Department of Anesthesiology, Mount Sinai Hospital, New York, NY 10029, USA.
J Clin Anesth. 2009 Nov;21(7):508-13. doi: 10.1016/j.jclinane.2008.12.026.
To determine the experience, attitudes, and opinions of program directors regarding the reintroduction of residents in recovery from substance abuse into the clinical practice of anesthesiology.
Survey instrument.
Anesthesia residency training programs in the United States.
After obtaining institutional review board approval, a list of current academic anesthesia residency programs in the United States was compiled. A survey was mailed to 131 program directors along with a self-addressed stamped return envelope to ensure anonymity. Returned surveys were reviewed and data compiled by hand, with categorical variables described as frequency and percentages.
A total of 91 (69%) surveys were returned, representing experience with 11,293 residents over the ten-year period from July of 1997 through June of 2007. Fifty-six (62%) program directors reported experience with at least one resident requiring treatment for substance abuse. For residents allowed to continue with anesthesia residency training after treatment, the relapse rate was 29%. For those residents, death was the initial presentation of relapse in 10% of the reported cases. 43% of the program directors surveyed believe residents in recovery from addiction should be allowed to attempt re-entry while 30% believe that residents in recovery from addiction should not.
The practice of allowing residents who have undergone treatment for substance abuse to return to their training program in clinical anesthesia remains highly controversial. They are often lost to follow-up, making it difficult, if not impossible to determine if re-training in a different medical specialty decreases their risk for relapse. A comprehensive assessment of the outcomes associated with alternatives to re-entry into clinical anesthesia training programs is needed.
确定项目主管在重新引入从药物滥用中恢复过来的住院医师进入麻醉学临床实践方面的经验、态度和意见。
调查工具。
美国麻醉住院医师培训计划。
在获得机构审查委员会批准后，编制了一份美国当前学术麻醉住院医师培训计划的清单。向 131 名项目主管邮寄了一份调查，并附上一个自贴邮票的回邮信封，以确保匿名。审查并手工汇总了已返回的调查，用频率和百分比描述了分类变量。
共收回 91 份（69%）调查，代表了 1997 年 7 月至 2007 年 6 月十年期间 11293 名住院医师的经验。56 名（62%）项目主管报告说有至少一名住院医师需要治疗药物滥用。对于允许继续接受麻醉住院医师培训的住院医师，复发率为 29%。对于这些住院医师，在报告的病例中，10%的最初表现为复发。接受调查的 43%的项目主管认为，应该允许正在康复的成瘾者尝试重新进入，而 30%的项目主管认为，正在康复的成瘾者不应被允许。
允许接受过药物滥用治疗的住院医师返回临床麻醉培训项目的做法仍然存在很大争议。他们往往无法跟踪，因此很难确定在不同的医学专业进行再培训是否会降低他们复发的风险。需要对替代重新进入临床麻醉培训计划的方案相关结果进行全面评估。
