• Donna M Windish, Jillian S Catalanotti, Aimee Zaas, Michael Kisielewski, and John P Moriarty.
• Yale Primary Care Residency Program, Yale New Haven Health, Yale University School of Medicine, St. Raphael's Campus, 1450 Chapel Street, Private 304, New Haven, CT, 06511, USA. donna.windish@yale.edu.
• J Gen Intern Med. 2022 Aug 1; 37 (11): 265026602650-2660.

BackgroundTraining future clinicians in safe opioid prescribing (SOP) and treatment of opioid use disorder (OUD) is critical to address the opioid epidemic. The Accreditation Council on Graduate Medical Education requires all programs to provide instruction and experience in pain management and will mandate addiction medicine clinical experiences for internal medicine trainees.ObjectiveAssess residents' training in SOP and treatment of OUD and identify training barriers.DesignCross-sectional nationally representative survey was emailed in 2019.ParticipantsFour hundred twenty-two Association of Program Directors in Internal Medicine members in US internal medicine residency programs.Main MeasuresProgram opportunities and challenges to developing or implementing training in SOP, treatment of OUD, and buprenorphine waiver training, and perceived curricular effectiveness.Key ResultsThe response rate was 69.4% (293/422). Most programs required didactics in SOP (94.2%) and treatment of OUD (71.7%). Few programs required clinical experiences including addiction medicine clinics (28/240, 11.7%), inpatient consult services (11/240, 4.6%), or offsite treatment rotations (8/240, 3.3%). Lack of trained faculty limited developing or implementing curricula (61.5%). Few respondents reported that their program was "very effective" in teaching SOP (80/285, 28.1%) or treatment of OUD (43/282, 15.3%). Some programs offered buprenorphine waiver training to residents (83/286, 29.0%) and faculty (94/286, 32.9%) with few mandating training (11.7% (28/240) and 5.4% (13/240) respectively). Only 60 of 19,466 (0.3%) residents completed buprenorphine waiver training. Primary care programs/tracks were more likely to offer waiver training to residents (odds ratio [OR], 3.07; 95% CI, 1.68-5.60; P < 0.001) and faculty (OR, 1.08; 95% CI, 1.01-3.22; P = 0.05).ConclusionsIn this nationally representative survey, few internal medicine residency programs provided clinical training in SOP and treatment of OUD, and training was not viewed as very effective. Lack of effective training may have adverse implications for patients, clinicians, and society.© 2021. Society of General Internal Medicine.

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