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Medical education on alcohol- and drug-related problems at the University of Toronto covers undergraduate, residency and graduate programs, a result of collaboration since 1959 between the university and the Addiction Research Foundation of Ontario. An undergraduate core curriculum, developed in the early 1970s, is offered in year 2; it has been supplemented by electives, selectives and comprehensive clinics. The undergraduate program is rated highly by students; since 1978, 3024 have completed the core program. Residency training started in 1974 and is available through electives lasting from 1 to 12 months in internal medicine, psychiatry, and family and community medicine. To date, 370 residents have completed one of these electives; 129 have completed graduate programs in which their theses concerned alcohol- and drug-related topics, and there have been an additional 13 research and postdoctoral fellows. Despite the progress, there is still a need to improve and expand the undergraduate and residency programs and to develop an effective program of continuing medical education. The goals should be to ensure that, as far as possible, all medical graduates from the University of Toronto have the knowledge, attitudes, skills and behaviours needed to contribute effectively to the prevention and treatment of alcohol- and drug-related problems in their chosen field of practice and to avoid problems from their personal use of alcohol and other drugs.