Expression of Interest - Medical Director, Addiction Medicine Specialist

Pay: CA$200.00-CA$250.00 per hour

Position: Medical Doctor - Addiction Medicine Specialization

Job Type: Fixed-term Contract

Work Location: Flexible – In-Person and Virtual

Application Deadline: Open until filled

Anticipated Start Date: As soon as possible

Job description:

I. Introduction

Orca Lelum is seeking expressions of interest from a qualified Medical Doctor (MD) specializing in Addiction Medicine to serve as the Medical Director and provide medical oversight, prescribing authority, and clinical leadership for BC’s first Indigenous youth withdrawal management and wellness centre.

Orca Lelum is an Indigenous-led youth wellness centre on Vancouver Island providing culturally grounded, trauma-informed care for Indigenous youth navigating substance use and mental health challenges.

Orca Lelum offers a 10-week live-in wellness program for Indigenous youth aged 12–18 who are navigating substance use challenges, mental health concerns, and healing from trauma.

The program is delivered through a holistic model of care that integrates medical supervision and primary care support, individual and group counselling, wellness planning, therapeutic activities, and Indigenous cultural practices and teachings. All programming and operational practices at Orca Lelum aim to provide services through a trauma-informed, culturally rooted, and holistic framework, ensuring care that supports the physical, emotional, mental, and spiritual wellbeing of each young spirit.

Our approach is guided by Snuwuyulh (traditional teachings), the 4 posts of the longhouse (mind, body, spirit, and heart), and the Canoe Model, which emphasizes unity, resilience, and collaborative healing.

In addition to delivering the 10-week live-In Wellness Program, commencing April 2027 Orca Lelum will offer withdrawal management services delivered within a culturally rooted, trauma‑informed medical environment at the new Withdrawal Management Centre.

The Withdrawal Management Centre will serve as the exclusive site for withdrawal management services for youth presenting with moderate levels of acuity. Services provided at the Withdrawal Management Centre include structured transitions from moderate acuity withdrawal management to either Orca Lelum 10-week Live-In Wellness Program or bridging to other care.

Withdrawal management services will be delivered within a culturally rooted, trauma-informed medical environment using CIWA-Ar (Clinical Institute Withdrawal Assessment for Alcohol-revised), COWS (Clinical Opiate Withdrawal Scale) and SWS (Stimulant Withdrawal Scale) protocols. Services are limited to licensed scope and staffing capacity with clear escalation thresholds to hospital maintained.

II. Scope of Work & Deliverables

The Medical Doctor will report to the Wellness Program Director and serves as the primary medical authority for Orca Lelum, ensuring safe, effective, and culturally responsive medical care for youth. The physician will bring clinical expertise in addiction medicine to support withdrawal management, medication safety, and ongoing medical care for youth within the program.

1. Prescribing Authority & Medical Decision-Making

· Serve as the primary medical authority for prescribing, modifying, or discontinuing medications related to participant care within the program.

· Provide specialized addiction medicine consultation related to:

o Opioid use disorder

o Alcohol use disorder

o Stimulant use disorder

o Cannabis use disorder

o Concurrent mental health and substance use conditions

o Withdrawal management and stabilization

· Review and approve all medication orders, standing medical directives, withdrawal protocols, and harm reduction approaches applicable to Orca Lelum participants.

· Support evidence-based pharmacological interventions, including opioid agonist therapy (OAT), symptom management, relapse prevention, and psychiatric medication management where appropriate.

· Provide medical input into complex clinical decision-making related to participant safety, acuity, mental health, withdrawal risk, and capacity for care within the program.

2. Scheduled Medical Reviews

· Conduct regularly scheduled medical and addiction medicine reviews for participants enrolled in the program, either virtually or in person, at a frequency agreed upon in the service contract.

· Complete assessments related to:

Withdrawal and stabilization
Mental health and psychiatric symptoms
Substance use patterns
Physical health concerns
Medication management
Readiness for treatment and discharge planning

Document medical assessments, recommendations, and follow-up plans in accordance with College of Physicians and Surgeons of BC standards, provincial regulations, and organizational policies.

3. Medical Directives, Standing Orders & Protocols

· Develop, review, and authorize written medical directives and standing orders to guide nursing and non-regulated staff in:

Medication administration
Withdrawal assessment and monitoring
Symptom management
Escalation protocols
Emergency response

· Review and update withdrawal management protocols for alcohol, opioids, stimulants, cannabis, and polysubstance use as clinically indicated or at minimum annually.

· Ensure directives align with:

Evidence-based addiction medicine practices
BC Centre on Substance Use (BCCSU) guidance
College of Physician and Surgeons of BC standards
Trauma-informed and culturally safe care principles
Orca Lelum’s holistic model of wellness

4. Medical Oversight & Clinical Governance

Provide consultation, review, and approval in the following areas:

· Assessment of youth acuity and determination of staff capacity to safely meet individual needs

· Intake appropriateness and medical suitability for admission

· Withdrawal management planning and individualized care planning

· Ongoing assessment of medical and psychiatric stability

· Review and approval of intake, assessment, and discharge processes

· Guidance on the management of acute or chronic medical conditions

· Approval of diagnostic testing, procedures, and medical interventions as required

· Support prioritization of program entry for wait-listed youth based on acuity and available resources

5. On-Call Medical Consultation

Provide on-call medical consultation to Orca Lelum staff during agreed-upon hours to support decision-making related to:
Withdrawal concerns;
Medication issues
Mental health crises;
Intoxication or overdose risk
Escalation of care;
Emergency transfers.
Respond to urgent consultation requests within response timeframes specified in the service agreement.

6. Medication Safety, Quality Assurance & Risk Management

Provide oversight of medication management systems, including review of medication safety practices, pharmacy audits, controlled medication monitoring, and incident reports.
Participate in medication-related quality assurance activities, including review of adverse events and implementation of corrective actions as required.
Contribute to interdisciplinary case reviews, chart audits, and incident reviews to support continuous quality improvement and youth safety.

7. Discharge Planning, Escalation & Continuity of Care

Participate in discharge planning for participants requiring ongoing medical, psychiatric, or addiction follow-up.
Provide prescriptions, recommendations, referrals, and continuity planning as appropriate.
Provide medical input into decisions regarding escalation of care, including referral to emergency services, psychiatric services, detox, or hospital transfer when medically indicated.
Liaise with family physicians, psychiatrists, specialists, pharmacists, Indigenous health providers, and community care teams to ensure continuity of care and safe transitions.

8. Mentorship, Coverage & Continuity

· Provide mentorship and clinical guidance to nursing and clinical staff.Support staff education related to:

Addiction medicine
Harm reduction
Withdrawal management
Trauma-informed care
Medication safety
Youth mental health
Ensure appropriate and qualified medical coverage is in place during periods of absence to maintain continuity of oversight and care.

9. Culturally Informed & Evidence-Based Practice

Ensure all clinical practices align with evidence-based guidelines, regulatory standards, and principles of cultural safety.
Support the respectful integration of Indigenous health practices and ways of knowing alongside Western medical models.
Promote ethical care, patient safety, and positive health outcomes for Indigenous youth.

III. Qualifications & Experience

The successful candidate will have:

Medical Doctor (MD) designation with current full licensure and registration in good standing with the College of Physicians and Surgeons of British Columbia (CPSBC). Specialized training and/or certification in Addiction Medicine, such as:
Canadian Society of Addiction Medicine (CSAM) certification
Fellowship or enhanced competency in Addiction Medicine
Demonstrated equivalent clinical experience in addiction medicine practice
Experience working with:
Youth and adolescent populations
Withdrawal management and stabilization
Concurrent mental health and substance use disorders
Trauma-informed care settings
Demonstrated ability to provide:
Medical oversight
Prescribing authority
Clinical governance
Leadership within interdisciplinary teams
Experience with:
Medical directives
Standing orders
Medication safety oversight
OAT and harm reduction approaches
Experience working with Indigenous communities or demonstrated commitment to culturally safe, relational, and humble practice.
Knowledge of BC provincial addiction medicine resources, pathways, and regulatory requirements is considered an asset.

IV. Expression of Interest Requirements

· A brief professional background outlining relevant experience

· A statement of interest in working with Indigenous youth in substance use treatment

· Details of availability and preferred service delivery model (e.g., in-person, virtual, hybrid)

· Contact information for two professional references

V. Submission Instructions

Proposals must be submitted electronically to Nikita D’Souza at careers@orcalelum.ca

We look forward to reviewing your proposal and potentially working together to provide transformative care and wellness services to youth at Orca Lelum.

Thank you for your interest in supporting the healing and wellness of Indigenous youth.

Pay: $200.00-$250.00 per hour

Work Location: Hybrid remote in Lantzville, BC

Orca Lelum

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Expression of Interest - Medical Director, Addiction Medicine Specialist