New Methodology for Med Schools Training Future Doctors – Educating Doctors On What to Look for With Addiction

NJ is tackling addiction head on by training future doctors to look for the common signs and indicators that there may be a problem with substance or alcohol abuse.

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STRATFORD — Medical students Yukari Ueda and Jonathan Benjamin walked into an exam room wearing white lab coats and stethoscopes around their necks.

As their practice patient sat on crinkly paper covering a padded table, they asked her questions, performed some routine exams and tests, looking for any signs or information that showed she may be misusing drugs and addicted to prescriptions or other substances.

“Just from my life experiences, from the patients and people I see every day, the opioid crisis has become worse and worse,” said Benjamin, 28, a third-year student in Rowan University’s School of Osteopathic Medicine, “and it’s vital to doctors nowadays that we understand how to properly manage pain.”

To keep up with a rapidly growing addiction epidemic and address gaps in training and education on addiction among medical professionals, medical school programs across the country, including New Jersey, are bolstering those efforts for the next generation of doctors.

A 2012 report by the National Center on Addiction and Substance Abuse at Columbia University found most medical professionals who should have been providing addiction treatment “are not sufficiently trained to diagnose or treat it.”

Experts say most schools, at minimum, have courses dedicated to the subject, but training beyond that varies greatly depending on the school.

Only a small number of schools across the country offer long-term focused medical training on addiction medicine, with several developing fellowships in addiction medicine, but that number is growing.

Recognizing a gap in formal and extensive training and education on addiction, New Jersey medical school directors said they’ve worked to provide upcoming doctors with more hands-on education and a better foundation on addiction and related treatments.

Dr. Richard Jermyn, director of the Neuromusculoskeletal Institute at Rowan, said all primary care physicians should be offering some sort of treatment option for substance-use disorders.

He hopes that by requiring Rowan medical students to complete courses, rotations, simulations and work directly with pain patients and people suffering from substance-use disorders at the school’s detox center, they will take up a greater responsibility to address addiction in the communities they will serve.

“This is how we’re going to solve the crisis,” Jermyn said. “Students learn how to screen for addiction, proper dosing, how to take people off opioids, how to determine drug tests and how to treat addiction with medication. Working with these patients also helps break down that stigma of disease.”

In New Jersey, a record 2,750 people died from drug overdoses in 2017, state data shows, the majority of which involved opioids.

Rutgers New Jersey Medical School recently announced it will start a new fellowship in addiction medicine in July 2019.

Three positions will be open to graduates of any specialty.

The medical school also became the first in the nation when it announced earlier this year that all third-year students would be required to get federal certification to administer buprenorphine, vivitrol and other medication-assisted treatments used for substance-use disorders.

Hospitals and community health providers have worked for the last several years to educate and re-train practicing physicians and medical professionals to move away from opioid prescribing and to better pain management and treatment of people suffering from addiction.

Dr. Brian Timms, assistant program director of AtlantiCare’s Internal Medicine Residency Program, said recent medical school graduates are increasingly aware of the gravity of the epidemic, asking what the health system is doing in terms of addiction treatment during application processes.

While young doctors don’t get more extensive clinical experience until residency, they are eager to learn, especially in this area of medicine, he said, and that can sometimes inspire their elder physicians to learn more.

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“One of the biggest issues is getting providers to want to treat substance-use patients because of weariness,” Timms said. “Young providers tend to be more comfortable with it, they understand the dangers implicitly, and they are going to be the folks coming into practice.”

The pain and addiction rotation is considered one of the most difficult, but important, rotations, Ueda said.

Whether they’re going on to a residency in New Jersey, Pennsylvania or elsewhere in the county, they’ll have the tools to tackle addiction head on.

“If it’s something that you get a good foundation in before practice, it’s something you can incorporate as you practice,” she said. “If we become, then go on to become attendings, our residents will learn what we learn, and it kind of becomes a ripple effect.”