A national survey of training in substance use disorders in residency programs

Objective: To determine the amount of formal training in substance use disorders that occurs in selected residency programs and to identify the perceived barriers to such training. Method: A national survey was conducted of program directors in emergency medicine, family medicine, internal medicine, obstetrics/gynecology, osteopathic medicine, pediatrics and psychiatry. In 1997, program directors were mailed a brief survey to determine the extent to which required training in substance use disorders occurred and the median number of hours devoted to substance use disorders training. Follow-up telephone surveys were conducted with faculty designated in the survey as responsible for substance-related disorders training to determine type of training and barriers to training. Results: Of 1,831 program directors, 1,183 (64.6%) responded to the brief survey. The percentage of programs with required substance use disorders training ranged from 31.8% in pediatrics to 95.0% in psychiatry, with 56.3% for all programs combined. The median number of curricular hours ranged from 3 (emergency medicine and OB/GYN) to 12 (family medicine). Time was perceived to be the most common barrier to additional training. Conclusions: Consistent training for all residents in the initial diagnosis and management of substance use disorders has not been achieved. New strategics that integrate into existing residency structures are needed to improve substance use disorders training. Faculty development in substance use disorders and review of current substance use disorders training as part of the residency review process should facilitate this endeavor.