COPE Meetings

SAMHSA-COPE Region III Summit Meets in Washington, DC

Medical school faculty and health officials from five states — Delaware, Maryland, Pennsylvania, Virginia, and West Virginia — and the District of Columbia gathered in Washington, DC, for the SAMHSA-COPE Region III Summit on Medical Education in Substance Use.

The Summit was hosted by Jean Bennett, R.N., M.S., Ph.D., Region III Administrator for the federal Substance Abuse and Mental Health Services Administration (SAMHSA), and held in the Secretary’s conference room at the headquarters of the U.S. Department of Health and Human Services. Participants discussed needs, resources, models and strategies to enhance medical school curricula and medical students’ learning experiences with regard to the diagnosis and treatment of substance use disorders (SUDs).

Although greater attention to SUDs has long been endorsed by both federal agencies and private sector organizations, Dr. Bennett and COPE Chair David C. Lewis, M.D., pointed out that it has taken on new urgency because of the Affordable Care Act and the Paul Wellstone Mental Health Parity Act. They explained that, to achieve the full potential of the new laws, physicians-in-training will need to acquire the knowledge and skills to prevent, identify, and address substance use and related disorders in their patients. While this need is especially acute for physicians entering primary care, Dr. Lewis emphasized that it is relevant to all medical students, regardless of their future specialty or the populations they will serve.

Special Presentations
COPE Board member John A. Renner, Jr., M.D., introduced special presentations by Charles P. O’Brien, M.D., Ph.D., Kenneth Appel Professor of Medicine at the University of Pennsylvania, and P. Bradley Hall, M.D., DABAM, FASAM, MROCC, Director of the West Virginia Health Professionals Health Program.

Dr. O’Brien discussed his pioneering work in developing a course on addiction at the University of Pennsylvania, including the obstacles he overcame in having the course adopted and its progress over the years.

Dr. Hall described the program he directs in West Virginia, which provides assistance to medical students and residents as well as practicing physicians and thus is a model for types of student assistance programs that could be developed at other medical schools (which is one of COPE’s strategic goals).

A key component of COPE’s overall efforts will be achieved by several working groups of medical school faculty and administrators, each of which is charged with finding ways to facilitate the desired curriculum change. At the Region III Summit, COPE Board member Mark L. Kraus, M.D., FASAM, introduced the leaders of four such groups and invited them to describe their progress to date.

Group leader Charles P. Reznikoff, M.D., of the University of Minnesota Medical School, explained that the mission of Group 1 is to develop a carefully curated Resource Center by assembling, vetting, and organizing materials in a way that is most useful to the faculty who teach medical students. He reported that the members of Group 1 have decided on a four-step work plan: (1) Use the COPE curriculum survey and other sources of information to understand the resource needs of medical school faculty in multiple departments; (2) Collect resources that are likely to meet those needs; (3) Devise a method for curating the resources and for faculty to provide feedback on their usefulness in real academic settings; and (4) Organize the resources in an online COPE Resource Center in a way that is user-friendly and easy to access and update. (For example, Group 1’s members have decided that materials should be organized by topic, format, and intended audience.)

Group leader Gail M. Basch, M.D., of Chicago’s Rush University Medical Center, reported that Group 2 is working to identify faculty resource needs through the COPE Curriculum Survey, with a goal of administering the survey in all relevant departments of every U.S. medical school. She added that the survey seeks participants’ input regarding the challenges they face in teaching about substance use disorders, as well as approaches and resources they have found helpful and would recommend to others.

Dr. Basch identified a four-step plan developed by Group 2, which calls for: (1) Devising a survey and piloting it in several regions; (2) Soliciting feedback from faculty who complete the survey as to ways to make it more meaningful and user-friendly; (3) Revising the survey to reflect faculty input and experience gained; and (4) Administering the survey in multiple departments of every medical school. She reported that Group 2 has completed steps 1 and 2, and now is working to identify all the departments to which the survey is relevant and recruit faculty in those departments to complete the survey.

Group leader Jenifer Van Deusen, M.Ed., Curriculum Director at the University of New England College of Osteopathic Medicine, said that Group 3 is working to identify core competencies related to substance use prevention, identification and management that every medical student should acquire. She added that, after considerable research, it appears that such a statement of core competencies for undergraduate medical education does not currently exist (although current LCME standards call for 4 hours of training on SUDs, they do not specify the content of that training).

Ms. Van Deusen described Group 3’s approach to defining core competencies and explained that an early step will be to define the knowledge and skill sets that constitute core competencies. To do so, she said, Group 3 is collecting and analyzing statements of core competencies developed for other disciplines or levels of medical education (such as residents and practicing physicians). She added that a final step will be to pilot test the core competencies with U.S. medical schools and, ultimately, to promote their widespread adoption.

Group leader Marla O. Kushner, D.O., FASAM, FSAHM, of the Chicago College of Osteopathic Medicine, reported that Group 4 is developing initiatives to engage medical students in thinking about SUDs and related disorders as treatable medical conditions that are within their realm of interest and responsibility. She then briefed participants on an innovative pilot program through which a student at Chicago College of Osteopathic Medicine will administer the curriculum survey to faculty in as many departments as possible. Working under the guidance of a faculty mentor, the student also will assist the members of Groups 2 and 4 in creating a version of the survey instrument suitable for medical students and administering that survey to fellow students. Participating students will be designated “COPE Research Scholars” in recognition of their contributions

New Working Group
After discussing the four reports, participants recommended that a fifth working group be created to focus on improving channels of communication and collaboration between medical schools and the Federal and State health agencies that are charged with workforce development and improving the quality of and access to health care services. Summit participants strongly endorsed the recommendation, which will be implemented with the leadership of Dr. Jean Bennett.

COPE Board member Steven A. Wyatt, D.O., assured the Region III participants that COPE will provide ongoing support to the groups so that their work can continue to move forward. He added that resources developed by the working groups will be shared with Federal and State health agencies, with the national organizations that represent allopathic and osteopathic medical schools, and with faculty and administrators at individual medical schools across the country.

Dr. Wyatt also said that, using the Region I, III and V Summits as models, COPE plans to develop similar meetings in other parts of the U.S. and to revisit the HHS Regions where Summits already have been held. See future editions of Addiction Education News for announcements of future meetings and regular reports on progress by the working groups.

In addition to support from SAMHSA, the Region III Summit was made possible by generous grants from the American Osteopathic Academy of Addiction Medicine (AOAAM), the Connecticut Society of Addiction Medicine (CtSAM), C4 Recovery Solutions, and the Tim Allen Foundation.