An Epidemic of Incompetence: A Critical Review of Addictions Curriculum in Canadian Residency Programs

In Canada and the United States, the rising number of apparent opioid-related deaths have given to the aptly-named opioid epidemic. Despite the criticism physicians have received for their role in opioid overprescribing, physicians may very well be in the position to vanquish the opioid epidemic. While the importance of the importance of Addictions training in psychiatry and other disciplines has been recognized in Canada at a national level, training resources are scarce and difficult to implement, even when delivered in online formats. Many have speculated that the delivery of high-quality Addictions training has been hampered by multiple roadblocks endemic to the Canadian medical education system, particularly stigma towards individuals with substance use disorders. In navigating the winds of change in the Competency-Based Medical Education (CBME) era, it remains unclear how Addictions will be embraced. To date, there are no defined addictions competencies in the Canadian CBME infrastructure, despite the critical findings of the Association of Faculties of Medicine report in 2017, which was generated in response to the opioid epidemic. Despite these challenges, those who struggle with addiction can lead full, happy, productive lives if they have the right resources. With time, we can only hope that the increasing visibility of addiction will translate to improved training and curricula for the next generation of physicians.