ABAM: Residencies Key to Establishing Addiction Specialty

To become a recognized, certified specialty similar to addiction psychiatry, addiction medicine must receive approval by both the American Board of Medical Specialties (ABMS) and the Accreditation Council for Graduate Medical Education (ACGME). Meeting those standards has been no easy task, but the specialty is well on its way.

The American Board of Addiction Medicine (ABAM) and ASAM are working together to move the field forward, setting standards and processes that will eventually meet ACGME and ABMS requirements, says ABAM President Jeffrey Samet, M.D., M.P.H. Among the tasks the specialty must accomplish, none is more important than establishing and securing long-term funding for 20 to 25 ABAM Foundation-accredited addiction medicine residency programs.

“If we, as a board, want to become ABMS-blessed, then we need to establish an extensive list of accredited residency programs,” he says. “The desired number is somewhere between 20 and 25 programs, but that, of course, is a means to an end.”

Thursday’s Component Session 1, “The American Board of Addiction Medicine (ABAM), and The ABAM Foundation: The Development and Accredita­tion of Addiction Medicine Residency Training Programs, and the Recognition of Addiction Medicine as a Medical Specialty by the American Board of Medical Specialties (ABMS),” discussed this pathway at length, featuring ABAM Foundation Board Member and Training and Accreditation Committee Chair Richard D. Blondell, M.D.

“We’ve developed a standardized national curriculum for all of these programs to follow,” Dr. Blondell says. “There were fellowship programs that existed in addiction medicine prior to the national curriculum, but now we are moving forward and have also developed a set of core competencies that trainees are required to possess at the end of their training. From there, we began integrating that program into the existing structure at several medical schools and teaching hospitals around the country.”

Dr. Blondell says that the March 19 announcement that The ABAM Foundation had accredited the Addiction Medicine Fellowship  Program at  NYU School of Medicine signaled a big win for the specialty.

“That was a major watershed moment for  ASAM and ABAM because it brought the total number of accredited programs to 10,” he says. “In the next year, we would like to get 10 or more programs up and running because we will need at least 20 programs to move forward. This is an important step for our specialty because, right now, only psychiatrists can specialize in addiction psychiatry, and it is imperative that we open this up to physicians who are certified by other primary medical specialty boards.”

In addition to the NYU School of Medicine, the following programs have been accredited by the ABAM Foundation:

  • Addiction Institute of New York Fellowship in Addiction Medicine; St. Luke’s and Roosevelt Hospitals
  • Boston University Medical Center Addiction Medicine Residency
  • Cincinnati Addiction Medicine Fellowship; University of Cincinnati College of Medicine
  • Geisinger Addiction Medicine Residency at Marworth
  • Minnesota Addiction Medicine Residency Program: UM-HCMC-VA; University of Minnesota Medical School
  • University at Buffalo Addiction Medicine Fellowship
  • University of Florida Addiction Medicine Program
  • University of Maryland—Sheppard Pratt Training Program; University of Maryland Medical System
  • University of Wisconsin  Program; University of Wisconsin School of Medicine and Public Health

All of the programs are modeled on the ABAM Foundation’s national guideline, The Program Requirements for Graduate Medical Education in Addiction Medicine, which was released in March 2011.

Dr. Samet says that with addiction medicine maturing—residencies coming on line, a core set of documents describing the field in hand, a plan to train physicians, and a means to accredit programs and certify physicians—it is beginning to establish itself formally. It also provides assurances to the medical establishment, as well as health care organizations and patients, that a standard of excellence has been set.

Dr. Samet says that Course 7 “Setting Up an Addiction Medicine Fellowship,” from 2 to 4 p.m. Saturday in Rooms 204-205, will provide a solid nuts-and-bolts primer for attendees interested in learning more about the process behind creating a residency program. The course is led by Petros Levounis, M.D., ASAM Director-at-Large, ASAM Medical Education Council Member, Director of The Addiction Institute of New York, and Chief of Addiction Psychiatry at St. Luke’s and Roosevelt Hospitals, New York.

Dr. Levounis says the format should prove interesting because it will include a panel of physicians from his own fellowship program at The Addiction Institute of New York answering questions from a physician, Launette Rieb, M.Sc., M.D., CCFP, FCFP, who is in the middle of establishing her own residency program.

“We will have three presentations from the faculty here, but also we’re going to have an interactive segment based on a structured dialogue with Dr. Rieb about her own experience, and the challenges and opportunities that she has encountered,” he says. “So it won’t just be talking heads in a room, but instead I hope that both the presenters and the participants will engage in an open discussion with someone who has been facing the obstacles—and inevitable frustrations—that come with putting together a fellowship. So in a very real sense, she will keep us honest.”

This is a ground-up session that will explain how to build a residency program from The ABAM Foundation’s perspective.

“We are trying to get attendees at the meeting to understand what it might take to do this because they are the ones who are going to eventually realize that with some help, they can really put together a program and fill this need,” Dr. Samet says. “So we are taking out the guesswork, showing them what’s really involved, and what the standards for building a training program really are.”

Dr. Samet says that while he has enjoyed watching the existing residencies take shape, he is even more excited to watch the growth the overall program is beginning to see as the individual programs begin to collaborate and share ideas with another.

“It has been fairly remarkable to look at the progress we’ve made over the past few years,” he says. “Now it is all about establishing and feeding a body that helps newer programs get on board. As these existing programs continue to learn from one another, they can share what they’ve learned with the programs coming up behind them and cut the time-to-accreditation considerably.”