ☐ YES ☐ NO
Addiction Psychiatry
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 3/2015
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Resources
1. Describe the inpatient facilities available to the program. [PR II.D.1.; PR II.D.1.a)]
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2. Describe the partial hospitalization and/or day treatment programs that will be used for fellow
education. [PR II.D.2.-II.D.2.b)]
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3. Will there be a multidisciplinary ambulatory care facility? [PR II.D.3.] ........................... ☐ YES ☐ NO
4. Describe the patient population and how the program director will ensure that fellows achieve
competence in the required patient care outcomes. [PR II.D.4.; II.D.4.a)]
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NUMBER OF FELLOWS
Describe how the program director will ensure that the presence of other learners will not interfere with
the appointed fellows’ education. [PR III.B.2.]
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EDUCATIONAL PROGRAM
Patient Care
Indicate the settings and activities in which fellows will demonstrate proficiency in evaluating and
treating patients in each of the categories listed below. Also indicate the method(s) that will be used to
assess proficiency.
Patient Categories
Patients with primary substancerelated disorders, and their
families
[PR IV.A.2.a).(1).(a)]
Medical and surgical patients in
the emergency department,
intensive care units, and general
wards of the hospital with acute
and chronic substance-related
disorders, including acute
intoxication and overdose
[PR IV.A.2.a).(1).(a)]
Psychiatric inpatients and
outpatients with chemical
dependencies and co-morbid
psychopathology to include
affective disorders, psychotic
disorders, organic disorders,
Settings/Activities
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Assessment Method(s)
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Addiction Psychiatry
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 3/2015
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Patient Categories
Settings/Activities
personality disorders, and
anxiety disorders, as well as
patients suffering from medical
conditions commonly associated
with substance-related disorders
including hepatitis and HIV/AIDS
[PR IV.A.2.a).(1).(c)]
Medication-dependent patients
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with chronic medical
disorders/conditions, including
patients with chronic pain
[PR IV.A.2.a).(1).(d)]
Assessment Method(s)
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Medical Knowledge
Indicate the activities (lectures, conferences, journal clubs, clinical teaching rounds, etc.) in which
fellows will demonstrate proficiency in their knowledge in each of the following areas. Also indicate the
method(s) that will be used to assess proficiency.
Proficiency Area
The use of all of the major
categories of substances, as well
as knowledge of the types of
treatment required for each
[PR IV.A.2.b).(1)]
Signs of withdrawal from these
major categories of substances,
knowledge, and experience with
the range of options for
treatment of the withdrawal
syndromes, and knowledge of
the complications commonly
associated with such withdrawal
[PR IV.A.2.b).(1).(a)]
Signs and symptoms of
overdose, including the medical
and psychiatric sequelae of
overdose, and treatment of
overdose
[PR IV.A.2.b).(2)]
The social and psychological
problems and the medical and
psychiatric disorders which often
accompany the chronic use of
the major categories of
substances
[PR IV.A.2.b).(3)]
The special problems of the
pregnant woman with substancerelated disorders and of the
babies born to these women
Settings/Activities
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Assessment Method(s)
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Addiction Psychiatry
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 3/2015
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Proficiency Area
[PR IV.A.2.b).(4)]
Family systems and dynamics
relevant to the etiology,
diagnosis, and treatment of
substance-related disorders
[PR IV.A.2.b).(5)]
American culture and
subcultures, including immigrant
populations, particularly those
found in the patient community
associated with the educational
program, with specific focus on
the cultural elements of the
relationship between the fellow
and the patient including the
dynamics of differences in
cultural identity, values and
preferences, and power
[PR IV.A.2.b).(6)]
The genetic vulnerabilities, risk
and protective factors,
epidemiology, and prevention of
substance-related disorders
[PR IV.A.2.b).(7)]
Settings/Activities
Assessment Method(s)
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Practice-based Learning and Improvement
1. Briefly describe one planned quality improvement activity or project that will allow fellows to
demonstrate the ability to analyze, improve, and change practice or patient care. Describe planning,
implementation, evaluation, and provisions of faculty member support and supervision that will
guide this process. [PR IV.A.2.c).(1)] (Limit response to 400 words)
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2. Briefly describe one example of a learning activity in which fellows engage to develop the skills
needed to locate, appraise, and assimilate evidence from scientific studies, including major medical
journals and professional-scientific organizations dealing with research on the understanding and
treatment of substance-related disorders, and apply it to their patients' health problems. [PR
IV.A.2.c).(2)-(2).(a)] (Limit response to 400 words)
The description should include:
 Locating information
 Appraising information
 Assimilating evidence information (from scientific studies)
 Applying information to patient care
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3. Briefly describe one example of a learning activity in which fellows critically analyze research
reports as presented in journal clubs and seminars. [PR IV.A.2.c).(3)]
Addiction Psychiatry
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 3/2015
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4. Briefly describe one learning activity in which fellows demonstrate administrative and teaching skills
in the subspecialty, including teaching and supervising residents, medical students, and/or other
allied health professionals, in the care of patients with substance-related disorders. [PR
IV.A.2.c).(4)] (Limit response to 400 words)
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Interpersonal and Communication Skills
1. Briefly describe one learning activity in which fellows demonstrate interpersonal and communication
skills that result in the effective exchange of information and collaboration with patients, their
families, and health professionals. [PR IV.A.2.d)] (Limit response to 400 words)
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2. Briefly describe one learning activity in which fellows work collaboratively with specialists in the
treatment of addiction in the emergency department and intensive care units in the diagnosis and
management of acute overdose symptoms. [PR IV.A.2.d).(1)] (Limit response to 400 words)
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3. Briefly describe one learning activity in which fellows work collaboratively with other mental health
providers and allied health professionals, including nurses, social workers, psychologists, nurse
practitioners, counselors, pharmacists, and others who participate in the care of patients with
substance-related disorders. [PR IV.A.2.d).(2)] (Limit response to 400 words)
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4. Briefly describe one learning activity in which fellows work effectively with multidisciplinary teams as
consultants and team leaders, including integrating recommendations and decisions from
consulting medical specialists and other professionals in related health disciplines. [PR
IV.A.2.d).(3)] (Limit response to 400 words)
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5. Briefly describe one learning activity in which fellows demonstrate competence in effectively
interviewing socioculturally-diverse patients and families, which may include those with limited
English proficiency, health literacy, vision/sight, and hearing. [PR IV.A.2.d).(4)] (Limit response to
400 words)
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Professionalism
1. Briefly describe the learning activity(ies), other than lecture, by which fellows demonstrate a
commitment to carrying out professional responsibilities and an adherence to ethical principles. [PR
IV.A.2.e)] (Limit response to 400 words)
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Addiction Psychiatry
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 3/2015
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2. Briefly describe one learning activity in which fellows demonstrate sensitivity and responsiveness to
diverse patients, including to sex, age, culture, race, religion, disabilities, and sexual orientation.
[PR IV.A.2.e).(1)] (Limit response to 400 words)
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3. Briefly describe one learning activity in which fellows demonstrate competence in recognizing and
appropriately addressing biases in themselves, others, and the health care delivery system. [PR
IV.A.2.e).(2)] (Limit response to 400 words)
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Systems-based Practice
1. Briefly describe the learning activity(ies) through which fellows demonstrate an awareness of and
responsiveness to the larger context and system of health care, as well as the ability to call
effectively on other resources in the system to provide optimal health care. [PR IV.A.2.f)] (Limit
response to 400 words)
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2. Briefly describe the learning activity(ies) through which fellows incorporate considerations of cost
awareness and risk-benefit analysis in providing psychiatric and other health care services to
patients with substance-related disorder. [PR IV.A.2.f).(1)] (Limit response to 400 words)
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3. Briefly describe the learning activity(ies) through which fellows incorporate quality assurance
measures when treating substance-related disorders. [PR IV.A.2.f).(2)] (Limit response to 400
words)
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Addiction Psychiatry
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 3/2015
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Curriculum Organization and Fellow Experiences
1. List all planned seminars and didactic courses to be attended by fellows. Provide the name of the session, whether it is required or
elective, the name(s) of instructor(s), and length, frequency, and total number of sessions. Insert additional rows as necessary. [PR
IV.A.3.b); IV.A.3.b).(1); IV.A.3.b).(3)]
Title
Required or
elective
Addiction Psychiatry
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Instructor(s)
Length of
session
Frequency
Total number of
sessions
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2. Describe how clinical experience and didactics will be integrated to provide appropriate progressive
learning. [PR IV.A.3.b).(4)]
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3. Briefly describe fellow experiences with:
a) Evaluating acute and chronic patients in inpatient and outpatient, and/or residential, settings [PR
IV.A.3.c).(1)]
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b) Performing assessments, including community and environmental assessments, family and
care giver assessments, medical assessments, and physical assessments [PR IV.A.3.c).(2)]
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c) Managing opiate replacement therapy [PR IV.A.3.c).(3)]
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d) Using psychoactive medications in the treatment of psychiatric disorders often accompanying
the major categories of substance-related disorders [PR IV.A.3.c).(4)]
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e) Using techniques required for the intervention with chronic substance users, and dealing with
the defense mechanisms that cause such patients to resist treatment [PR IV.A.3.c).(5)]
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f)
Using the various psychotherapeutic modalities involved in the ongoing management of the
chronic substance using patient, including individual psychotherapies, couples therapy, family
therapy, group therapy, motivational enhancement therapy, and relapse prevention therapy [PR
IV.A.3.c).(6)]
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g) Working with patients who are participating in self-help programs [PR IV.A.3.c).(7)]
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h) Assessing and treating patients with substance-related disorders related to:
(1) Alcohol [PR IV.A.3.c).(8).(a)]
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(2) Benzodiazepines [PR IV.A.3.c).(8).(b)]
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Addiction Psychiatry
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 3/2015
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(3) Cannabis and hallucinogens [PR IV.A.3.c).(8).(c)]
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(4) Cocaine and other stimulants [PR IV.A.3.c).(8).(d)]
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(5) Opioids [PR IV.A.3.c).(8).(e)]
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(6) Other substances of abuse, including sedatives, hypnotics, or anxiolytics [PR
IV.A.3.c).(8).(f)]
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(7) Nicotine [PR IV.A.3.c).(8).(g)]
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(8) Miscellaneous or unusual substances [PR IV.A.3.c).(8).(h)]
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i)
Providing consultation to acute and chronic medically-ill patients with substance-related
disorders who are being treated on emergency, intensive care, medical, and/or surgical services
of a general hospital. [PR IV.A.3.c).(9)]
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(1) Will fellows function at the level of a specialist consultant to primary care physicians and to
intensive care specialists? [PR IV.A.3.c).(9).(a)] ............................................... ☐ YES ☐ NO
If “NO,” explain.
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4. How many hours will each fellow have of faculty preceptorship weekly? [PR IV.A.3.d)] ................. (#)
a) How much time will be dedicated to one-on-one preceptorship? .................................... (#) hours
b) How much time will be dedicated to group preceptorship? ............................................ (#) hours
5. Describe how the program director will ensure that each fellow will maintain a patient log
documenting all clinical experiences. [PR IV.A.3.e)]
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Fellows’ Scholarly Activities
Addiction Psychiatry
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 3/2015
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Will fellows participate in developing new knowledge or evaluating research findings? [PR IV.B.1.]
.......................................................................................................................................... ☐ YES ☐ NO
If “NO”, explain.
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FELLOW FORMATIVE EVALUATION
Will assessment include quarterly written evaluations of all fellows by all supervisors and directors of
clinical components of the program? [PR V.A.2.d)] ........................................................... ☐ YES ☐ NO
If “NO”, explain.
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Addiction Psychiatry
©2015 Accreditation Council for Graduate Medical Education (ACGME)
Updated 3/2015
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