Good day, everybody. Welcome to our current iteration of the MRO comprehensive training course. First thing I want to do today is just give you a little background on the course, plus an introduction to what we're trying to do, plus a little bit about the way we are updating the course as we go along to try to keep it current. This course has been given in one form or another for approximately 30 years now, with actually some of the same faculty, believe it or not. We will talk about the faculty specifically in a few slides. More importantly is that we are trying to update the course as we go along, and this is November 1st, 2023. The course is current to today. We are doing updates from October. More importantly, we do expect updates to continue to arrive possibly in 2023, but certainly in 2024. When that happens, we will again update the course. I want you to hear right now what I think is really important so you don't miss these updates when they do come out. Whether you are taking the course or even available to take the course at the time, I still want you to know when the updates arrive. During the course, we will give you links and instructions on how to find and log on to two different federal LISTSERVs that affect MROs very importantly. First of all is the Office in Drug and Alcohol Policy and Compliance under the Department of Transportation LISTSERV for MROs. We will give you a link for that. You can also find it on the ODAPC, which is the acronym for that office, the ODAPC website, dot.gov. Please find that and sign up for that LISTSERV. The other one is the National Laboratory Certification Program LISTSERV. That is through RTI in North Carolina with funding from the Substance Abuse and Mental Health Services Administration. SAMHSA and HHS updated guidelines are published before they appear in the Federal Register on that site. You can log on to dwp.samhsa.gov to find how to log on to that. Those are the most important contacts for you to stay current with federal changes as they happen. Moving on through this course, you will see some hopefully not too rough cut-ins for updates that have been done since we first recorded this course just before the pandemic in 2019. Like I say, I hope you will be able to, number one, be able to tell what is the update, but also that it is a hopefully logical follow-up to what you have heard before and after the update has been inserted. For those of you that have not taken this course before, again, welcome. All the lectures can be seen as updated. For those of you who have taken this course before, you will see that some of the talks have not been updated. You will easily tell the updated ones by looking at the date when you see the opening page to the course. The current dates, of course, are the ones that are updated. Some of the ones that did not need to be updated have the original dates around 2019 on there. If you are only looking for the updates, you are certainly open to do that, of course, but just open the ones that have the 2023 updates on. Before we get farther on into this, I want to introduce you to our faculty. Dr. Donna Smith was present at the inception of the entire federal drug testing program in the late 1980s and 1990s as the acting head of the Office of Drug and Program Compliance under DOT. She was responsible for the beginning of the programs, has maintained a very influential role throughout since that time, and happily she is here talking to you about collections and DOT regulations, things which she knows and can repeat in her sleep. Dr. Barry Sample is currently an independent consultant after having spent, I don't know, many years as director of science and technology at one of the largest laboratories doing forensic drug testing in the country, Quest Laboratories. He is again at the forefront of the research and the actual techniques of testing. There's no one that is better able to give you the discussion of laboratory processes, federal drugs, how it's looked at, and bring you up to date with all the newer things that are going on over and above the federal updates that we are specifically making these courses comply with. Dr. Tony Decker is a long-time MRO with history of, is an addiction medicine physician as well, working for the Department of Defense, the Department of Indian Health Service, is currently working for the state of Arizona as a chief medical officer in the Division of Developmental Disabilities. And as all of those roles have really given him the ability to stay right on top of the new stuff that we're seeing on the street and there's nobody better to give you that talk about the new things that you will see in your practice as an MRO, both in federal testing and in non-federal testing. He said during his talk that he doesn't think anything in his talk will be on the examination. I wouldn't bet on that, just saying. So it's a really good talk. Please pay attention. And the fourth name on my list is Dr. Ian McDonald. Now, he's not physically present in this presentation, but Ian McDonald is the one that started this all. He was one of the first drug czars in the country, in the Reagan administration. He was one of the first MROs in this country, and he was one of the first people to develop MRO training. I was fortunate enough to be mentored by him and that many of the presentations that you will see are significantly evolved from Ian McDonald's initial presentations, but I owe a lot of the format of the course and the presentation to Ian McDonald. I also owe him a lot about where I am right now today, and I just wanted to bring that up so that everybody could know that. And for those of you that knew Ian, he is 92 years old and still doing well at this recording. More power to him. I do want to say we've been doing this course in various different formats from when Ian started it in the 90s up until now. So 20 plus years of teaching this course, and we've seen some things that I would like to at least bring to your attention at the start. Many of you are going to be taking the certification exam after this course. What we've seen over the years are the tough areas on the exam are the section of the exams relative to the regulations and the sections of the exam relative to clinical addiction medicine. We have tried to focus on those in this course. Please pay attention to that during this course, because historically at the exam, those are the toughest areas for people to get good scores. Yes, you can retake the exam. One of the other instructors of comprehensive MR training even suggests taking the exam as a trial run first, because you get a second one gratis anyway, so just do it. You can do that if you want to, but I'm trying to save you some time and make it a little more efficient. Keep in mind regulations are really important. The clinical aspects of addiction medicine are really important. You will notice in some of these lectures, things get repeated. If you see them being repeated from one presenter to a different presenter in different talks and ongoing, that should be a hint that we want you to pay good attention to that, because it might be on the exam. Those are the most important things to take home with you now. Just one little bit of soapbox, and then I will let you start the course. The world right now needs more MROs. Big TPAs, employers are having a very difficult time in finding qualified MROs to fill all the spots where they're needed, so I welcome you newbies. I hope you enjoy this enough to do it. There are many advantages to do it. I will touch on them in my lecture, but there is a great need for qualified and interested people to be MROs. MROs are really changing. We are evolving. There are reasons that our doctors are in this profession. Theoretically, you might think that doctors don't need to be in this profession, but there's a reason they are, and one of those reasons is to help the evolution of the profession go in medically verifiable and medically appropriate directions, so please consider becoming an MRO. Job openings are posted on the Medical Review Office of Certification Council, the MROC website. Go check them out. Now, I hope you enjoy the course. Thank you.

MRO training

regulations

clinical addiction medicine

certification exams

qualified MROs