1. Louis E. Baxter, Sr., M.D., DFASAM, DABAM
Residents and Fellows in Recovery: How to Evaluate for Training Programs
Louis E. Baxter, Sr., M.D., DFASAM, DABAM
President and CEO Professional Assistance Program of NJ
Director Addiction Medicine Foundation (ABAM)
Assistant Clinical Professor Medicine
Rutgers New Jersey Medical School
Co-Director Addiction Medicine fellowship Howard University Hospital

2. What Are The Considerations ?
What is “recovery” ?
Recovery from what ?
How is recovery measured?
What is the quality of recovery?
How long should one be in recovery before selection?
What are the risks?
What are the benefits?
Documentation of recovery …
ADA and HIPPA

3. What is “Recovery” ?
Noun… “a return to a normal state of health, mind, or strength”
SAMHSA … “a process of change through which individuals improve their health and wellness, live self-directed lives and strive to reach their full potential.”
Signs of recovery:
1. I can address problems without using;
2. I have at least one person I can be completely honest with;
3. I have personal boundaries;
4. I take time to restore my energy physical and emotional

4. How much “recovery” time is enough?
How much recovery time is sufficient before hiring?
Does recovery time need to be documented?
Some entities require 90 days to 6 months up to 1 or 2 years of documented recovery (licensing boards, insurance panels, and medical groups)
Fellowship programs need to decide
Promising candidates without documentation can be enrolled in PHPs

5. Recovery Status / Risks and Benefits
Candidate in poor or undocumented recovery may relapse
Institutional and Program liability (ADA & Malpractice Exposure)
Patient care issues – competent medical care
Documented recovery and ongoing monitoring of recovery provides advocacy for the candidate and
Provides the program with added assurances of ongoing wellness

6. Assessing Recovery Status
Is Candidate currently enrolled in a PHP?
If so request documentation of recovery status
If not, consider enrollment for assessment, documentation and advocacy of ongoing recovery
Is candidate attending 12 Step Recovery or other recovery support groups, IDAA, ongoing counseling or therapy

7. Red Flags … No documentation of recovery or monitoring
No UDS screening history
No support or treatment history when a diagnosis of SUD or Psychiatric illness exists
Multiple training programs and postgraduate facilities
History of suspended licenses or training permits
Resistance to suggestion of ongoing monitoring for advocacy

8. Recommendations Pre-employment UDS testing and “for cause” testing
Psychiatric Clearance for those with mental illness history
Enrollment in PHP for ongoing documentation and advocacy of recovery status
Protects Fellows from allegations of impairment
Protects the Fellowship Program
Helps to assure the ongoing wellness of the Fellow selected

9. ADA and HIPPA Compliance
ADA (reasonable accommodations) must not be violated (i.e. Discrimination because of SUD or psychiatric history)
HIPPA Be sure rules and regulations are followed in collecting recovery information
Signed Employment agreements that encompass employment expectations

10. Questions and Comments?