In the summer of 2014, Professor Cor de Jong of the Nijmegen Institute for Scientist Practitioners in Addiction (NIPSA) Radboud University Nijmegen, The Netherlands, initiated and hosted a meeting of an international group of Addiction Medicine (AM) physicians and educational specialists. Those attending came from the UK, Canada, Switzerland, Belgium, Norway, Lithuania and The Netherlands. The aim of the meeting was to explore how AM could be better positioned with medical training. By bringing together those involved in initiatives to improve education in training of medical students and qualified doctors in substance misuse and addictions many issues were aired. The first day was given over to sharing of best practice and identifying any common issues, with the central one being the barrier to the introduction of AM training into mainstream medical education. Day two was about moving forward to develop a comprehensive educational model for AM, drawing upon recent initiatives from the UK, Canada and the Netherlands.
As a result of the meeting a set of consensus statements was developed and agreed:
- Excessive substance use and addictive behaviours are common, associated with different medical problems, and present a great burden for the individual and society.
- Patients with excessive substance use and addictive behaviours are insufficiently identified and receive inadequate care.
- These patients are often confronted with negative perceptions and attitudes among health professionals, including medical doctors.
- Training in Addiction Medicine can improve knowledge, attitudes and clinical practice related to addiction and addictive behaviours.
Furthermore, the group concluded that it is in the best interests of patients and health policy to make addiction medicine interesting and relevant for young physicians. [Interestingly this issue was one of those explored in the 2015 SSA Society Lecture “Integrating treatment for substance use disorders into mainstream medicine: Who benefits? “ by Thomas McLellan]. The group recommended that universities should develop an AM curriculum that allows physicians to be competent at screening for problematic substance use and addictive behaviour in all patients, and to work with patients with addiction in all medical disciplines.
Every medical faculty is encouraged to have: -
- An addiction medicine training program in the undergraduate curriculum, with both in depth (elective) blocks and teaching strands across the years of medical school, with a recognised coordinator for the AM curriculum.
- Meetings with all concerned teachers and students to discuss the core aims and learning outcomes of AM training.
- A focus on a broad set of competencies ( figure 1) in order to develop skills, knowledge and attitudes related to addiction and addictive behaviours at various levels (undergraduate, post graduate, specialist) (figure 2 ).
- People in recovery from addiction involved in the development of the program and teaching.
- A multidisciplinary team of professionals (including general practitioners, psychologists, AM physicians, psychiatrists and scientists) involved in the development of the program and teaching.
- Formal evaluation of the identified learning objectives.
The group were pleased to be able to air these matters at the International Society for Addiction Medicine Congress 2015 over a day and half and also to link with nurses concerned about addiction education. This has led the group to start working on a road map for taking AM training forward in order to bridge the current treatment gap for patients with excessive substance use and addictive behaviours. An interesting outcome from the ISAM Congress was a commitment to explore the issue of AM further. Finally a crucial next step is to further engage the international field and those working in education roles to convince medical schools to implement an internationally-approved AM training.
On behalf of the “Radboud Invitational conference International Addiction Medicine Training 2014”
Prof. Dr. Cor De Jong
Prof. Dr. Barbara Broers
Dr. Arnt Schellekens
Mrs Christine Goodair
Prof. Dr. Cor De Jong, Nijmegen Institute for Scientist Practitioners in Addiciton (NISPA), Radboud University Nijmegen, The Netherlands. NISPA.DEJONG@GMAIL.COM
Effectiveness and Organization of Addiction Medicine Training Across the Globe. Ayu AP, Schellekens AF, Iskandar S, Pinxten L, De Jong CA. Eur Addict Res. 2015;21(5):223-39. doi: 10.1159/000381671.
Integrating treatment for substance use disorders into mainstream medicine: Who benefits? Dr Thomas Mclellan PhD http://www.addiction-ssa.org/symposium/presentation/integrating-treatment-for-substance-use-disorders-into-mainstream-medicine
See also The Substance Misuse in the Undergraduate Medical Curriculum Project in the knowledge hub section.
The opinions expressed in this commentary reflect the views of the author(s) and do not necessarily represent the opinions or official positions of the Society for the Study of Addiction.