Have efforts to improve medical students' drug and alcohol knowledge, skills and attitudes worked?

A series of surveys were undertaken at one Australian medical school to examine alcohol and drug-related knowledge, skills and attitudes before and after the introduction of the National Campaign Against Drug Abuse and also before and after major alcohol and drug medical education initiatives. The surveys were conducted with 5th year medical students at the University of Sydney in 1986, 1990 and 1993 (total n = 379). Response rates of approximately 70% were achieved in each of the survey years. The three cohorts of students were similar demographically with the exception that significantly more males in 1990 and 1993 reported that English was not their first language. Very low prevalence levels for smoking were reported. By 1993, only 3% of 5th year medical students reported that they smoked. There was a significant decrease in the frequency of drinking occasions for males and females between 1986 and 1990. There was also a four-fold increase in both male and female abstainers. There was no significant difference in the amount of alcohol consumed on any drinking occasion, although there was a trend in that direction. There was a significant increase in alcohol and drug-related knowledge in the 1990 and 1993 groups, compared to the 1986 group. Skill levels were not found to change significantly across the three year groups. Students' ability to recognize NHMRC hazardous consumption levels increased substantially between 1986 and 1990. Only 4% of 1986 students considered <30 of alcohol a day to be hazardous for females compared to 47% in 1990. For men, only 8% of students considered 31-60 hazardous drinking in 1986 compared to 55% in 1990 and 61% in 1993. More recently trained students tended to express slightly more tolerant and accepting views about patients with alcohol and benzodiazcpine dependence and had greater confidence in success of interventions. The present studies indicate important progress and achievements have been made. The paper discusses the further work needed to ensure that newly graduating medical practitioners are adequately equipped to deal effectively with alcohol and drug-related problems.