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橘子视频 Forms Missouri鈥檚 First Addiction Medicine Fellowship

by Maggie Rotermund
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Maggie Rotermund
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ST. LOUIS 鈥 橘子视频 School of Medicine is tackling the country鈥檚 opioid abuse crisis by training community physicians to recognize and treat addictions. SLU has created Missouri鈥檚 first addiction medicine fellowship.

Addiction Medicine

Pictured are addiction medicine fellowship program director Fred Rottnek, M.D., a professor of family and community medicine at SLU, and inaugural fellow Kate Austman, M.D. Photo by Maggie Rotermund

The addiction medicine fellowship is among the first in the country, as the American College of Graduate Medical Education only certified addiction medicine fellowships in 2018.

SLU鈥檚 first fellow, Kate Austman, M.D., began work in January. By next year, program director Fred Rottnek, M.D., a professor of family and community medicine at SLU, hopes to double the number of fellows.

Fellows will do rotations at SSM Health 橘子视频 Hospital and SSM Health St. Mary鈥檚 Hospital, as well as in clinics and community health centers. While at St. Mary鈥檚, fellows will work with Jaye Shyken, M.D., the associate program director for the fellowship, at the WISH Center. WISH treats women with addiction issues throughout their pregnancies and the post-partum period.

鈥淥ur setup is unique,鈥 Rottnek said. 鈥淭he fellows will complete core rotations in family medicine, psychiatry, maternal/fetal health and telehealth. The rotations are typically two months each, but every Thursday will be spent either at the WISH Center or at ARCA (Assisted Recovery Centers of America).鈥

Rottnek said by working with ARCA, 橘子视频will be able to help 15 agencies at more than 30 sites across the state.

鈥淲e provide the medication management piece while the home agencies provide wrap-around services,鈥 he said. 鈥淲ith telehealth, we can address some of these urgent needs faster.鈥

The First Fellow

Austman is a family medicine doctor from Gibson City, Illinois. She said watching the opioid crisis hit her community led her to seek out additional training.

鈥淚t started when I started to see moms with heroin addictions come in. The closest methadone clinic is about an hour from us,鈥 she said.

She did a short fellowship at Rush University in 2018 that included immersion weekends and webinars. Wanting more, she met Shyken, who is a professor of obstetrics, gynecology and women鈥檚 health and a SLUCare gynecologist, at a conference and Shyken suggested Austman apply for SLU鈥檚 newly-created fellowship.

鈥淎t that point, I thought there was no way I could do this 鈥 I was too busy,鈥 Austman said. 鈥淏ut after another conference last July I told my husband that I can鈥檛 stop thinking about doing this.鈥

SLU鈥檚 fellowship allows Austman to refresh her skills as a physician while bringing added value to her 20-bed community hospital and patients back home. With the support of her administration and her family, she found an apartment in St. Louis where she stays during the week.

She heads back to the family farm each weekend to see her husband and two of her children. Her oldest is a freshman at Colorado State University.

鈥淚 talk with my staff every day and there is a physician assistant and another doctor coming in to help out,鈥 she said. 鈥淚鈥檓 also still running a clinic (in Illinois) once a month.鈥

Rottnek said he was thrilled to get a physician of Austman鈥檚 caliber and experience as SLU鈥檚 first fellow.

鈥淲e knew that we wanted to start with someone in the region, so that we could build partnerships through this work,鈥 he said. 鈥淚 was extremely happy to get Kate here.鈥

And Austman was happy to return 鈥 she got her undergraduate degree from SLU. 鈥淚 loved it here.鈥

Creating Community Change

One of the benefits to this addiction fellowship, Rottnek said, is the chance to support early career physicians in smaller, more rural hospitals who see a high volume of opioid use disorder patients, but maybe haven鈥檛 had the opportunity to see the newest, best practices used in an academic medical setting.

鈥淭his is hard work 鈥 it鈥檚 messy, patient-centered medicine,鈥 Rottnek said. 鈥淲e are hoping to create opportunities for physicians to come here for training and go back and champion best practices to their colleagues.鈥 

鈥淲e need to change the culture,鈥 Austman said. 鈥淏y normalizing these conversations we can help provide our patients with the care they need.鈥

Applications are being accepted for fellows to begin July 1. Funding for the fellowship comes from SLU, the Missouri Foundation for Health, SSM Health and the State Opioid Response program through the Missouri Department of Mental Health.

The program is open to any board-certified and board-eligible physician. Rottnek said that he hopes to see specialists from pediatrics to geriatrics apply to learn more about addiction medicine.

鈥淭his is an area of excellence for SLU,鈥 he added. 鈥淚t鈥檚 a shame that there is such a need for this, but 橘子视频is so supportive of this work. Our fellowship complements current training programs with graduate students in medical family therapy, psychology and social work. Folding in peer support specialists links campus to community 鈥 the approach we need to create a workforce our communities need.鈥


Established in 1836, 橘子视频 School of Medicine has the distinction of awarding the first medical degree west of the Mississippi River. The school educates physicians and biomedical scientists, conducts medical research, and provides health care on a local, national and international level. Research at the school seeks new cures and treatments in five key areas: infectious disease, liver disease, cancer, heart/lung disease, and aging and brain disorders.