Internal medicine residency training for unhealthy alcohol and other drug use: recommendations for curriculum design

<p>Abstract</p> <p>Background</p> <p>Unhealthy substance use is the spectrum from use that risks harm, to use associated with problems, to the diagnosable conditions of substance abuse and dependence, often referred to as substance abuse disorders. Despite the prevalence and impact of unhealthy substance use, medical education in this area remains lacking, not providing physicians with the necessary expertise to effectively address one of the most common and costly health conditions. Medical educators have begun to address the need for physician training in unhealthy substance use, and formal curricula have been developed and evaluated, though broad integration into busy residency curricula remains a challenge.</p> <p>Discussion</p> <p>We review the development of unhealthy substance use related competencies, and describe a curriculum in unhealthy substance use that integrates these competencies into internal medicine resident physician training. We outline strategies to facilitate adoption of such curricula by the residency programs. This paper provides an outline for the actual implementation of the curriculum within the structure of a training program, with examples using common teaching venues. We describe and link the content to the core competencies mandated by the Accreditation Council for Graduate Medical Education, the formal accrediting body for residency training programs in the United States. Specific topics are recommended, with suggestions on how to integrate such teaching into existing internal medicine residency training program curricula.</p> <p>Summary</p> <p>Given the burden of disease and effective interventions available that can be delivered by internal medicine physicians, teaching about unhealthy substance use must be incorporated into internal medicine residency training, and can be done within existing teaching venues.</p

The need for an aging and cancer curriculum for hematology/oncology trainees

There has long been recognition for the need of education and training in aging and cancer. As the proportion of older individuals in the United States increases, with 20% being over 65 by 2030, it will become increasingly important for hematology–oncology trainees to have directed curriculum in geriatric-oncology. In order to better define the best way to meet the need for educational material specific to the special population of older patients for Oncology Training Programs, a survey was developed and administered to Hematology–Oncology Program Directors, in order to perform an educational needs assessment. The survey was administered during the 2008 Annual Meeting to 54 attendees at the Program Director's Breakfast. The survey asked questions regarding general program characteristics, as well as the importance of geriatric-oncology curriculum, a description of such current curriculum, the most important topics to cover in the curriculum, and recommendations for the format of the curriculum. The survey showed that 32% of training programs had a formal curriculum that covered topics in geriatric-oncology, 56% had an informal curriculum, and 2% had no curriculum. Most used a multimodality approach including clinical experience, journal clubs and lectures. Most hematology–oncology fellowship directors believe curriculum in geriatric-oncology is important; have faculty with either training or interest in geriatric-oncology that could facilitate curriculum delivery; and would use a curriculum if it were readily available. Investment in developing content and curriculum in geriatric-oncology would be very valuable and well-received