Chemical dependency in emergency medicine residency programs: Perspective of the program directors

Abstract

To evaluate the educational background, knowledge, and experiences regarding chemical dependency among emergency medicine program directors. The program directors' awareness of substance use and alcohol abuse among emergency medicine residents was examined by comparing their estimates with the actual rates reported by the residents. An anonymous survey mailed in March 1992. The program directors of all 86 Accreditation Council for Graduate Medical Education-approved emergency medicine residencies. None. The 67 responding program directors represented 1,637 (77%) of the 2,130 emergency medicine residents on duty at the time of the survey. Thirty-three (49%) had suspected chemical dependency in a resident at least once, 22 (33%) had identified a chemically dependent resident, and nine (13%) hired a resident known to be in recovery. Substantial percentages reported no or slight knowledge regarding physician impairment issues. Twenty program directors (30%) received no education or only informal education regarding physician impairment. Compared to a February 1992 survey of emergency medicine residents, the program directors' estimates of resident use rates in the past year for seven substances were fairly accurate. However, the program directors estimated that only 16 (1.0%) of their current residents were impaired by alcohol; the resident survey yielded CAGE scores consistent with presumed or suspected alcoholism in 12.5% of emergency medicine residents. Emergency medicine program directors must be more attentive to potential alcohol abuse among emergency medicine residents and should receive additional education regarding chemical dependency.