title: Education of preventive medicine residents: alcohol, tobacco, and other drug abuse.
abstract: BACKGROUND
  Generalist physicians' addiction training is inadequate, but general preventive medicine residency (PMR) programs have not been studied. We determined PMR programs' alcohol, tobacco, and other drug abuse (ATOD) training from 1995 to 2000 and identified barriers to this education.
  
  
  METHODS
  Interviewer-administered telephone survey of program directors (PDs) of accredited PMR programs in the United States.
  
  
  RESULTS
  We interviewed all 41 PMR PDs. While 78% of PMR PDs reported interest in increasing ATOD education, for 68% it was not a high educational priority. Tobacco ranked in the top third of preventive medicine topics by 58%, while alcohol and other drugs ranked in the bottom third by 48% and 52%, respectively. Twenty-two percent of programs required a clinical ATOD rotation, most commonly smoking-cessation clinics. Only 29% of PMR PDs felt that residents were well prepared in clinical aspects of ATOD, while 60% felt that residents were prepared in ATOD research and public health issues. The most commonly reported barriers to ATOD training were lack of resident interest and defined competencies (64% each); limited faculty time (59%); limited teaching time (54%); lack of available teaching materials (53%); and lack of faculty expertise (51%).
  
  
  CONCLUSIONS
  While the majority of PMR PDs recognize the importance of incorporating teaching about addictions into training, much of the ATOD education in PMRs focuses on tobacco alone. Setting educational standards, defining competencies, investing in faculty development, and creating ATOD curricular modules are important next steps toward preparing preventive medicine physicians to effectively reduce the public health toll of addictions.
authors.affiliation: Clinical Addiction Research and Education (Care) Unit, Section of General Internal Medicine, Development of Medicine, Boston University School of Medicine, Boston, Massachusetts 02118, USA.
authors.forename: Toni
authors.initials: T
authors.lastname: Abrams Weintraub
authors.forename: Richard
authors.initials: R
authors.lastname: Saitz
authors.forename: Jeffrey H
authors.initials: JH
authors.lastname: Samet
mesh_terms: D000428:Alcohol Drinking / Q000009:adverse effects*; D001291:Attitude of Health Personnel; D006292:Health Priorities; D006801:Humans; D007396:Internship and Residency; D011315:Preventive Medicine / Q000193:education*; D000074606:Smoking Prevention; D019966:Substance-Related Disorders / Q000517:prevention & control*; D014481:United States