Risk and outcomes of substance use disorder among anesthesiology residents: A matched cohort analysis

David Oman Warner, Keith Berge, Huaping Sun, Ann Harman, B. S. Andrew Hanson, Darrell R. Schroeder

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: The goal of this work is to evaluate selected risk factors and outcomes for substance use disorder (SUD) in physicians enrolled in anesthesiology residencies approved by the Accreditation Council for Graduate Medical Education. Methods: For each of 384 individuals with evidence of SUD while in primary residency training in anesthesiology from 1975 to 2009, two controls (n = 768) who did not develop SUD were identified and matched for sex, age, primary residency program, and program start date. Risk factors evaluated included location of medical school training (United States vs. other) and anesthesia knowledge as assessed by In-Training Examination performance. Outcomes (assessed to December 31, 2013, with a median follow-up time of 12.2 and 15.1 yr for cases and controls, respectively) included mortality and profession-related outcomes. Results: Receiving medical education within the United States, but not performance on the first in-Training examination, was associated with an increased risk of developing SUD as a resident. Cases demonstrated a marked increase in the risk of death after training (hazard ratio, 7.9; 95% CI, 3.1 to 20.5), adverse training outcomes including failure to complete residency (odds ratio, 14.9; 95% CI, 9.0 to 24.6) or become board certified (odds ratio, 10.4; 95% CI, 7.0 to 15.5), and adverse medical licensure actions subsequent to residency (hazard ratio, 6.8; 95% CI, 3.8 to 12.2). As of the end of follow-up, 54 cases (14.1%) were deceased compared with 10 controls (1.3%); 28 cases and no controls died during residency. Conclusion: The attributable risk of SUD to several adverse outcomes during and after residency training, including death and adverse medical license actions, is substantial.

Original languageEnglish (US)
Pages (from-to)929-936
Number of pages8
JournalAnesthesiology
Volume123
Issue number4
StatePublished - Oct 1 2015

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Anesthesiology
Internship and Residency
Substance-Related Disorders
Cohort Studies
Medical Licensure
Odds Ratio
Graduate Medical Education
Accreditation
Licensure
Medical Education
Medical Schools
Anesthesia
Physicians
Mortality

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Warner, D. O., Berge, K., Sun, H., Harman, A., Andrew Hanson, B. S., & Schroeder, D. R. (2015). Risk and outcomes of substance use disorder among anesthesiology residents: A matched cohort analysis. Anesthesiology, 123(4), 929-936.

Risk and outcomes of substance use disorder among anesthesiology residents : A matched cohort analysis. / Warner, David Oman; Berge, Keith; Sun, Huaping; Harman, Ann; Andrew Hanson, B. S.; Schroeder, Darrell R.

In: Anesthesiology, Vol. 123, No. 4, 01.10.2015, p. 929-936.

Research output: Contribution to journalArticle

Warner, DO, Berge, K, Sun, H, Harman, A, Andrew Hanson, BS & Schroeder, DR 2015, 'Risk and outcomes of substance use disorder among anesthesiology residents: A matched cohort analysis', Anesthesiology, vol. 123, no. 4, pp. 929-936.
Warner DO, Berge K, Sun H, Harman A, Andrew Hanson BS, Schroeder DR. Risk and outcomes of substance use disorder among anesthesiology residents: A matched cohort analysis. Anesthesiology. 2015 Oct 1;123(4):929-936.
Warner, David Oman ; Berge, Keith ; Sun, Huaping ; Harman, Ann ; Andrew Hanson, B. S. ; Schroeder, Darrell R. / Risk and outcomes of substance use disorder among anesthesiology residents : A matched cohort analysis. In: Anesthesiology. 2015 ; Vol. 123, No. 4. pp. 929-936.
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abstract = "Background: The goal of this work is to evaluate selected risk factors and outcomes for substance use disorder (SUD) in physicians enrolled in anesthesiology residencies approved by the Accreditation Council for Graduate Medical Education. Methods: For each of 384 individuals with evidence of SUD while in primary residency training in anesthesiology from 1975 to 2009, two controls (n = 768) who did not develop SUD were identified and matched for sex, age, primary residency program, and program start date. Risk factors evaluated included location of medical school training (United States vs. other) and anesthesia knowledge as assessed by In-Training Examination performance. Outcomes (assessed to December 31, 2013, with a median follow-up time of 12.2 and 15.1 yr for cases and controls, respectively) included mortality and profession-related outcomes. Results: Receiving medical education within the United States, but not performance on the first in-Training examination, was associated with an increased risk of developing SUD as a resident. Cases demonstrated a marked increase in the risk of death after training (hazard ratio, 7.9; 95{\%} CI, 3.1 to 20.5), adverse training outcomes including failure to complete residency (odds ratio, 14.9; 95{\%} CI, 9.0 to 24.6) or become board certified (odds ratio, 10.4; 95{\%} CI, 7.0 to 15.5), and adverse medical licensure actions subsequent to residency (hazard ratio, 6.8; 95{\%} CI, 3.8 to 12.2). As of the end of follow-up, 54 cases (14.1{\%}) were deceased compared with 10 controls (1.3{\%}); 28 cases and no controls died during residency. Conclusion: The attributable risk of SUD to several adverse outcomes during and after residency training, including death and adverse medical license actions, is substantial.",
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