June this year, Business Insider reported 12 ideas the country can use to tackle the opioid epidemic. One of them being through doctor’s education in medical school.
A call for curriculum changeDr Martin Klapheke, assistant dean at the University of Central Florida’s College of Medicine, says that “revamping the curriculum” would be the answer.
In his university, students learn about opioids buse in their first year. On their paediatrics rotation, students observe the tremors, seizures, and incessant high-pitched wails of babies born with opioids in their system. They role-play talking to patients about alternative pain management.
Students are also taught how to help patients with addiction issues. Because of the curriculum’s success, UCF is now sharing it with eight other Florida med schools. "It’s going to take time for the culture to change," asserts Klapheke.
John Davis, MD, PhD, associate professor of clinical internal medicine and associate dean for medical education, at The Ohio State University Wexner Medical Centre, Columbus, Ohio, believes that medical school is the ideal time for future physicians to learn about issues facing communities, such as the opioid epidemic.
“It is also the time to learn about responsible opioid use, how to prevent addiction, how to detect addiction, and how to manage it when it occurs,” he says. “Any gaps in this education could lead to physicians not appreciating the importance of this health crisis or being unable to use their diagnostic and therapeutic abilities to address the crisis.”
University rankings play a roleImproving education standards of future doctors seem to be the right step in curbing the crisis. A paper published by economics professors at Princeton University has found that physicians who studied at lower-ranked medical schools prescribe nearly three times as many opioids per year as those who attended top-tier institutions.
The research, sparked by an interest to find out physician’s role in the opioid crisis used data on all opioid prescriptions written in the US between 2006 and 2014. The researchers used a combined ranking of medical schools from US News & World Report to examine the link between physicians’ prescribing practices and where they attended medical school.
On average, the researchers found, physicians who attended Harvard wrote fewer than 100 opioid prescriptions per year, while physicians trained at the lowest-ranked schools wrote about 300 per year.
Harvard Medical School is among the few that takes active stand in trying to fight the Opioid epidemic. Earlier this year, Harvard students organised their own trainings on how to use new medication to treat opioid addiction. The group also launched a campaign to raise awareness about how to buy and use naloxone, the overdose-reversal drug.
White House interventionLast March, The White House asked medical schools to sign a pledge to require students to learn new federal guidelines for safe opioid prescribing before they graduate. It was discovered that 61 out of 170 plus medical school in the US signed, others including Harvard Medical refused.
“We don’t agree with the idea of taking pledges with what to put in our curriculum,” dean Dr Jeffrey Flier said in an interview. If Harvard started doing that, “I don’t see what would limit the number of groups going through, telling us what to put in our curriculum,” he added, “which would be the death of higher education.”
However, some students advised that receiving the training has helped them in making better decisions regarding opioids prescription.
"I felt more comfortable and confident in myself, knowing not only when to say no but also when to say yes," said Dr. Kevin O'Day, a 2016 graduate from the University of Massachusetts School of Medicine who is now an internal medicine resident at the university.
Keck Graduate Institute School of Pharmacy’s four-year PharmD program has incorporated the Centres for Disease Control and Prevention’s (CDC) guideline into its therapeutics module on pain control. The matter addresses the assessment and treatment of pain, including opioid, non-opioid, and non-pharmacologic interventions.
“We also teach students about the risks and benefits of prescribing opioids and about opioid use disorder—including addiction risk factors,” said Talia Puzantian, PharmD, BCPP, associate professor, Keck Graduate Institute School of Pharmacy, Claremont, California. MIMS
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