Journal of general internal medicine · 2026
Risk Perceptions of Substance Use Recovery Disclosure in Medical School Applications: A National Sample of Physicians and Dentists.
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Chang Rachel, Ganek Nicholas, Colgrove James K, Pereyra Margaret R, Parish Carrigan L, Jacobs Petra, Horigian Viviana E, Pollack Harold A, Feaster Daniel J, Metsch Lisa R
Аннотация
AIMS: Given stigmatizing attitudes held by many healthcare providers toward substance use, medical and dental school applicants in recovery from past substance use face the dilemma of whether to disclose this during the admissions process. We assessed current physicians' and dentists' perceptions of the risk that such disclosure would have on an applicant's prospects of admission and how this was influenced if the disclosure was framed as part of a professional journey to help others.
DESIGN: A national probability survey of physicians and dentists using a sampling frame from the American Medical Association and American Dental Associations.
SETTING: Online and paper questionnaire.
PARTICIPANTS: One thousand two hundred forty emergency department physicians, primary care physicians, and dentists.
MEASUREMENTS: A 125-item survey assessing provider stigma toward people with substance use disorders with two questions on the perceived risk of disclosure of substance use on medical and dental school applications.
FINDINGS: A total of 82.5% of physicians and dentists reported that disclosure of a history of substance use by medical or dental school applicants would carry a "moderate" or "significant" risk for adverse admissions outcomes. When past substance use was framed as part of an applicant's professional motivation, half of the respondents (49.8%) perceived disclosure as "moderately" or "significantly" risky. Respondents who reported having a friend or patient who uses or used drugs were more likely to perceive substance use disclosure (without context) as riskier than their corresponding colleagues.
CONCLUSION: Physicians and dentists overall perceive high risk for adverse admissions outcomes when applicants disclose their past substance use in their medical and dental school applications. This risk is lessened yet remains prominent when the experience is framed as part of the applicant's professional motivation. This may reflect a certain persistence of stigma among physicians and dentists toward people with a history of substance use.
DESIGN: A national probability survey of physicians and dentists using a sampling frame from the American Medical Association and American Dental Associations.
SETTING: Online and paper questionnaire.
PARTICIPANTS: One thousand two hundred forty emergency department physicians, primary care physicians, and dentists.
MEASUREMENTS: A 125-item survey assessing provider stigma toward people with substance use disorders with two questions on the perceived risk of disclosure of substance use on medical and dental school applications.
FINDINGS: A total of 82.5% of physicians and dentists reported that disclosure of a history of substance use by medical or dental school applicants would carry a "moderate" or "significant" risk for adverse admissions outcomes. When past substance use was framed as part of an applicant's professional motivation, half of the respondents (49.8%) perceived disclosure as "moderately" or "significantly" risky. Respondents who reported having a friend or patient who uses or used drugs were more likely to perceive substance use disclosure (without context) as riskier than their corresponding colleagues.
CONCLUSION: Physicians and dentists overall perceive high risk for adverse admissions outcomes when applicants disclose their past substance use in their medical and dental school applications. This risk is lessened yet remains prominent when the experience is framed as part of the applicant's professional motivation. This may reflect a certain persistence of stigma among physicians and dentists toward people with a history of substance use.