title: Providing competency-based family medicine residency training in substance abuse in the new millennium: a model curriculum.
abstract: BACKGROUND
  This article, developed for the Betty Ford Institute Consensus Conference on Graduate Medical Education (December, 2008), presents a model curriculum for Family Medicine residency training in substance abuse.
  
  
  METHODS
  The authors reviewed reports of past Family Medicine curriculum development efforts, previously-identified barriers to education in high risk substance use, approaches to overcoming these barriers, and current training guidelines of the Accreditation Council for Graduate Medical Education (ACGME) and their Family Medicine Residency Review Committee. A proposed eight-module curriculum was developed, based on substance abuse competencies defined by Project MAINSTREAM and linked to core competencies defined by the ACGME. The curriculum provides basic training in high risk substance use to all residents, while also addressing current training challenges presented by U.S. work hour regulations, increasing international diversity of Family Medicine resident trainees, and emerging new primary care practice models.
  
  
  RESULTS
  This paper offers a core curriculum, focused on screening, brief intervention and referral to treatment, which can be adapted by residency programs to meet their individual needs. The curriculum encourages direct observation of residents to ensure that core skills are learned and trains residents with several "new skills" that will expand the basket of substance abuse services they will be equipped to provide as they enter practice.
  
  
  CONCLUSIONS
  Broad-based implementation of a comprehensive Family Medicine residency curriculum should increase the ability of family physicians to provide basic substance abuse services in a primary care context. Such efforts should be coupled with faculty development initiatives which ensure that sufficient trained faculty are available to teach these concepts and with efforts by major Family Medicine organizations to implement and enforce residency requirements for substance abuse training.
authors.affiliation: Department of Family Medicine, Mercer University School of Medicine & Medical Center of Central Georgia, 3780 Eisenhower Parkway, Macon, GA 31206, USA. seale.paul@mccg.org
authors.forename: J Paul
authors.initials: JP
authors.lastname: Seale
authors.forename: Sylvia
authors.initials: S
authors.lastname: Shellenberger
authors.forename: Denice Crowe
authors.initials: DC
authors.lastname: Clark
mesh_terms: D005194:Family Practice / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000191:economics; D017146:Models, Organizational; D018794:Problem-Based Learning / Q000191:economics / Q000458:organization & administration*; D019966:Substance-Related Disorders; D011795:Surveys and Questionnaires
references.citation: J Gen Intern Med. 2006 Sep;21(9):966-72
references.pmid: 16918743
references.citation: Br J Addict. 1986 Jun;81(3):405-18
references.pmid: 3461849
references.citation: J Addict Dis. 1995;14(2):23-31
references.pmid: 8541357
references.citation: J Gen Intern Med. 2009 Jan;24(1):40-7
references.pmid: 18937015
references.citation: J Gen Intern Med. 1994 May;9(5):296-8
references.pmid: 8046535
references.citation: Aust N Z J Public Health. 1996 Aug;20(4):401-8
references.pmid: 8908764
references.citation: J Fam Pract. 1999 Sep;48(9):725-9
references.pmid: 10498080
references.citation: Alcohol Clin Exp Res. 2006 Aug;30(8):1393-9
references.pmid: 16899042
references.citation: Fam Med. 1994 Jul-Aug;26(7):447-51
references.pmid: 7926362
references.citation: J Stud Alcohol. 2000 Nov;61(6):912-5
references.pmid: 11188498
references.citation: Fam Pract. 2000 Dec;17(6):535-40
references.pmid: 11120727
references.citation: Subst Abus. 2002 Sep;23(3 Suppl):207-22
references.pmid: 23580996
references.citation: Alcohol Alcohol. 2004 Jul-Aug;39(4):351-6
references.pmid: 15208170
references.citation: J Med Educ. 1985 Aug;60(8):618-26
references.pmid: 3894664
references.citation: Subst Abus. 2004 Mar;25(1):17-26
references.pmid: 15201108
references.citation: Subst Abus. 2005 Mar;26(1):23-31
references.pmid: 16492660
references.citation: J Gen Intern Med. 2000 Feb;15(2):84-91
references.pmid: 10672110
references.citation: Acad Med. 2009 Mar;84(3):340-6
references.pmid: 19240441
references.citation: Fam Pract. 1995 Dec;12(4):419-22
references.pmid: 8826058
references.citation: J Gen Intern Med. 1994 May;9(5):248-54
references.pmid: 8046526
references.citation: Acad Med. 2001 May;76(5):410-8
references.pmid: 11346513
references.citation: JAMA. 1989 Jun 2;261(21):3115-20
references.pmid: 2716143
references.citation: Acad Med. 1992 Jul;67(7):482-3
references.pmid: 1616568
references.citation: Fam Med. 1997 Mar;29(3):194-8
references.pmid: 9085102
references.citation: Int J Psychiatry Med. 1998;28(1):137-46
references.pmid: 9617653
references.citation: J Subst Abuse Treat. 2003 Jul;25(1):29-35
references.pmid: 14512105
references.citation: J Interprof Care. 2006 Dec;20(6):655-64
references.pmid: 17095443
references.citation: Med Care. 2005 Mar;43(3):229-36
references.pmid: 15725979
references.citation: N Z Med J. 1997 Aug 8;110(1049):291-4
references.pmid: 9293283
references.citation: Ann Fam Med. 2004 Mar-Apr;2 Suppl 1:S3-32
references.pmid: 15080220
references.citation: Fam Med. 2005 Mar;37(3):174-7
references.pmid: 15739132
references.citation: J Stud Alcohol. 2005 May;66(3):361-8
references.pmid: 16047525
references.citation: J Am Board Fam Med. 2009 Jul-Aug;22(4):387-98
references.pmid: 19587253
references.citation: Can Fam Physician. 1994 Sep;40:1570-9
references.pmid: 7920050
references.citation: J Addict Dis. 2000;19(2):43-58
references.pmid: 10809519
references.citation: J Reprod Med. 2007 May;52(5):345-8
references.pmid: 17583230
references.citation: Addiction. 2000 Jun;95(6):949-57
references.pmid: 10946443
references.citation: Subst Abus. 2004 Mar;25(1):43-51
references.pmid: 15201111
references.citation: Fam Med. 1987 Jul-Aug;19(4):276-80
references.pmid: 3622974
references.citation: Fam Pract. 2003 Jun;20(3):270-5
references.pmid: 12738695
references.citation: Subst Abus. 2001 Dec;22(4):257-263
references.pmid: 12466685
references.citation: Prev Chronic Dis. 2006 Apr;3(2):A53
references.pmid: 16539794
references.citation: J Gen Intern Med. 2006 May;21(5):453-9
references.pmid: 16704387
references.citation: Fam Med. 1992 May-Jun;24(4):299-302
references.pmid: 1601241
references.citation: BMC Fam Pract. 2005 Nov 04;6:46
references.pmid: 16271146
references.citation: Am J Public Health. 2004 Apr;94(4):663-71
references.pmid: 15054022
references.citation: J Addict Dis. 2002;21(3):87-99
references.pmid: 12095002
references.citation: Addiction. 2000 May;95(5):677-86
references.pmid: 10885042
references.citation: Med Care. 2004 Dec;42(12):1158-66
references.pmid: 15550795
references.citation: Acad Med. 1992 Oct;67(10):691-3
references.pmid: 1388535
references.citation: Acad Med. 1997 May;72(5):376-81
references.pmid: 9159584
references.citation: Br J Addict. 1991 Mar;86(3):263-75
references.pmid: 2025689
references.citation: J Adv Nurs. 2002 Aug;39(4):333-42
references.pmid: 12139645
references.citation: JAMA. 1992 Sep 2;268(9):1111-7
references.pmid: 1501333
references.citation: Addiction. 2006 Jan;101(1):10-5
references.pmid: 16393188
references.citation: J Med Educ. 1987 Jan;62(1):17-24
references.pmid: 3795240
references.citation: Subst Abus. 2000 Mar;21(1):1-7
references.pmid: 12466643
references.citation: Med Clin North Am. 1997 Jul;81(4):831-43
references.pmid: 9222256
references.citation: J Stud Alcohol. 1975 Jul;36(7):949-55
references.pmid: 240074
references.citation: BMJ. 2002 Oct 19;325(7369):870
references.pmid: 12386040
references.citation: Fam Med. 1994 Apr;26(4):221-5
references.pmid: 8034139
references.citation: Arch Intern Med. 1991 May;151(5):958-64
references.pmid: 2025144
references.citation: Drug Alcohol Rev. 2003 Jun;22(2):169-73
references.pmid: 12850903
references.citation: Acad Med. 1992 Apr;67(4):260-6
references.pmid: 1558600
references.citation: Fam Med. 1988 Mar-Apr;20(2):108-11
references.pmid: 3360228
references.citation: Prev Med. 2004 Apr;38(4):473-8
references.pmid: 15020181
references.citation: Subst Abus. 2005 Dec;26(3-4):5-15
references.pmid: 16837406
references.citation: JAMA. 1995 Sep 6;274(9):700-5
references.pmid: 7650822