MEDICAL EXPERT
- KNOWLEDGE: Demonstrate an overall effective level of knowledge and understanding of the basic science and clinical knowledge relevant to the addictive behaviours and concurrent mental health and addictions:
1.1 History, conceptual issues and classification of addictions
1.2 Etiology and symptoms of addictive behaviours
1.3 Concurrent disorders (medical, psychiatric co-morbidities)
1.4 Diagnosis and differential diagnosis
1.5 Phenomenology, pathology and investigations
1.6 Course and outcome, functional impairments and illness trajectories
1.7 Evidence-based addictions treatments – Pharmacological
1.8 Evidence-based addictions treatments – Psychosocial
1.9 Treatment adherence issues and psychoeducation
1.10 Continuum of care, long-term treatment issues and relapse prevention strategies
1.11 Treatment Modalities – individual, family, group, MI, Relapse-Prevention
1.12 Basic science knowledge and application to addictions (genetics, neurophysiology, neuroanatomy, neurochemistry, neuropsychology)
2. Skills: Demonstrate the general ability to assess, diagnose, consult on, and treat the full range of addictive disorders in the chronic care (with an emphasis on schizophrenia, bipolar disorder and other serious and persistent mental illness) population using an evidence-based approach. Need to be proficient in technical and procedural skills and minimize risks and discomforts to the patient and be able to: Assessment:
2.1 Establish and maintain rapport and an effective therapeutic alliance, using motivational interviewing methods
2.2 Conduct and organize an appropriate addiction assessment, including drug use history taking, assessment of functional impairment associated with alcohol/drug misuse, ordering and interpretation of toxicology testing
2.3 Perform an appropriate psychosocial assessment, including assessment of substance use and the family
2.4 Demonstrate expertise in obtaining collateral information from additional sources from family and significant others as appropriate
Formulation:
2.4 Synthesize a diagnosis according to DSM 5 criteria
2.5 Integrate and present a bio-psycho-social understanding/formulation
Treatment Plan:
2.6 Develop and implement an integrated biopsychosocial treatment plan
2.7 Use appropriate psychiatric, psychological, medical and imaging diagnostics and/or investigations
2.8 Make appropriate referrals to other professionals and community resources
2.8 Assess suitability for, prescribe and use appropriate psychological treatment
2.9 Assess suitability for, prescribe and use appropriate psychopharmacological treatment for addictions
Treatment Implementation:
2.10 Show expertise in abstinence initiation, and relapse prevention strategies
2.11 Show expertise in identifying and addressing unique issues in working with those from diverse cultural backgrounds
2.12 Attend to safety issues, including the management of the suicidal or violent patient, as well as the recognition and appropriate referral of medically urgent issues
COMMUNICATOR:
Demonstrate the following abilities:
1.1 Listening effectively
1.2 Communicating and negotiating with patient, family, and health care team, an accurate, clear, 1.3 coherent and timely account of the diagnoses, treatment plans and prognosis in all clinical cases
1.4 Conveying pertinent information and opinions to medical colleagues in a timely, efficient and 1.5 effective manner, in both verbal and written formats
1.6 Preparing documentation that is accurate, timely and succinct
COLLABORATOR:
Demonstrates the following abilities:
1.1 Consulting effectively with other physicians, health care professionals, and agencies as appropriate
1.2 Working collaboratively with other members of the health care team: – recognizing their roles 1.3and responsibilities – contributing to inter-disciplinary team activities
1.4 Facilitating the learning of patients, students and other health professionals
LEADER:
Demonstrates:
1.1 Setting and implementing realistic priorities and using time effectively in order to optimize professional performance and balance patient care and learning needs
1.2 Competence and willingness to direct patients to relevant community resources
HEALTH ADVOCATE:
Demonstrates:
1.1 Effective understanding of advocacy issues which embraces the biopsychosocial and cultural needs of addicted patients and their families within the health care system and community
1.2 Ability to identify and understand the determinants of health affecting addicted patients and communities, recognizing and responding to those issues where advocacy is appropriate for the patient or community
SCHOLAR:
Demonstrate the following abilities:
1.1 Critical appraisal of medical information, successful integration of information from a variety of sources, and conforming to evidence-based principles of practice in relation to addicted patients
PROFESSIONAL:
Demonstrate:
1.1 Integrity, compassion and respect for diversity
1.2 Realistic but hopeful, positive and anti-stigmatizing attitudes towards patients with addictive and concurrent disorders
1.3 Fulfillment of the medical, legal and professional obligations of the psychiatrist, practising within the Code of Ethics Annotated for Psychiatry and Ministry of Health regulations.
1.4 Collaborative and respectful patient relationships that demonstrate gender and cultural awareness
1.5 Responsibility, dependability, self-direction, and punctuality
1.6 Acceptance and constructive use of supervision and feedback
1.7 Awareness and appropriate response to personal limitations including reactions to addicted / concurrent disorder patients (e.g. countertransference issues)
1.8 Responsibility in attendance and participation in educational opportunities, including addiction psychiatry seminars