Addiction experts: The discrepancy between expectations and reality of generalist psychiatry training

Objective: The generalist psychiatrist is recognised in Australia as a specialist in the management of addiction. However, generalist training does not adequately prepare psychiatrists to take on this expert role. This problem is exacerbated by the lack of consensus around core competencies and training pathways. This article conceptualises the status of addiction training in generalist psychiatry training, outlines current gaps and worrying trends and provides suggestions for how these can be addressed. Conclusion: Limited international leadership in the field provides an opportunity for psychiatry training in Australia and New Zealand to set a gold standard for training general psychiatrists to hold core competencies in addiction psychiatry. Key strategies will include: the identification and monitoring of addiction rotations; providing a formal training module in addiction; specifying a set proportion of addiction exam questions; and obtain consensus on core competencies.