Two new workforce developments aim to increase the number of addiction medicine specialists and provide new training opportunities in the subspecialty.

The American Board of Medical Specialties (ABMS) recently certified its first formal wave of addiction medicine physicians, adding 1,200 specialists to the field. Addiction medicine was first recognized as a subspecialty by ABMS in 2015, followed by the first certification exam in 2017.

In addition, the Accreditation Council for Graduate Medical Education (ACGME) will now offer medical residents accredited, 1-year subspecialty training programs in addiction medicine. The fellowships are open to residents who have completed a residency in a primary specialty such as pediatrics, family medicine, or internal medicine. The full-time fellowship programs will be based in hospitals, outpatient programs, and community clinics.

The two developments “will change the landscape in substance use prevention, early intervention, and in addiction treatment and management,” said Lon R. Hays, MD, president of The Addiction Medicine Foundation , in Chevy Chase, Md., and director of the addiction medicine fellowship program at the University of Kentucky, Lexington.

“Many more trained physicians will be available to address the opioid crisis and other addictions,” Dr. Hays said in a statement. “They will also be able to help prevent and intervene early with unhealthy substance use in all its forms. For the first time, when aspiring physicians consider a career path, they will now have as an available choice an addiction medicine specialty that meets the highest standards of medicine.”

The new certifications are a tremendous development for addiction medicine, said Timothy K. Brennan, MD , a pediatrician and director of the Addiction Institute at Mount Sinai West and Mount Sinai St. Luke’s Hospitals, both in New York. He also directs the addiction medicine fellowship program at Mount Sinai and is vice president for medical and academic affairs for The Addiction Medicine Foundation.

“When the American Board of Medical Specialties welcomed addiction medicine as its newest subspecialty, it in a lot of ways, legitimized our discipline,” Dr. Brennan said in an interview. “The American Board of Medical Specialties really represents the ‘House of Medicine.’ Being able to enter into that, it gives us a measure of credibility in the eyes of the public, and it basically codifies that these physicians who have passed this board exam have achieved a level of competency and knowledge that makes them trustworthy and safe to provide care to folks suffering from addiction.”

While the 1,200 additional addiction medicine specialists are an improvement, many more are needed, Dr. Brennan said, adding that he is optimistic that the new addiction medicine training opportunities provided by ACGME will help achieve higher numbers.

“For addiction medicine, we’ve had fellowships for about 10 years, but the funding for those fellowships was really challenging,” Dr. Brennan said. “Once you get ACGME-accredited, it gives you the ability to partake of [Centers for Medicare & Medicaid Services] funding that funds most of the graduate medical education residency fellowship spots in the United States. ACGME is the gold standard. I think that makes us much more potentially attractive for graduating physicians who are finishing their residencies.”

The certification of new addiction specialists is welcome news, particularly in the midst of the current epidemic, added Clif Knight, MD , senior vice president for education for the American Academy of Family Physicians.

“This is really good news [especially considering], the difficulty that the country is having with so much addiction – of course opioids are in the forefront – but there are so many different types of addiction,” he said in an interview. “This is good news that the certification is available and that physicians are pursuing obtaining additional expertise and recognition in their ability to treat addictions.”

Dr. Knight expressed appreciation that the ACGME training opportunities in addiction medicine are open to doctors of various specialties, he said.

“A lot of times subspecialty fellowships are only available to one specialty,” said Dr. Knight, a family physicians in Indianapolis. “In this case, it looks like they’ve been very deliberate to make this available to multiple specialties. I think that really sends an important message that this is not just one specialty that is focused on [addiction medicine], but really should be something that all specialties are engaged and involved in.”


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