Dallas Addiction Leadership Training (DALT) - VA North Texas Health Care System
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Dallas Addiction Leadership Training (DALT)

Overview

VANTHCS is recruiting a physician and psychologist and/or pharmacist for a two-year Dallas Addiction Leadership Training (DALT). This fellowship is designed to develop our future clinical, academic and/or administrative leaders in the addiction field. Fellows will spend at least 75% of their time on a mentored project of particular interest and relevance to the fellows' future goals. No more than 25% of fellow effort will be for required clinical service. Specialized training in leadership skills will also be a focus during the fellowship. The physician can be board eligible or board certified in any specialty. The psychologist can be licensed or license eligible. The pharmacist can be licensed in any state or U.S. territories. Recent graduates as well as mid-career applicants are encouraged to apply. The first class will begin September 2014.

Description

Leadership

This component was developed to ensure fellows cultivate advanced proficiencies in:

  1. Essential leadership and management skills needed to promote addiction clinical care and/or research and its resourcing.
  2. Appreciation of how different disciplines (physicians, psychologists, pharmacists, nurses, administrators, etc.) think, organize information and communicate.
  3. Thorough understanding of how to market addiction efforts with goal of showing how they align with and support other management efforts.

Knowledge and skills in these areas will be acquired through structured educational activities and key publications in the area as well as individual supervision and mentorship with current clinical, academic and/or administrative leaders at VANTHCS, affiliated sites such as UT Southwestern Medical Center, or other professionals within the community whose areas of expertise align well with those of the DALT fellow.

Mentored Project

The mentorship component of the DALT fellowship is designed to facilitate the unique career goals and particular interests of the fellows. Fellows work with co-Directors of the program to determine a primary and secondary mentor whose expertise is consistent with individualized professional goals. In addition to administrators and researchers at Dallas VAMC, mentors can be selected from affiliated sites such as UT Southwestern Medical Center or other professionals within the community.

Within the realm of addiction, DALT fellows have varied areas of focus. Thus, mentored projects can involve program evaluations, investigation of resource utilization in the treatment of substance use disorders, design of novel treatments, research project or other approaches that guide the fellows toward competence in leadership, scholarship and/or management.

Scholarship

The scholarship experience will develop professional skills and knowledge in academic research, ethics and education. Although the focus of this effort is on addictive disorders, skills and knowledge translate into all areas of medicine and psychology. Scholarship is promoted with didactics, clinical training, journal clubs and supervisory sessions on ethics in research, research design, manuscript writing and individualized mentorship. In addition to the extensive leadership training at VA North Texas Health Care System, classes in the UT Southwestern Clinical Translational and Research Scholar Program are freely available to all fellows. Fellows will share training experiences with advanced trainees from other programs at VA North Texas Health Care System, including the Interdisciplinary Substance Abuse Fellowship Program, Addiction Psychiatry Fellowship Program and VA North Texas Psychology Postdoctoral Program.

Multiple mentors and sites are available for scholarship experience. Listed below are potential ongoing and recently completed studies that could mentor a DALT fellow.

  • Clinical Translation Studies in Addiction: Dr. Bryon Adinoff has been conducting studies exploring the biological underpinnings of addiction for almost 30 years. These studies include neuroendocrine explorations of the stress-response systems and neuroimaging (using functional MRI and SPECT) to explore neural processes related to impulsivity and stress reactivity.
  • Epidemiological Approaches using the VA National Database: Funded by a NIDA K-award, Dr. Arthur Westover is exploring a national retrospective cohort study of Veterans to determine whether use of prescription amphetamines is associated with increased risk of stroke, myocardial infarction and cardiovascular death. Statistical techniques will include novel, computationally complex and sophisticated statistical approaches to adjust for potential biases.
  • Psychoeducation for HCV and Alcohol Behaviors: Dr. Carol North is conducting a NIAAA funded study to develop, implement and test a family-responsive psychoeducation program for hepatitis C.
  • Homelessness in Veterans: Dr. Carol North has conducted extensive studies in the homeless population, including a 2-year longitudinal study of service use and costs among 400 homeless individuals (most of whom have drug and alcohol problems), a cross-sectional study of 250 homeless people with neuropsychological testing at The Bridge in Dallas, and a geospatial pilot study and study regarding journeys of homeless people.
  • Vocational Rehabilitation: Dr. James LePage is evaluating supported employment and vocational rehabilitation for previously incarcerated Veterans with mental illness and/or substance use disorders (Project About Face, RR&D MERIT).
  • Integrated Stepped Care of Patients with HIV and Alcohol Use Disorders: Dr. Roger Bedimo is site principle investigator of a 5-site NIAAA-funded study assessing the effectiveness of an Integrated Stepped Care (ISC) intervention versus treatment as usual (TAU) on alcohol consumption in HIV+ Veterans. Three groups are being assessed: 1) at risk drinkers, 2) alcohol abuse or dependence, and 3) moderate alcohol use with liver disease. Interventions may include Brief Negotiated Intervention (BNI), addiction physician management and alcohol pharmacotherapy and MET.
  • Medications, Alcohol, and Substance use in HIV (MASH): A Substudy of the Veterans Aging Cohort Study (VACS). Dr. Roger Bedimo is also principle investigator of this study. The purpose of MASH is to collect additional observational data concerning the use of VA and non-VA medications to inform our understanding of the relationship between HIV disease, aging, mental and physical comorbidities, multisubstance use (MSU including alcohol, tobacco), and polypharmacy (prescription and nonprescription drugs) and adverse drug effects so that modifiable mediators of important patient outcomes (costs, utilization morbidity and mortality) might be targeted for intervention.

Clinical Training

A broad array of clinical service programs focused on treating Veterans with substance use disorders are available at VANTHCS. This provides opportunities for DALT fellows to train in a variety of settings, including: 1) Substance Abuse Residential Rehabilitation Program, 2) Inpatient Detoxification Unit, 3) Intensive Outpatient Treatment Program for Addictions, and 4) Methadone Maintenance Clinic. These programs utilize empirically supported pharmacological interventions as well as evidence based psychotherapy for addiction and comorbid psychiatric conditions. The integrated approach to treatment is a clear strength of our facility and a focus of the fellows' clinical training experience.  Training opportunities are also available at private addiction programs within the community as well as local hospitals affiliated with the Addiction Psychiatry Fellowship. As noted above, fellows will spend no more than 25% of their time providing clinical services. 

Qualifications

The following are required for physicians:

  1. Completion of an ACGME accredited residency program
  2. Full and unrestricted license to practice in the U.S. or any of its territories
  3. Board certified or eligible with demonstration of active pursuit of board certification
  4. U.S. citizenship
  5. Evidence of ECFMG certification if graduate of a foreign medical school

The following are required for psychologists:

  1. U.S. citizenship
  2. Graduation from an APA-accredited doctoral program in Clinical or Counseling Psychology or from an APA-approved respecialization training program in Clinical or Counseling Psychology
  3. Successful completion of an APA-accredited doctoral internship.

The following are required for pharmacists:

  1. U.S. citizenship
  2. Completion of an ACPE-accredited Pharm.D. program
  3. PGY1 residency training
  4. Full/Unrestricted license to practice in the U.S. or any of its territories

Application

Interested applicants should submit a personal statement (maximum 2 pages), CV and three letters of reference. One of the references should be the training program director or medical director/chief of staff. The letter of interest should include: a brief summary of educational, clinical and research experiences relevant to addictions and a statement of career goals, including areas of focus you are interested in pursuing. Materials should be submitted by email to the program co-Directors, Geetha Shivakumar, MD (Geetha.Shivakumar@va.gov) or Jamylahk Jackson, Ph.D. at jamylahk.jackson@va.gov. Applications will be accepted until positions are filled.