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Pain Med. 2017 Apr 1;18(4):664-679. doi: 10.1093/pm/pnw340.

Deconstructing One Medical School's Pain Curriculum: II. Partnering with Medical Students on an Evidence-Guided Redesign.

Author information

Department of Public Health and Community Medicine Tufts University School of Medicine, Boston, Massachusetts.
Department of Family Medicine and Community Health University of Massachusetts, Worcester, Massachusetts.
Department of Surgery, University of Vermont School of Medicine, Burlington, Vermont.
College of Osteopathic Medicine, University of New England, Biddeford, Maine, USA.



To reshape medical education about pain to present it as a population-based public health process as well as a neuron-centered phenomenon.


Collaborate with students to apply a recent inventory of pain-related preclinical curricular content and clinical training in order to modify the current multiyear presentation and offer a broadened social perspective on pain. Appraise fourth-year medical students' pain-related educational needs by surveying their knowledge, attitudes, experience with the curriculum, and self-reported assessment of pain-related competencies.

Setting and subjects.:

University-affiliated medical school and its fourth-year medical students.


Analysis of a detailed inventory of first- and second-year curricula. Survey of graduating medical students assessing attitudes, skills, and confidence. Construction of a fourth-year pain education elective and collaboration with enrollees to better integrate pain throughout the four-year curriculum.


This student-faculty collaboration produced an evidence-guided proposal to reorganize pain-related content across the longitudinal medical curriculum. An attitudes/skills/confidence survey of graduating medical students (104 respondents of 200 polled) found that 70% believed chances for successful outcomes treating chronic pain were low. Self-evaluated competency was high for evaluating (82%) and managing (69%) acute pain; for chronic pain, both were lower (evaluating = 38%; managing = 6%). Self-evaluated knowledge of pain physiology and neurobiology was poor (14%), fair (54%), or good (30%), but rarely excellent (2%).


To meet graduating students' desire for increased competency in pain, pain-related curricula can and should be reorganized to include pain as a disease state and a widespread public health burden, not merely a symptom.


Curriculum; Education; Medical Students; Pain Medicine

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