Pre-employment drug testing of housestaff physicians at a large urban hospital.
In an effort to address drug use and abuse among physicians beginning their graduate medical education. The Presbyterian Hospital at Columbia-Presbyterian Medical Center began a pre-employment drug testing program for housestaff physicians in 1987. Between 1987 and 1990, each of the 791 housestaff physicians beginning training at the hospital received a pre-employment urine toxicology examination. Despite the limitations of pre-employment drug testing, the program did identify two physicians who tested positive for illegal drugs. Based upon their test results and individual clinical evaluations, both physicians were denied a clinical appointment at the hospital. Their clinical training was temporarily interrupted while they received indicated treatment. The author suggests the main value of the program is to provide a focus for addressing issues related to substance abuse during graduate medical education.