While more than 21 million Americans live with a substance-use disorder, there are just 4,500 physicians nationwide who are board certified in addiction medicine or addiction psychiatry, according to figures from the Michigan Collaborative Addiction Resources & Education System (MI CARES).
An AMA Medical Student Section education session explored a project at Michigan State University College of Human Medicine that has incorporated addiction medicine training into the curriculum and created a pathway for board certification of new addiction-medicine subspecialists.
The AMA believes that science, evidence and compassion must continue to guide patient care and policy change as the nation’s opioid epidemic evolves into a more dangerous and complicated illicit drug overdose epidemic. Learn more at the AMA’s End the Epidemic website.
“In general, in undergraduate medical education, courses dedicated to addiction medicine are rarely, if ever, taught,” said Cara Poland, MD, MEd, associate professor of women’s health at Michigan State.
Dr. Poland noted that while there is no national data on the number of medical school hours dedicated to addiction medicine, she estimates it is between two and 10.
“Often, they're embedded within maybe a psychiatry clerkship, often taught by a general psychiatrist. Maybe there's bits and pieces depending on where a student does their primary care rotation," she said. “But there are very minimal expected competencies in the NBME [National Board of Medical Examiners] blueprints, meaning that most schools aren't able to prioritize this as a topic.”
Meanwhile, the drug-overdose overdose epidemic has made training in addiction medicine increasingly urgent, and medical students know it. Recent graduates of the medical school have even petitioned Michigan State for more education in this area.
“It was pretty clear that we were teaching our students how to take off the airplane, meaning start opioids, and how to land the airplane—meaning taper opioids or discontinue opioids after acute surgery or other acute events—but we weren't talking about what happens in the case of a midflight emergency,” such as a patient developing an opioid-use disorder, Dr. Poland said during the education session, which was recorded for the 2022 AMA Annual Meeting.
Longitudinal and lasting
The project at Michigan State is built around modules developed by MI CARES. The modules are incorporated into classroom electives offered at the end of each academic year, and students can also choose clinically based electives in years three and four.
The MI CARES modules—which are available free of charge to medical schools and students—are helping physicians obtain addiction-medicine certification so they can serve as core faculty at universities, “because you can't train medical students if you don't have the expertise in your institution to train them,” Dr. Poland said.
Michigan State initially offered the year-one elective to 32 medical students, but ended up increasing the cap to 36. Last year, it offered the course to 48 students and again upped its cap, this time to 52 students.
“We still have a wait list for this elective of 50 students of a class of 200,” Dr. Poland noted. “So that means over one-quarter of the students are saying: We want this education.”
Read about the other highlights from the 2022 AMA Annual Meeting.