Teaching Pain Management to Medical Students

Pain affects more Americans than does diabetes, heart disease, and cancer combined according to a 2006 report.1 Many individuals with pain have multiple comorbidities, are elderly, and require ongoing treatment for management of their pain. These statistics underscore how imperative it is for there to be a pool of physicians who specialize in pain management, and for all physicians to have basic training in pain and its treatment. However, very few medical schools (only 3%) in the United States currently have a designated portion of the curriculum or course that specifically addresses pain.2 Medical student Jonathan Nathan suggests in this issue of Pain Practice that appropriate education in pain management of all parties involved in health-care delivery, including medical students, is needed so that patients will not suffer despite the array of available therapeutic options that are available. He further suggests that current legal and regulatory actions targeting pain physicians may dissuade current and future physicians from specializing in pain medicine. One international organization, the International Association for the Study of Pain, initiated efforts in 1985 to increase educational standards in the field of pain.3 However, this effort has failed to result in the formal inclusion of pain management as a specific entity in medical school curricula because of the intense competition for time. Other approaches must be utilized and documented. For example, problem-based learning activities can provide an important venue for pain education. There should be discussions of chronic and cancer pain management in scenarios of complex patients, and it is important that pain specialists participate in the selection of case material as well as in the discussions. Medical students can be proactive in learning about pain. One approach used by Ninani Kombo, a student at Yale University, was to organize a symposium on pain management for medical students in the spring of 2008.2 Educators must satisfy the need and desire for education in pain medicine.