Random Drug Screening at Residency Programs

[SockyMD]

I recently found out that one of the residency programs I had considered applying to conducts random employee drug screening throughout your participation in the residency. I am well-prepared for pre-employment screening, but was surprised by the prospect of ongoing testing. Without getting into the politics of the way I like to spend my free time away from the hospital, what other programs share this sort of requirement? It would be helpful to know if this practice is widespread before canceling my interview at that institution.

(Posted anonymously for obvious reasons.)

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[efex101]

WTF? you should be fine with random drug screens, participating in illegal substances is not conducive to this profession IMHO. My program does not do this.

 

[Frugal Traveler]

It is probably a hospital policy for all employees... residents are employees.

There are many reasons to do random drug screening, and I think doing this for hospital employees is completely acceptable if it is the organization's corporate policy. Grocery stores, some private high schools, hospitals, and other institutions do this... I do not have any literature saying how effective it is... but the bottom line is it is their policy... so you have to follow it. If you don't like it, go play in your own tree house

If it is a deal breaker, then decline the invitation and let someone else interview at the program.

 

[RegularNihilist]

I'd like to describe what I think of that program, however the SDN seems to make a big deal out of common profanities, so I'll refrain.

I wish every doc would be allowed to smoke pot in hospital, to chill out properly in the stressful environment. "#% nazis telling me what to do with my own hippocampus.

 

[drfunktacular]

It kind of seems like cancer screening...

American Cancer Society is now changing their tune recently to say that screening may not be as great as we once thought for some cancers (breast, prostate come to mind).

Likewise, should we really be screening everyone for substance use if it is not noticeably affecting their performance leading to impairment?

Clearly, providing a bit of urine is hardly as invasive as a breast core biopsy. But it does make me wonder how many adverse effects are really prevented by booting people who roast a bone on their golden weekends...

 

[Rendar5]

Most places I know of don't do drug screenigns. I'm sure plenty of other places do perform entry level drug screenings. That said, I personally would rethink any program that offered drug screens. Too many things can cause a false-positive on those tests.

 

[peppy]

At any program, you have to be prepared for the chance that you will be asked to take a drug test randomly. My program has only asked everyone to do a pre-employment drug test, but they did mention that they may do a random drug test if at any time they suspect drug use. Even if the risk of getting caught is smaller at some programs than others, do you really want to take the risk of getting fired over something like this?

 

[gutonc]

Keep in mind that, no matter where you do residency or get a job, if you want to get life/disability insurance at any point, you will be peeing in a cup before you get it. And if you file a disability claim, you will likely be doing it again. And any time you change jobs, or your employer changes plans...that's right...time to unzip.

I agree that random screening is ridiculous and unnecessary. But it's out there and there's not a ton you can do about it.

 

[dragonfly99]

I've never been screened for drugs at any med school, residency or fellowship program where I've been. Not even preemployment.
I have had multiple criminal background checks.
If you don't want to work somewhere that does these types of screenings, you probably can avoid it.

But I agree that if you are going to be a doc, then using pot or any other drug isn't worth the risk of losing your license. I honestly wouldn't feel too hot about being treated by someone who smokes pot, but I know some others would feel differently.

 

[CambieMD]

I recently found out that one of the residency programs I had considered applying to conducts random employee drug screening throughout your participation in the residency. I am well-prepared for pre-employment screening, but was surprised by the prospect of ongoing testing. Without getting into the politics of the way I like to spend my free time away from the hospital, what other programs share this sort of requirement? It would be helpful to know if this practice is widespread before canceling my interview at that institution.

(Posted anonymously for obvious reasons.)

I think that all residency programs should conduct random drug screening.
Please tell me what your problem with random drug screenig is. Drug screening is not a violation of your privacy. I have known of a few impaired physicians. No, they were not anesthesiologists.

Cambie

 

[CambieMD]

I agree that random screening is ridiculous and unnecessary. But it's out there and there's not a ton you can do about it.

I completely disagree. I find it ridicuous that someone who can do well enough to get into and complete med school would blow everything on drugs.
A lot of people can remain high functioning while they are using drugs. Judgement ,however is impaired. I wonder how many docs are impaired.
An impaired doc could harm patients.

Cambie

 

[Flopotomist]

I think that all residency programs should conduct random drug screening.
Please tell me what your problem with random drug screenig is. Drug screening is not a violation of your privacy. I have known of a few impaired physicians. No, they were not anesthesiologists.

Cambie

My problem with random drug screening is that it is a huge invasion into my personal, private life suggesting that even outside of my employment my employers little paws are controlling and policing me. Now if you have a justifiable cause for drug screening me, I would have no problem understanding the rationale. If you suspect that I may be compromised in my ability to provide care, or you suspect that there are drugs missing from the pyxis - fine - test me.

The problem here is that drug screening is often not used to actually identify impaired physicians (or any other employees) the tests themselves have too narrow a range in which they can detect drugs for this to be feasible in all but the most frequent of drug users. The real reason drug screening occurs is to exhert control over subordinate employees and subconsciously instill a sense of "being owned."

If you doubt this, do you wonder why the CEO of the hospital doesn't pee in a cup? How about the chair of the department? Clearly both of these individuals could do far more damage to the system if they were impaired, yet it is only the junior members of the staff who are humiliated into peeing in a cup.

Before you go makin assumptions - I took a whiz quiz recently and passed just fine - I had no choice as my school requires it for certain rotations, but I was PISSED about it. It didn't help that I had to actually PAY for it too!

If worrying about impaired physicians is actually the motive (which I argue it is not) the money spent on these programs would be FAR better spent helping physicians impaired by alcohol. Alcohol is much more widely abused than the illicits screened for with the utox.

 

[jey2283]

I think drug screening (random) is a waste if it is uncalled for. What people do on their own times is their business, so long as they are on the ball when at work. Besides, don't they have products that help you 'beat the test.' If that's so, then the entire process seems like a waste.

Oh well, looks like until a policy change occurs, i'll be peeing in a cup. I hope they don't want to watch me pee though, i get stage fright 😀

 

[Barclay]

The irony of all of this is that the drugs that are REALLY serious are out of the system in a couple of days, and won't be detected. Random screens will end up with a lot of positive results for marijuana, but not cocaine or heroin or the many drugs that aren't tested on those tox screens.

 

[Ttan]

[/COLOR]

I completely disagree. I find it ridicuous that someone who can do well enough to get into and complete med school would blow everything on drugs.
A lot of people can remain high functioning while they are using drugs. Judgement ,however is impaired. I wonder how many docs are impaired.
An impaired doc could harm patients.

Cambie

Im not even a doctor and I know 3 doctors who smoke pot or have smoked during their time in the field. All three are intelligent, capable, and very intent on always aiming to be 100% on their game just like any other caring physician. Marijuana can be tested positive in the system for a long time after use, up to 30 days I think, but the actual impairment lasts for maybe 1-3 hours (depending on the person and hisher psychological attachment). So wheres the hole in your logic?

 

[Apollyon]

I have known of a few impaired physicians. No, they were not anesthesiologists.

The plural of anecdote is not data. Your anecdote holds little stead. Anesthesiologists are 10% of doctors, but make up 30% of (known) impaired doctors. It's due to access.

 

[Danae00]

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[Rendar5]

I think that all residency programs should conduct random drug screening.
Please tell me what your problem with random drug screenig is. Drug screening is not a violation of your privacy. I have known of a few impaired physicians. No, they were not anesthesiologists.

Cambie

Here is the problem: got allergies or have to take a sinus med? BAM! false-positive for amphetamines. Eat poppy seed hamentashen for Purim (Jewish holiday)? BAM! false-positive for opiates. take certain uncommon NSAIDS such as oxaprozin for a pain condition? BAM! false-posiive for benzo's. On certain cough syrups to keep ou going when u have a cold? BAM! false-positive for PCP.

Oh, and what? you're a xanax abuser? aww, don't worry man, that one hardly ever shows up positive on drug screens! you're home free.

don't believe that this stuff is common enough to nearly ruin ur professional career? go back to july on this forum and go see what **** the resident who took prescription Claritin-D had to go through even after she explained the origin of her obvious false-positive.

(yeah, yeah, I realize i'm biased. I got trained against them because in toxicology they're among the most useless tests ever)

 

[RegularNihilist]

[/COLOR]
A lot of people can remain high functioning while they are using drugs. Judgement ,however is impaired. I wonder how many docs are impaired.

Sexual arousal can impair your thinking. I think there should be mandatory chemical castration for every male considering a career in medicine.