Primary Care Training and Education in Addiction Medicine Fellowship: expanding the addiction medicine workforce

Justine W Welsh; Mandana Masoumirad; Stephen Delisi; Careesa Garcia; Jessica Rivera; Elizabeth McCord; Annamarie Stehli; Ariel B Neikrug; Sanchit Maruti; David E Marcovitz; Elizabeth Salisbury-Afshar; Dustin DeMoss; Jane P Gagliardi; Robert McCarron

doi:10.1186/s12909-025-07494-z

Primary Care Training and Education in Addiction Medicine Fellowship: expanding the addiction medicine workforce

BMC Med Educ. 2025 Jul 1;25(1):992. doi: 10.1186/s12909-025-07494-z.

Authors

Affiliations

¹ Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA. justine.welsh@emory.edu.
² Joe C. Wen School of Population & Public Health, University of California Irvine, Irvine, CA, USA.
³ Hazelden Betty Ford Graduate School, St. Paul, MN, USA.
⁴ School of Medicine, Office of Medical Education, University of California Irvine, Irvine, CA, USA.
⁵ Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA.
⁶ Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA, USA.
⁷ Department of Psychiatry, University of Vermont Health, Burlington, VT, USA.
⁸ Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.
⁹ Department of Family Medicine and Community Health, University of Wisconsin-Madison, Madison, WI, USA.
¹⁰ Department of Psychiatry, John Peter Smith Hospital, Fort Worth, TX, USA.
¹¹ Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.

Abstract

Background: Primary care providers (PCPs) are well-suited to identify candidates for substance use disorder (SUD) treatment and to provide patients with necessary longitudinal services and support. However, training for PCPs on how to diagnose and treat SUD is often lacking. The Primary Care Training and Education in Addiction Medicine (PC-TEAM) program is a one-year in-person and virtual hybrid program that provides more than 50 h of training and focuses on SUD-specific content.

Methods: This article describes the PC-TEAM training program and presents baseline and post-fellowship data on enrolled fellows (n = 88) to evaluate program effectiveness including changes in participant attitudes, knowledge, and comfort level in treating substance use in the primary care setting. Area Deprivation Index (ADI) scores were calculated by practice location of fellows to determine disadvantage across census tract groups.

Results: Large effect sizes in fellows' comfort levels were observed in caring for patients with SUDs and employing motivational interviewing for SUD (Cohen's $d$ = 1.1, 0.78, and 0.91, respectively). The knowledge exam indicated significant improvement across all measures from pre- to post-fellowship. Nearly one in three providers (28.4%) practiced in areas with the highest ADI score of 10 and 50% in areas with an ADI score of 8 or higher.

Conclusion: TNT Fellows experienced an increased overall knowledge and level of comfort in delivering treatment to individuals with SUDs. Fellows typically worked in underserved areas serving vulnerable populations. The PC-TEAM training program provides the opportunity to further develop skills related to evidence-based screening, assessment, and treatment of SUDs.

Keywords: Addiction; Education; Primary care; Substance use disorder; Training.

MeSH terms

Addiction Medicine* / education
Adult
Clinical Competence
Fellowships and Scholarships*
Female
Humans
Male
Primary Health Care*
Program Evaluation
Substance-Related Disorders* / diagnosis
Substance-Related Disorders* / therapy