MI CARES: Answering the Call for More Addiction Specialists

Reprinted from summer 2019 Michigan Family Physician 
In 2017, the Michigan Department of Health and Human Services (MDHHS) reported 2,686 drug overdose deaths—a record high for the state and a 12% increase from 2016. Kent (63%), Oakland (27%), and Macomb (23%) counties saw the most significant increases in drug overdose death rates. Kent County was significantly impacted by deaths involving heroin with an increase of 111%. With less than 200 addiction medicine specialists in Michigan and only one in the entire Upper Peninsula, there are simply not enough highly-trained and qualified physicians in the state to tackle the problem.
Strides are being made, thanks to a two-year, $1.5 million grant from MDHHS. Led by Michigan State University in collaboration with University of Michigan, Wayne State University, and Grand Rapids-based Spectrum Health, Michigan CARES, or Collaborative Addiction Resources and Education System (MI CARES), provides an opportunity to train more physicians to become addiction medicine specialists by streamlining the board certification process.
The program is spearheaded by Cara Poland, MD, MEd, FACP, DFASAM, a Spectrum Health Medical Group physician and certified addiction medicine specialist, and Kelly Strutz, PhD, an epidemiologist and assistant professor in the MSU College of Human Medicine, in collaboration with Edward Jouney, DO, clinical instructor and program director for the University of Michigan Addiction Psychiatry Fellowship Training Program, and Mark Greenwald, PhD, professor and director of Wayne State’s Substance Abuse Research Division.

Against the Clock

In April 2016, the American Board of Medical Specialties (ABMS) announced addiction medicine would be a new multi-specialty subspecialty of preventive medicine. As a result, a five-year window of opportunity opened to build a sustainable workforce by 2021 through Practice Pathway. This enables physicians to use a combination of experiential hours coupled with passing a board examination to become an ABMS board-certified addiction medicine provider, without having to complete an addiction medicine fellowship.
The ability to enter the addiction medicine specialty through Practice Pathway is crucial so Michigan can train as many new providers as possible between now and when the pathway closes in 2021. Once Practice Pathway ends, the only way for physicians to become board certified in addiction medicine will be to complete a 1- to 2-year Accreditation Council for Graduate Medical Education (ACGME)-approved addiction medicine fellowship training program. With Michigan’s only addiction medicine fellowship trainingprogram at St. Joseph Mercy Hospital in Ann Arbor, the state is at a critical period to build a sustainable workforce.
Addiction specialists provide their communities with the skills necessary for adequate prevention, screening, intervention, and treatment for substance use disorders and addiction.

Practice Pathway

Any physician who has pursued board certification or subspecialty certification understands the process can be daunting. The MI CARES team is creating a curriculum to better prepare physicians to successfully enter the specialty of addiction medicine through Practice Pathway. The curriculum will closely follow the American Board of Preventive Medicine (ABPM) blueprint for subspecialty certification by providing a comprehensive overview of the 17 core competencies of addiction medicine medical knowledge. In addition, the MI CARES program will provide an in-depth overview of Practice Pathway requirements and detail examples of acceptable addiction medicine practice activity, teaching, research, and administrative duties that qualify physicians to meet the 1,920 hours of addiction medicine experience required for certification:
  • All practice time must have occurred within the 5-year period preceding June 30, 2019
  • Minimum of 480 hours of direct patient care (25%)
  • Maximum of 1,440 hours of research, administration, and teaching activities (75%)
  • Maximum of 480 hours of general practice can count toward Practice Pathway (25%)
  • Remaining 75% of this time MUST be specific to
  • addiction medicine practice

MI CARES Enrollment

To qualify for enrollment in MI CARES, physicians must have:
  • An unrestricted and current medical license
  • ABMS board certification from any of the 24 ABMS member boards
  • Engaged in the practice of addiction medicine and able to document 1,920 hours; the hours must occur over at least 24 of the previous 60 months prior to application in the year in which they apply

MI CARES can facilitate connecting physicians with addiction medicine and addiction psychiatry providers in their area to help complete the required hours.

If you are a physician interested in becoming certified in addiction medicine and would like additional information about the MI CARES program, visit micares.msu.edu.
For assistance through the process, contact MI CARES Program Curriculum Director Lia Bennett, MPH at lia.bennett@spectrumhealth.org.
For enrollment assistance, contact Candace Heeringa, research assistant, at heeringc@msu.edu.