Ib. Crome, The trouble with training: substance misuse education in British medical schools revisited. What are the issues?, DRUG-EDUC P, 6(1), 1999, pp. 111-123
My 1987 survey of substance misuse education in British medical schools hig
hlighted inadequacies in the quality of undergraduate substance misuse trai
ning. The continuing difficulty in engaging generalists in the care of subs
tance misusers suggested it was time to revisit the issue. Deans, Heads of
Departments of Psychiatry and 13 other specialities in 23 medical schools w
ere surveyed. The response rate fr om Deans and Heads of Psychiatry was 70%
. Psychiatry provided a mean of 6.7 (range 2-14) hours formal training (lec
tures/seminars), excluding one model department which provided 30 hours and
co-ordinated an additional 30 hours of undergraduate substance misuse educ
ation. In 10 (45.5%) schools training is very limited, while 10 (45.5%) sch
ools provide average (three) or above average (seven) training hours. Avera
ge or above average undergraduate training was found in schools with an aca
demic department of addiction behaviour. These centres were associated with
the most comprehensive services and the most postgraduate substance misuse
training opportunities. These findings may partially explain why most doct
ors are ill-equipped to deal with substance problems. Since 1987, psychiatr
y has doubled input, but this is offset by diminished input from other depa
rtments. The establishment of academic departments of addiction studies in
medical schools would influence decision making within university and servi
ces, promote scientific credibility and benefit communities.