On July 1, the first group of medical residents will start training in 10 newly accredited addiction medicine residencies around the country. The programs, accredited by the American Board of Addiction Medicine (ABAM) Foundation, will signal a new era in addiction medicine, says ABAM Foundation President Kevin Kunz, MD.
“The average primary care physician sees many patients with addictive disorders, but they often don’t have anyone to consult with or refer to in order to help these patients,” Dr. Kunz said. “The residencies will produce physicians with full training in addiction medicine to help with the care of these patients. Physicians who graduate from these residencies will be a vital component of the multidisciplinary teams that treat addictive disorders.”
Dr. Kunz says demand for addiction treatment will grow as more Americans become insured under the Patient Protection and Affordable Care Act that was signed into law last year. The program will begin with approximately 25 students. He anticipates that the ABAM Foundation will accredit an additional 10 residencies in 2012.
Creating National Standards
Until now, there have been no national standards for training in addiction medicine, Dr. Kunz said. He notes that separate courses in addiction medicine are uncommon in medical schools, and there are no addiction medicine residencies among the almost 9,000 residencies accredited in the United States by the Accreditation Council of Graduate Medical Education (ACGME). The residency programs will be required to meet the ABAM Foundation’s Program Requirements and Curriculum Objectives in evidence-based addiction medicine. The ABAM Foundation’s eventual goal is to have the addiction medicine residencies accredited by the ACGME, he said.
“The addiction medicine residency accreditation process is modeled on residencies in other fields, such as cardiology and sleep medicine,” says Richard Blondell, M.D., Chair of ABAM Foundation’s Training and Accreditation Committee, and Professor of Family Medicine at the University at Buffalo School of Medicine.
Inpatient and Outpatient Rotations
The one- to two-year programs, which will include a 12-month core educational component, will include rotations through inpatient and outpatient settings, with electives to round out residents’ training. “Someone coming in with a pediatric background may want to do an elective taking care of adults, while an internist might want three months in psychiatry,” says Dr. Blondell, who will head up the University at Buffalo School of Medicine’s addiction medicine residency program. Inpatient rotations may include a hospital-based rehabilitation program or medically managed residential program, while outpatient rotations may involve addiction medicine consult services or opioid replacement or maintenance programs.
“One-quarter of the program requirements will be determined by the program director, depending on the resources of the community,” Dr. Blondell said. “One medical school might have a really good addiction medicine consultation service that the residents can be assigned to, while in another city, a resident may have to rotate through several services, such as psychiatry and pain management, to get a similar experience.”
Dr. Blondell said that the impact of the program should be felt as soon as July 2012, when the first graduates finish the program. “We will begin to see a real formal identity to the specialty and from that changes will flow in practice patterns, education and in the public’s perception of addiction as a medical problem,” he said. “Addiction is a widespread problem, but addiction medicine has not been under the tent of organized medicine. We hope that these residencies allow more people who suffer with addiction to get the help they need.”
The following addiction medicine residency training programs will be training residents under ABAM Foundation accreditation starting this July:
• Boston University Medical Center Addiction Medicine Residency, Boston University Medical Center
• Geisinger Addiction Medicine Residency at Marworth, Geisinger Health System, Marworth Treatment Center
• Addiction Institute of New York Fellowship in Addiction Medicine, The St. Luke’s and Roosevelt Hospitals
New York, NY
• University at Buffalo Addiction Medicine Fellowship, University at Buffalo School of Medicine, Department of Family Medicine
• University of Florida Addiction Medicine Program, University of Florida College of Medicine, Department of Psychiatry
• University of Hawaii Addiction Medicine Training Program, University of Hawaii, John A. Burns School of Medicine
• Cincinnati Addiction Medicine Fellowship, University Hospital, University of Cincinnati College of Medicine, VA Medical Center
• University of Maryland-Sheppard Pratt Training Program, University of Maryland Medical System, Sheppard Pratt
• Minnesota Addiction Medicine Residency Program: UM-HCMC-VA, University of Minnesota Medical School, Department of Psychiatry
• University of Wisconsin Program, University of Wisconsin School of Medicine and Public Health, Center for Addictive Disorders