Chronic Pain Education in Portugal: Perspectives from Medical Students and Interns

Abstract

Introduction: The International Association for the Study of Pain advocates a mandatory curriculum on chronic pain in medical schools. The objective of this study was to assess the opinions of final year medical students and interns about chronic pain education in eight
Portuguese medical schools.
Material and Methods: Cross-sectional study. Online questionnaire (30 questions; voluntary and anonymous responses) available in the first quarter of 2016.
Results: A total of 251 responses were received from 142 finalists and 109 interns (women 72.9%; 25.3 ± 1.6 years). Pain is a vital sign (92.4%), but 18.7% only assessed pain if the patient complained of it. Pain self-assessment scales were known (87.2%), but the hetero-evaluation was not (70.9%). Pain was not assessed regularly because patients may not express pain; lack of time; short duration of consultations. Education was insufficient on opioids (78.1%), pathophysiology and treatment of pain (66.1%) and interviewing patients with pain (67.7%); it lasted 1 to 10 hours (median). Respiratory depression was the most worrying effect of opioids (56.2%). The risks of opioids outweigh the clinical benefit (33.5%).
Discussion: Education on chronic pain is scattered, unstructured and optional. More education is required in medical schools (98.4%). It should occur in year 5 and last more than 15 hours. Clinical stages are advised in chronic pain clinics.
Conclusion: There is a need for improvement in the medical undergraduate curricula so that young doctors develop competencies to adequately control pain and fight the avoidable suffering of their patients.