MEDICAL-EDUCATION ABOUT SUBSTANCE-ABUSE - CHANGES IN CURRICULUM AND FACULTY BETWEEN 1976 AND 1992

Purpose. To examine changes in substance abuse education in U.S. medic al schools between 1976 and 1992. Methods. In 1991-92 the authors cond ucted a 16-year follow-up survey of six clinical departments in each o f the 126 U.S. medical schools. Two previous surveys by scholars and s urveys conducted by the Liaison Committee on Medical Education, Associ ation of American Medical Colleges, and the National Center for Medica l Fellowships in the Addictions provided baseline data for comparison. The statistical methods used in the comparisons were paired t-tests, one-way analyses of variance, and tests of differences between proport ions. Results. Significant increases were found in the numbers of requ ired and elective curriculum units for medical students between 1986-8 7 and 1991-92. The number of medical schools requiring courses in subs tance abuse treatment increased from five to eight between 1986-87 and 1991-92. For residents, there were significant increases in the numbe rs of curriculum units for residents in family medicine and pediatrics . The average number of faculty in the 116 medical schools that report ed units on substance abuse was 4.1. There were 45 fellowships in addi ction medicine identified in 1991-92, with a total of 61 fellows in tr aining. Conclusion. While the findings confirm positive changes, the a mount of curricula time and the number of faculty having expertise in substance abuse education do not compare well with the amounts of time and numbers of faculty involved in clinical problems of similar preva lence, such as cancer and heart disease.