Overview
The Concurrent Disorders & Pain Nursing Fellowship is an advanced practice opportunity for nurses seeking to expand their expertise in mental health, substance use, and complex pain. Led by Fellowship Director Jessica Machado and delivered through the Azar Lab in partnership with Vancouver Coastal Health, this fellowship combines immersive clinical rotations with targeted academic learning. Fellows will work alongside leading clinicians across specialized sites, contribute to innovative research, and develop the skills needed to lead in integrated, person-centered care.
What you'll gain
Learning activities
Fellows will engage in a range of academic and professional development experiences designed to deepen clinical insight and sharpen leadership skills. Learning activities include but are not limited to:
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Capstone Project: an independent inquiry or initiative developed under faculty guidance for a conference presentation
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Complex Case Rounds: interdisciplinary discussions focused on challenging real-world cases
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Research & Education Seminars: exposure to emerging evidence, systems thinking, and quality improvement
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Participation in Research Activities: fellows are invited to attend research meetings and lab presentations (note: these are not always compensated, and participation is expected in the spirit of professional development and volunteerism)
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Monthly Journal Club: Fellows attend monthly journal club sessions and are expected to present at least once during the fellowship.
Rotations
Fellows will progress through a structured rotation pathway beginning with foundational placements in hospital-based mental health and addiction care, followed by community-based and pain-specific experiences, and concluding with a final consolidation placement. Clinical sites include:
Foundational Placements (First 6 months — 26 weeks total)
Duration: 3 months
CPAS is an inpatient consultation team that serves the entire hospital. It is broken up into several “lines” with dedicated physicians that cover specific care areas during the week, covering both complex pain and substance use, as well as mental health challenges in patients. While every service line does see these types of patients, certain lines will have exposure to specific patient populations more so though than others.
Duration: 3 months
Psych-CL is consult team that assesses admitted patients for mental health challenges throughout the whole hospital after receiving a direct consultation from the attending physician.
Specialized Community-Based Placements (2.5 months — 10 weeks total)
Duration: 2 weeks
AAC is a pivotal entry point for individuals aged 17 and over experiencing non-life-threatening mental health and substance use concerns in Vancouver. Operating within the Joseph & Rosalie Segal & Family Health Centre, the AAC offers services including mental health and substance use assessments, crisis intervention, short-term treatment, and referrals to appropriate Vancouver Coastal Health services. The centre emphasizes low-barrier, client-centered care, ensuring timely connection to necessary resources.
Duration: 4 weeks
This Primary Care Clinic, situated in Vancouver’s Downtown Eastside operates under the BC Centre for Excellence in HIV/AIDS (BC-CfE). Established in late 2019, the clinic delivers interdisciplinary, low-barrier, and evidence-based care to individuals with complex medical, mental health, and substance use challenges. The clinic's model emphasizes proactive, coordinated care, integrating harm reduction strategies and psychosocial supports to address the multifaceted needs of its clientele.
The H2H clinic offers a comprehensive range of services, including primary care, mental health support, addiction treatment programs (such as opioid agonist therapy), and access to diagnostics like ECG and blood work. The clinic's interdisciplinary team comprises family physicians, nurse practitioners, registered nurses, licensed practical nurses, social workers, peer support specialists, and allied health professionals. This collaborative approach ensures holistic care, addressing both medical and social determinants of health.
Duration: 4 weeks
Foundry Vancouver-Granville is an integrated health and wellness centre serving youth aged 12–24. Operated by Providence Health Care and supported by St. Paul’s Foundation, it offers a comprehensive suite of services under one roof, including: Mental health care, Substance use services, Primary health care, Youth and family peer supports, and Social services. The centre emphasizes early intervention and provides navigation to specialized services, creating seamless pathways of care. Given its downtown location, it often serves youth requiring higher-intensity service.
Specialized Pain-Focused Placements (2 months — 8 weeks total)
Duration: 4 weeks
TPC is located at the Gordon and Leslie Diamond Health Care Centre, is a short - term interdisciplinary pre- and post-surgical program that supports patients in preparing for surgery and recovering from post-surgical pain or trauma. Rooted in a philosophy of compassion, nonjudgment, respect, and shared learning, TPC recognizes each client’s pain as real and uniquely shaped by biological, psychological, social, and spiritual factors. Using a biopsychosocial framework, the clinic provides multi-modal, evidence-informed care through a team of physicians, nurses, psychologists, physiotherapists, and occupational therapists.
Fellows in this placement will engage in comprehensive pain assessments, observe and support individualized care planning, and contribute to trauma-informed patient education on pain science, opioid safety, and self-management strategies. The placement emphasizes collaborative practice, opioid stewardship, and functional goal-setting. Fellows will also participate in weekly interdisciplinary team huddles, shadow consults, and reflect on pain care delivery in an outpatient setting that prioritizes early intervention and prevention of chronic post-surgical pain.
Duration: 4 weeks
The POPS team is involved in the management of surgical post-operative pain control with a multi-modal pain approach to assist with early rehabilitation. They have a multidisciplinary team approach to care, with involvement from nurse clinicians and anaesthesiologists. Fellows participating in this program will have frequent exposure to many routes of medication but will be able to see frequent intravenous (IV) routes of pain control and management through Patient Controlled Analgesia, as well as other IV pain modalities, such as ketamine infusions, nerve blocks, and epidurals.
Final Consolidation Placement (2 months — 8 weeks total)
Duration: 8 weeks
In the final two-month placement of the fellowship, nursing fellows will return to the Complex Pain and Addiction Service (CPAS) to consolidate their learning and demonstrate advanced clinical competencies. Fellows will independently conduct comprehensive assessments, provide ongoing follow-up care, and address patient-needs via treatment plans for patients living with concurrent disorders, complex pain, and/or substance use/mental health disorders. Clinical practice is supported through regular case reviews with a supervisor.
This placement emphasizes the transition from advanced beginner to independent practitioner. Fellows are expected to integrate knowledge and skills acquired across all previous placements, with a particular focus on leadership in practice. A key component of this placement involves providing education and mentorship to other health care providers, especially nursing colleagues through formal and informal teaching opportunities. Fellows will also finalize and evaluate their learning goals, preparing to exit the fellowship with confidence in their ability to lead in this specialized area of care.
Fellowship structure
Program duration
12 months, one 8 hour clinical shift per week.
Schedule
Core hours: Typically Monday to Friday, 9:00 AM – 5:00 PM
(Some activities such as research meetings or conferences may occur outside these hours.)
Compensation
Fellows are paid at the appropriate rate based on their current FTE and receive payment via direct self-employment cheque.
Employment Status
Your employment status is not affected. The fellowship runs in addition to your current role.
Application
Applicants must be registered nurses in good standing with the BCCNM. A minimum of one year of clinical experience in mental health, substance use, or pain management is recommended but not required.
Important: Completion of the following required prerequisite courses before the program start date:
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Open to RNs and RPNs
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Must be currently employed
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Community-based nurses are welcome to apply; if located outside the Lower Mainland, please contact Jessica Machado to discuss feasibility of participation
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Commitment to the full duration of the fellowship (12 months, 1 day per week)
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Completed Application Form (Jump to application form →)
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Current CV or Résumé
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Personal Statement (Maximum 500 words). Your statement should address:
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Your clinical and professional background, and how it has prepared you for this fellowship
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Your motivation for applying to a Concurrent Disorders & Pain Fellowship
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Your personal and professional learning objectives, and how completing the fellowship will support them
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Any specific interests in clinical placements, rotations, or research activities
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Three Letters of Reference:
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Academic — addressing your clinical knowledge and experience
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Professional — ideally from a current supervisor or manager, indicating their support for your participation
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Character — speaking to your integrity, leadership, or commitment to service
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Applications Open: June 1, 2025
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Application Deadline: September 1, 2025
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Interviews Conducted: October 6, 2025
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Notifications Sent: November 3, 2025
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Deadline for Acceptance Offer by Applicant December 1, 2025
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Fellowship Start Date: January 5, 2026
Note: There may be some flexibility with the start date depending on the applicant’s schedule.
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Fellows are expected to attend research meetings, educational sessions, and other enrichment activities as part of the broader learning experience. These activities are not always financially compensated and are considered part of the fellowship’s spirit of professional development and volunteerism.
FAQ
You will be paid at your current hourly rate based on your existing full-time equivalent (FTE). Depending on your FTE, this may include straight time or overtime pay, along with additional compensation in lieu of benefits and premium rates. Payment is issued via a direct self-employment cheque. You will also receive additional stipends for approved continuing education courses and conferences, which may cover travel, accommodation, and/or registration costs. If you have any questions about your specific compensation details, please reach out to Jessica Machado.
The fellowship runs one day per week, Monday to Friday, from 9:00 AM to 5:00 PM. During the first six months, one weekend day per month will be scheduled for on-call shifts in place of a weekday. Some components, such as online workshops, academic work, or scholarly contributions may occasionally fall outside of these hours.
You will receive advance schedules to support coordination with your primary clinical responsibilities. Flexibility and proactive communication with your manager will be essential to successfully integrate the fellowship with your ongoing work.
No. The fellowship is designed to complement your existing FTE and clinical duties. You will retain your current role, benefits, and entitlements. This program supports nurses who wish to pursue extended learning in concurrent disorders and complex pain while continuing their current employment.
Yes, nurses from all practice settings are encouraged to apply. Shifts are typically scheduled between Monday to Friday, and therefore, if working a rotation that exclusively is M-F, this opportunity may not be possible. If you're based outside the Lower Mainland, please connect with Jessica Machado to discuss logistics and potential clinical placement options.
You will be recognized as a Nursing Fellow throughout the program. This title reflects your engagement in a structured, advanced practice and professional development opportunity.
Please reach out to Fellowship Director Jessica Machado for any inquiries related to the program or application process.
You will be supported by a dedicated fellowship leadership team, site supervisors, clinical mentors, and a research team. Ongoing mentorship, structured evaluations, and personalized feedback will help you build advanced practice skills with confidence, as well as build expertise in domains such as education, leadership, and research.
The fellowship is designed to complement your current FTE, but it does require time management and proactive planning. Fellows are encouraged to schedule protected time for fellowship days, stay in regular contact with their managers, as well as the Fellowship team and utilize tools like shared calendars and milestone trackers. The program also provides structured check-ins and mentorship to help you maintain balance and identify support early if you're feeling overwhelmed.
Life happens. If you need to take a temporary leave from the fellowship, please connect with the Fellowship leadership team as soon as possible. We’ll work with you to explore options such as a modified schedule, temporary pause, or deferred completion, depending on the circumstances and program timelines.
Yes. Upon successful completion of the program, you will receive a Fellowship Certificate that can be used for professional development portfolios. This includes documentation of your hours, learning outcomes, and scholarly contributions.