1. Joan B. Kernan Shannon Carlin-Menter

2. Purpose: gather preliminary data on where programs are and how we can provide assistance. Survey Responses 70% of Programs Responded/ 16 of 23 3 email reminders 70% completed the Survey Monkey 35% completed a budget/ 8 of 23 22% did not have a budget or could not break it out Program Director Experience n=16 (including other programs besides ADM) 37% 0 -1 year 13% 1-2 years 50% > 2 years

3. Number of Unfilled Fellowship Positions N=16 (due to insufficient funding for the training year starting July 2014) Mean # unfilled positions.5 6 programs have 1 unfilled position: 38% 1 has 2 unfilled positions: 6% 9 have 0 unfilled positions:56%

4.  Program Administration: This includes the day to day human resources and administrative operations to ensure the viability of the ADM Program.  Items were rated from 1 = Strongly Disagree to 5 = Strongly Agree. Agree and Strongly agree responses were combined here as Agree/Strongly and Strongly Disagree, Disagree and Neutral were combined into Disagree/Neutral. Note: statements have been abbreviated from the original survey.

5. Strengths Identified in Program Administration Excellent faculty (2) Experience running an addiction program (2) Person developing overall strategy and advocating for investment Ability to 'piggy-back' on strong Addiction Psych fellowship, wide variety of training sites, support from NIH clinical trials (fellows fill study physician roles) Needs Little administrative support (2) Overburdened bureaucracy Still solidifying funding Need resources to protect time for program director and faculty. Protected funding, more departmental of GME support

6.  Faculty Development: This includes the enhancement of educational knowledge and skill of faculty members so their educational contributions can extend to advancing the educational program and not just teaching in it. Items were rated from 1 = Strongly Disagree to 5 = Strongly Agree. Agree and Strongly agree responses were combined here as Agree/Strongly and Strongly Disagree, Disagree and Neutral were combined into Disagree/Neutral. Note: statements have been abbreviated from the original survey.

7. Needs or Strengths Identified within Faculty or Faculty Development Scholarly activity is not emphasized for attendings, though it is available Child/adolescent is limited, though we do have clinicians with experience with young adults While we have a fair number of addiction psychiatrists, we would like to involve more addiction medicine faculty in the training program. Youth/adolescents currently not a strength, not currently a clear training site and/or faculty at our center. Faculty across Medicine and Psych are very strong, many with common experience supervising residents and Addiction Psych fellows.

8.  Educational Supports: This includes services to enhance academic experiences for students, such as curriculum, clinical and academic experiences, evaluation, and ongoing quality improvement. Items were rated from 1 = Strongly Disagree to 5 = Strongly Agree. Agree and Strongly agree responses were combined here as Agree/Strongly and Strongly Disagree, Disagree and Neutral were combined into Disagree/Neutral. Note: statements have been abbreviated from the original survey.

9. Educational Supports % Lower Agreement Note: statements have been abbreviated from the original survey.

10. Strengths Identified in Educational Supports SBIRT curriculum under development with our Youth Addiction and Concurrent Disorders Program Needs Developing a more efficient and useful evaluation process, funding for educational programs and conference attendance for residents. We haven't completed a full fellowship year yet, so much of this is still a work in progress.

11. Please think about what your ADM Program "needs" to be successful and LIST your Top 5 Needs Funding mentioned by 50% of programs  Funding for admin support  Expand program  Increased Institutional funding for other fellowship spot  (2x) Additional fellowship salary/benefits  Licensing, CME, Coursework & Professional Development  Flexible funding sources  Stipend support for 1-2 fellows - consistent source of funding not dependent on clinical revenues.

12. Institutional Support mentioned by 38% of programs  (2x) for inpatient ADM service  Faculty admin time  Protected time for faculty/Program Director  Adequate support for program director and core faculty  Time and resources for scholarship / research  Compensated, dedicated time for program director  More faculty supervision time. Administrative Support mentioned by 31% of programs  No coordinator to assist

13. Resources mentioned by 25% of programs  Milestones  Model curriculum documents  Evaluations  Model documentation for evaluating fellows and faculty  An online resource for all the necessary forms (evaluations, milestones, etc.) to meet ACGME accreditation requirements.

14. Scholarship/Research mentioned by 25% of programs  Time & resources for scholarship/research  More faculty involved in scholarly activity  Journal club, Ideas for scholarly activity.

15. Marketing/Recruitment mentioned by 25% of programs  Improved marketing presence (website, site directors of family medicine residency programs) for recruitment  Strong applicant pool  Strong addiction medicine faculty  Recruitment of fellows.

16. Adolescent Outreach mentioned by 19% of programs  Access to child/adolescent treatment  More work with adolescents.  Youth/adolescents not currently a clear training site and/or faculty at our center.

17. Other Uncategorized Needs Mentioned by Programs ~ Clearer guidelines on how to adjust the program for residents coming in with different backgrounds ~ Greater integration with community primary care providers ~ More collaboration across disciplines (psychiatry, family medicine, pain/anesthesia, etc.) ~ Limited didactics (would appreciate guidance for this) ~ Network of program directors and fellows ~ More training in primary care setting, with SBIRT.

18. ADM Program Budget Worksheet Responses– 35% 2013-2014 Average Revenue [Hospital support (4x), Psychiatry clinical revenue, VA grant, VA PGY-4 funding, Federal grant, Donation $129,621.83 Average Expenses $178,195.77 Program Director Salaries $49,022 @.2 fte; 150,000 25,000 62,500 85,600 98,800 @.5 fte % share of expenses that are fixed and part of budget. 0%, 10%, 50%, 60%, 66%, 75% % share of expenses that are variable to new FTE slots and require new funding. 0%, 25%, 30%, 34%, 40%, 50%, 100%