Project CREATE was an initiative to strengthen undergraduate medical education in addictions. As part of a needs assessment, forty-six medical students at Ontario's five medical schools completed a bi-weekly, interactive web-based survey about addiction-related learning events. In all, 704 unique events were recorded, for an average of 16.7 entries per student. The most commonly discussed topic was alcohol withdrawal and the complications of alcohol use. The most common learning venues were lectures and clinical encounters in the emergency department or hospital. The proportion of advice-related topics (e.g., advice to drinkers and smokers) to advice plus non-advice related topics (e.g., medical complications) was greater for outpatient and community settings than for acute care and didactic settings (ratio 1.29, chi sq 15.85, p < 0.01). Students reacted strongly to the psychosocial impact of addictions on patients, yet they viewed addiction as a personal choice, not an illness.
Conclusion: Medical students are not being trained to diagnose addiction or provide advice and counseling. Medical schools need to provide students with positive clinical experiences supervised by physicians experienced in addictions.