Educational leaders from Boston University School of Medicine (BUSM) believe teaching the subject of unhealthy substance use must be incorporated into internal medicine residency training and can be done within existing teaching venues. The findings, which currently appear on-line in BioMedCentral Medical Education, represent a national model for addressing this issue for internal medicine residents.
Unhealthy substance use can be serious and chronic and despite its prevalence and impact, medical education in this area remains lacking. Physicians need tools and expertise to address one of the most common and costly health conditions.
According to the authors, medical education has begun to address the need for physician training in unhealthy substance use. Formal curricula has been developed and evaluated, but broad integration into a busy residency program remains a challenge. In addition, many physicians fail to address substance use conditions due to discomfort with substance use-related patient discussions, deficient knowledge and clinical skills.
In order to address these issues, the BUSM researchers reviewed the development of unhealthy substance use related competencies, and describe a curriculum that integrates these competencies into internal medicine resident physician training. The researchers then outline strategies to facilitate adoption of such curricula by the residency programs. Their article also provides an outline for the actual implementation of the curriculum within the structure of a training program, with examples using common teaching venues. They describe and link the content to the core competencies mandated by the Accreditation Council for Graduate Medical Education.
"The time is right to improve, and require excellence in residency training about unhealthy substance use in internal medicine residency training programs," said lead author Angela Jackson, MD, Vice Chair for Education, department of medicine Director, Primary Care Training Program and an associate professor of medicine at BUSM. "Because clinical management for substance use is most effective when integrated with medical and other care, education should mirror this approach, integrating curricula on unhealthy substance use into overall residency training," she added.
Funding for this study was provided by the Betty Ford Institute.
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