Residents Eager for More Training on Opioid Addiction

Megan Brooks

May 15, 2018

NEW YORK — Incoming residents lack the experience and knowledge to address the opioid epidemic appropriately, and the vast majority of them want more formal training in opioid use disorder (OUD) during residency, preliminary results from the first wave of a cross-sectional survey show.

"We need innovations in education for residents and medical students so that they are better prepared to treat patients with opioid use disorder," Isabella Morton, MD, MPH, from the University of Maryland Medical Center in Baltimore, told Medscape Medical News.

Morton and her colleagues developed a 33-item survey to evaluate incoming residents' knowledge of and attitudes toward OUD. They plan to give the survey to incoming residents during the next 4 years.

The results were presented here at the American Psychiatric Association (APA) 2018 annual meeting.

Clear Unmet Needs

The preliminary findings from the first year of the survey included in-person interviews with 52 residents — 16 in psychiatry, 15 in internal medicine, 14 in emergency medicine, and seven in obstetrics and gynecology — who were in their first month of training at the University of Maryland Medical Center.

Overall, more than one third (38%) of those surveyed said they had received no formal training in OUD in medical school. Only 15% felt knowledgeable about OUD treatment and resources in their community.

Nearly half of all residents (48%) and 31% of psychiatry residents said they felt unprepared to diagnose OUD, and an "impressive" 84% of all residents and 94% of psychiatry residents said they wanted more formal training in residency in the treatment of OUD, Morton said.

About 44% of all residents felt unprepared to diagnosis opioid withdrawal. The figure was 25% among psychiatry residents.

"Many residents complained that they didn't get any training on what to do when a patient came in with opioid use disorder and in withdrawal. We felt like this was a really significant problem that wasn't being adequately addressed in training in our residency," Morton told Medscape Medical News.

Reached for comment, Frances Levin, MD, professor of clinical psychiatry at Columbia University in New York City, said the results of this survey are noteworthy because they "demonstrate that the needs expressed by students are not matched by the responsiveness of the faculty providing the training."

The results are also not surprising, and it's "good that students want more training," said Levin, who heads the Addiction Psychiatry Fellowship Program at New York–Presbyterian Hospital. Training in OUD should be addressed in medical schools, said Levin.

The study had no commercial funding. The authors and Dr Levin have disclosed no relevant financial relationships.

American Psychiatric Association (APA) 2018. Poster P2-005, presented May 5, 2018.

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