title: One approach to the return to residency for anesthesia residents recovering from opioid addiction.
abstract: OBJECTIVE
  There is a high rate of relapse among anesthesia residents attempting to re-enter clinical anesthesia training programs after completing treatment for opioid addiction. Individuals may return to clinical practice after a short period of treatment only to relapse into active addiction, and for the opioid addicted anesthesia resident, this often results in death. The objective of this study was to determine weather or not a period of time away from clinical practice after treatment would reduce the rate of relapse by allowing the individual to concentrate on recovery in the critical first year after treatment, during which the majority of relapses occur.
  
  
  METHODS
  5 residents identified as being addicted to a controlled substance were removed from residency training and offered treatment. Prior to returning to residency training they were required to complete a post-treatment program involving no less than 12 months of work in the anesthesia simulator, followed by a graded re-introduction into the clinical practice of anesthesia.
  
  
  METHODS
  Academic anesthesia practice in a large teaching hospital.
  
  
  RESULTS
  Of the 5 residents who participated in the program, 3 (60%) successfully completed their residency program and their 5 year monitoring contract, and entered the anesthesia workforce as attending anesthesiologists.
  
  
  CONCLUSIONS
  The treatment of addicted physicians can be successful, and return of the highly motivated individual to the clinical practice of Anesthesiology is a realistic goal, but this reintroduction must be undertaken in a careful, stepwise fashion. A full understanding of the disease process, the potential for relapse, and the implications of too rapid a return to practice must be taken into careful consideration.
authors.affiliation: Department of Anesthesiology, The Mount Sinai Medical Center, PO Box 1010, New York, NY 10029-6574, USA. Electronic address: ethan.bryson@msnyuhealth.org.
authors.forename: Ethan O
authors.initials: EO
authors.lastname: Bryson
authors.affiliation: Department of Anesthesiology, The Mount Sinai Medical Center, PO Box 1010, New York, NY 10029-6574, USA.
authors.forename: Adam
authors.initials: A
authors.lastname: Levine