drug testing in residency programs

[seattledoc]

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I'm curious, since the topic has come up a couple of times in other threads. Are there programs that routinely perform urine or hair sample drug screens. To my knowledge, none of the places I've been affiliated with have done this unless you've been busted and they are policing the situation.

Please chime in with what other programs around the country are doing.

 

[Sugar72]

I'm curious, since the topic has come up a couple of times in other threads. Are there programs that routinely perform urine or hair sample drug screens. To my knowledge, none of the places I've been affiliated with have done this unless you've been busted and they are policing the situation.

Please chime in with what other programs around the country are doing.

One of the places i interviewed said that they do a drug test - i can't remember which one it was because it is not an issue for me. I feel like it was either UTMB or VCU, but I can't remember which one.

 

[deleted50478]

MGH said they drug test. I think few programs do right now, but more and more will as time goes by.

 

[Pooh & Annie]

One of the transitional programs I interviewed at does (I don't want to be TOO specific, but it is in Washington state). I didn't hear anything about testing from the anesthesiology programs.

 

[Danger Man]

These days most, if not all, programs test as part of the medical clearance for residency. Time for some of you to put away the hippie lettuce. 😱

 

[seattledoc]

See, this is what I always hear. People talking in the abstract about what they heard certain programs do and don't do. Has anybody out there being periodicly randomly tested or is drug testing just something people hear happens to other people? So far it sounds like not much testing goes on. Speak up if you've been tested

 

[Danger Man]

See, this is what I always hear. People talking in the abstract about what they heard certain programs do and don't do. Has anybody out there being periodicly randomly tested or is drug testing just something people hear happens to other people? So far it sounds like not much testing goes on. Speak up if you've been tested

Tested.

 

[cubs3canes]

Tested.

Sugar72 UTMB's policy was that in order to go to some of the outlying sites you have to be drug tested.

Who knows? But how do you ask that. If you ask, do you test, then you look like a drug user? If you do not ask and smoke some pot and fail then you look like an idiot. This is an interesting dilemma for some people I bet.

Not for me however, I stop using those steroids as soon as baseball's drug testing policy changed. I know that I am 70 homers away from the record, but it is not worth the risk.

Cubs

 

[fuzzy_wuzzy]

Tested.

Randomly tested w/o warning or was this a one time thing w/ warning?

 

[drrosenrosen]

Randomly tested w/o warning or was this a one time thing w/ warning?

Every program I know of tests as part of their pre-employment medical screen. I've never heard of a program that does random, or even periodic scheduled testing. Also never heard of a program that does hair tests.

 

[Danger Man]

Randomly tested w/o warning or was this a one time thing w/ warning?

Prior to starting residency--no tests afterwards.

 

[LostTommyGuns]

I'm a 3rd year med student. But take a step back for a minute. I've never heard of a program testing unless they believe that you're actually using something/stealing it. It may well be the case that some or possibly most programs test before the start of your residency. I just feel like I would have heard more about it if it were widespread.
Second consider the type of test they are doing and what they are testing for. By now you know that you can test Urine, Blood, or Hair. So what is it that these programs are testing? I'm guessing Urine but I'd be interested to hear from someone who has actually been tested. Second what is it that they are testing for? Do they do the standard 5 drug (NIDA 5, Cannabinoids, Cocaine, Amphetamines, Opiates and Phencyclidine) or expanded tests that include barbituates, benzos, ethanol, ecstasy, etc.?
Finally why would they test? Presumably having graduated medical school you are smart enough to either not do drugs, or at least know enough to figure out how to beat the system. In my opinion drug screens are meant to find people that are so addicted to a substance that they can't go the 2-4 days that most substances take to clear your system...
Thoughts?

 

[Sugar72]

I'm a 3rd year med student. But take a step back for a minute. I've never heard of a program testing unless they believe that you're actually using something/stealing it. It may well be the case that some or possibly most programs test before the start of your residency. I just feel like I would have heard more about it if it were widespread.
Second consider the type of test they are doing and what they are testing for. By now you know that you can test Urine, Blood, or Hair. So what is it that these programs are testing? I'm guessing Urine but I'd be interested to hear from someone who has actually been tested. Second what is it that they are testing for? Do they do the standard 5 drug (NIDA 5, Cannabinoids, Cocaine, Amphetamines, Opiates and Phencyclidine) or expanded tests that include barbituates, benzos, ethanol, ecstasy, etc.?
Finally why would they test? Presumably having graduated medical school you are smart enough to either not do drugs, or at least know enough to figure out how to beat the system. In my opinion drug screens are meant to find people that are so addicted to a substance that they can't go the 2-4 days that most substances take to clear your system...
Thoughts?

In the non medicine world - and i assume also in the medical world- the rates an organization must pay for their occupational insurance (workers comp-like stuff)will be reduced if they have a policy of preemployment drug screens and a policy of randem drug tests. Everything these days is about the bottom line and of course medico-legal. DId you read the news story earlier in the week about the neurosurgeon trying to operate while drunk? Are you being serious with the "too smart to do drugs" line?

 

[VolatileAgent]

testing, in our field, is a by-product of access. it is a commonly held opinion (at least at the extensive evidence-based, anti-drug training i've received in my program) that the field does not necessarily attract or create drug addicts, but provides an easy means to acquire dangerous medicines in the hands of those who have that tendency. many times, those who've gone into rehab as a result of either willingly coming forward or otherwise directly being caught diverting narcotics have often, when later examined, had a history of alcohol and substance abuse (either diagnosed or undiagnosed) and/or emotional problems. this makes sense. my advice: this is not the field for you if you fit either of those descriptions.

now, for those of you who dabble in the occassional ganja, more advice:

• stop.
• think about what you are doing.
• it's time to put it away.

i'm not making a value judgment or personal affront on those of you who've, up to this point, made the decision to enjoy the occassional indulgence. i'd only be throwing stones at the glass house in which i used to live. what i am suggesting is that you now make the decision to cease that activity. it's not even a question (i hope) of the potential for on-the-job impairment. it's just that, as you transition into the world of medical licensure and truly being responsible for taking care of another human being, there's just too much at stake. so, i seriously hope that you will consider the benefit-to-risk ratio of this behavior. this is something that we do everyday with our patients, and you need to not forget yourself as you make such critical assessments.

having said all of that, here's to the issue of drug testing becoming a moot point. but, yes, most programs test residents as a screening tool at the beginning of their residency. yes, you are likely to get randomly tested at any program if they suspect you have a problem. no, neither of these are a reason to quit. the reason to quit is that you care more about your career than you do about catching an occassional buzz.

i hope you seriously think about and consider what i'm saying here. your career may be at stake. and, if you have a problem and/or can't compel yourself (for whatever reason) to quit, please get help before you enter this dangerously easy to obtain field. remember: curiousity killed the cat.

 

[LostTommyGuns]

Let the record first reflect, I am not a substance abuser by any stretch of the imagination. I like Beer and I like Gin and Tonics... that's about the extent of things.
The points I make (only a few of which were answered) were simply because I find that many people I deal with consider theory only rather than applying theory to reality. For instance, it may well be the case that insurance rates go down if they drug test everyone and that would be a logical reason to do it. However, take workers comp for instance: whenever someone has to go to the ER they are required to give a Urine sample (if able) to confirm that they were not on anything while an incident occurred. That is a much more efficacious way to avoid paying medical costs, by drug testing when an accident occurs.
I presume that the monologue about quitting drugs was not aimed towards me, despite the constant use of "you", but rather as a topic of conversation and I don't disagree with what was said. I drink I don't do drugs, however I would like to pose a theoretical question to VolatileAgent: If I go out and have a few drinks say for 4-5 hours, or I indulge in marijuana for roughly the same time period. What's the difference? Without delving deeply into pharmacokinetics it is not unreasonable to say that you clear marijuana overnight the same way you do alcohol. Now for a moment disregard that one is legal and one is not. What's the difference? Both are mild-altering substances, what difference does it make which one you use?
Let me say again, I don't smoke marijuana but I do find it irritating when people equate doing it with being a bad person. If you want to harp on an issue, attack obese surgeons doing Gastric By-passes and doctors that smoke a pack or more a day and treat COPD.
Just a thought.

 

[VolatileAgent]

Now for a moment disregard that one is legal and one is not. What's the difference? Both are mild-altering substances, what difference does it make which one you use?

i'm not even remotely attempting to make a scientific argument. and i'm certainly not being sanctimonious. i don't even personally agree with the fact that it should be classified as illegal. there is, in my book, no difference between the occassional use of marijuana and the occassional use of alcohol.

but...

the whole point is that you can't disregard the fact that it is illegal. the laws of our society dictate this. not only may your medical license be at stake, but you are exposing yourself to HUGE liability if you make the decision to continue this behavior. all it takes is one smirch - deserved or not - on your record and, even if you keep your license and continue to practice, you'll forever be wearing that scarlet letter. and lawyers will have a field day with that if you ever end up in court. it doesn't even ultimately matter what your peers or the program or the state licensing board thinks - just what the jury and your insurer do.

it's all about benefit-to-risk, and any rational (and unimpaired) person should be able to see that the risk far outweighs anything you get out of continuing do smoke in return. just say "no".

 

[seattledoc]

an amusing aside...there's a casino in my hometown and I've got a fair number of old friends that have worked there and some still do. They had a drug testing policy there, and they would test for the usual substances. If you failed a drug test, you got probation. After three failures, you couldn't work there for 2 years. The casino had to stop testing for MJ because they saw that they would decimate their work force and have to close shop! Now they only test for the more serious substances...pathetic (one of my friends was asked to bring in a urine sample to be tested, I think his supervisor was hoping he would bring in someone else's urine that would test clean. The only problem was that my friend couldn't find anybody to give him a clean sample!!!!!)

As far as making serious decisions while being impaired, this can easily be extrapolated to other fields. How many DA's are on their 3rd scotch when they make a life and death decision, what about politicians (look at Teddy Kennedy)!!! I'm not saying it's OK, rather I'm saying that this is a societal problem that spans casinos, truckdrivers, police, politicians, and of course health care workers.

 

[Lizard1]

The only problem was that my friend couldn't find anybody to give him a clean sample!!!!!)

what does that say about you? 😀

 

[Sugar72]

an amusing aside...there's a casino in my hometown and I've got a fair number of old friends that have worked there and some still do. They had a drug testing policy there, and they would test for the usual substances. If you failed a drug test, you got probation. After three failures, you couldn't work there for 2 years. The casino had to stop testing for MJ because they saw that they would decimate their work force and have to close shop! Now they only test for the more serious substances...pathetic (one of my friends was asked to bring in a urine sample to be tested, I think his supervisor was hoping he would bring in someone else's urine that would test clean. The only problem was that my friend couldn't find anybody to give him a clean sample!!!!!)

As far as making serious decisions while being impaired, this can easily be extrapolated to other fields. How many DA's are on their 3rd scotch when they make a life and death decision, what about politicians (look at Teddy Kennedy)!!! I'm not saying it's OK, rather I'm saying that this is a societal problem that spans casinos, truckdrivers, police, politicians, and of course health care workers.

I worked at a casino for 3 years. We were drug tested preemployement via hair and they had "random" drug checks where they would post a list of who was going to be randomly drug checked in the next 30 days so they had a warning. Employers don't necessarily care they have hoops like everyone else does. My fellow casino workers were some booze-drinking, weed smokin' maniacs! Craps dealers are a hard living bunch!

 

[seattledoc]

what does that say about you? 😀

Well. I live 1500 miles away now. I guess I could have fed-ex'd it. Smart-a ss

 

[jetproppilot]

I worked at a casino for 3 years. We were drug tested preemployement via hair and they had "random" drug checks where they would post a list of who was going to be randomly drug checked in the next 30 days so they had a warning. Employers don't necessarily care they have hoops like everyone else does. My fellow casino workers were some booze-drinking, weed smokin' maniacs! Craps dealers are a hard living bunch!

Twelve on 6 & 8, and I'll buy the 5, Sug.