Highland Hospital-Alameda Health System Addiction Medicine Fellowship is a 12 month fellowship in a medically underserved community within Oakland, California. Our safety-net hospital has a high prevalence of substance use disorders, and we are the most consulted specialty service within our system. Our radically low barrier Bridge clinic sees 100-150 patients per day with a variety of use disorders, and we are a top performer in the state of California for followup after acute care.