Recent advances in health professional training on substance abuse disorders

The trainee health professional is influenced by many factors-personal and family experiences, the effectiveness of the teacher as role model, the attitudes in the institution in which training takes place and the cultural norms of society. Adverse experiences, if any, in these areas can negate the input from training programmes. This is particularly true for training in substance use disorders. In designing curricula in this field it is crucial to identify the core competencies expected at the end of training. 'Project Adept', a comprehensive compilation of curriculum materials, is based on such competencies. It emphasizes skills training and an adult learning mode of education. However, to achieve sustained curricular changes, development of a committed faculty is essential. Training must be complemented by systematic programmes of early diagnosis and treatment for substance use disorders in teaching hospitals. The need to train generalist physicians and to focus on early intervention have been endorsed by the recent Institute of Medicine report on the treatment of alcohol problems.