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John R. Knight, MD; Ja'Nean Palacios; Michael Shannon, MD, MPH

Arch Pediatr Adolesc Med. 1999;153:1181-1183.

Objective  To measure the prevalence of alcohol-related problems among pediatric trainees.

Methods  An alcoholism screening test was administered anonymously to participants at a mandatory substance abuse education and prevention program.

Setting  A large urban pediatric residency training program.

Subjects  One hundred fifteen pediatric residents attended the program during 3 consecutive years (1996-1998). Eighty-five (74%) screening tests were returned and 81 (70%) were analyzed

Main Outcome Measure  The 25-item Michigan Alcoholism Screening Test (MAST). Differential MAST cut-points have been established to "suggest" or "indicate" a lifetime diagnosis of alcoholism.

Results  Twelve residents (15%) had scores suggestive and 6 (7%) indicative of alcoholism. Twenty-eight (35%) admitted to having alcohol-associated amnesia (blackouts), 13 (16%) to "feeling bad" about their drinking, 9 (11%) to drinking before noon, 6 (7%) to getting into fights when drunk, and 2 (2%) to alcohol-related marital problems. However, only 1 (1%) had gone to anyone for help and none admitted to alcohol-related problems at work.

Conclusions  These screening data suggest that alcohol abuse and related problems exist among pediatric trainees at troubling rates. While more than one third of the trainees had experienced a serious consequence from heavy drinking, only 1 had gone for help and problems were not apparent at work. Greater emphasis should be placed on alcohol prevention and early intervention programs as a routine part of pediatric training.

From the Division of General Pediatrics (Dr Knight), Physician Health Committee (Ms Palacios), and Division of Emergency Medicine and Program in Clinical Toxicology (Dr Shannon), Children's Hospital, and the Department of Pediatrics (Drs Knight and Shannon) and Division on Addictions (Dr Knight), Harvard Medical School, Boston, Mass.

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