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Developing Core Competencies for the Prevention and Management of Prescription Drug Misuse: A Medical Education
Karen H Antman1, Harris A Berman, Terence R Flotte
1K.H. Antman is dean, Boston University School of Medicine, and provost, Boston University Medical Campus, Boston, Massachusetts.H.A. Berman is dean and professor of public health and community medicine, Tufts University School of Medicine, Boston, Massachusetts.T.R. Flotte is dean, provost and executive deputy chancellor, and Celia and Isaac Haidak Professor of Medical Education, University of Massachusetts Medical School, Worcester, Massachusetts.J. Flier is dean, Harvard Medical School, Boston, Massachusetts.D.M. Dimitri is clinical associate professor, Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, Massachusetts, and past president, Massachusetts Medical Society, Waltham, Massachusetts.M. Bharel is commissioner, Massachusetts Department of Public Health, Boston, Massachusetts.
Abstract:
Drug overdose has become the leading cause of injury death in the United States. More than half of those deaths involve prescription drugs, specifically opioids. A key component of addressing this national epidemic is improving prescriber practices.A review of the curricula at the four medical schools in Massachusetts revealed that, although they taught components of addiction medicine, no uniform standard existed to ensure that all students were taught prevention and management strategies for prescription drug misuse. To fill this gap, the governor and the secretary of health and human services invited the deans of the state's four medical schools to convene to develop a common educational strategy for teaching safe and effective opioid-prescribing practices. With leadership from the Department of Public Health and Massachusetts Medical Society, the deans formed the Medical Education Working Group in 2015. This group reviewed the relevant literature and current standards for treating substance use disorders and defined 10 core competencies for the prevention and management of prescription drug misuse.The medical schools have incorporated these competencies into their curricula and have committed to assessing students' competence in these areas. The members of the Medical Education Working Group have agreed to continue to work together on key next steps, including connecting these competencies to those for residents, equipping interprofessional teams to address prescription drug misuse, and developing materials in pain management and opioid misuse for practicing physicians. This first-in-the-nation partnership has yielded cross-institutional competencies that aim to address a public health emergency in real time.
