For addiction psychiatry core competencies, the psychiatry specialist (by the end of PGY V) must be able to:
1. Ability to adopt a preventive approach in clinical practice
Including an awareness of potential iatrogenic harm; of safe prescription practices; and of the appropriate management of chronic pain, chronic insomnia, chronic anxiety and chronic somatization conditions in dependency-vulnerable individuals; a familiarity with harm-reduction practices and the skills to promote them; an adequate knowledge of child neglect, child abuse and domestic violence issues, as well as the legal obligations of health care providers in such cases; the ability to assess fitness to operate vehicles or to perform high risk occupations, and an adequate knowledge of the health-care provider's legal responsibilities in this area.
2. Identify important determinants of patients' (and public) health.
Including the risks of substance use; sequelae of substance use behaviours; genetic / family planning issues etc.
3. Intercede on behalf of their patients
This is key as the patient weaves his/her way through complex health care institutions and services. This is especially important for individuals with concurrent disorders who are often excluded from treatments due to exclusion criteria of services that only deal with aspects of a person's situation.
4. Recognize and respond to those issues where advocacy is important.
This includes helping others understand the nature of addiction as a chronic illness with its biopsychosociocultural implications. This also includes advocating for people requiring social services / disability and are being rejected for having a concurrent addiction issue.
These skills will be taught through the following:
1. Lectures / discussions at PGY I and II core lecture series and other rounds within the Department of Psychiatry.
2. Allowing opportunities for residents to participate in (or design) advocacy projects for addiction and concurrent disorder patient
3 Working with other health care providers or being a member of the interdisciplinary team to understand and gain skills on advocacy for patients.
These skills will be evaluated through the following:
1. Participation in or development of advocacy projects
2. Observation and feedback from supervisor(s).