Intractable pain: a neglected area of medical education in the UK

Unease over the previous management of 67 patients referred for treatment to 3 pain relief clinics led us to investigate the current state of education in pain and pain control in the UK. Twenty-seven medical schools provided data which revealed; (i) in 4 schools no teaching whatsoever is given in these subjects; (ii) in the remainder it is accorded an average of 3.5 hours during the 5 year course, with little evidence of multidisciplinary teaching; (iii) only 10 schools (37%) regularly set questions on pain control in formal examinations. A survey of 219 general practitioners revealed a wide-ranging lack of knowledge about the facilities and approach to treatment at their local pain relief clinic. These findings have wide reaching implications for medical education. At the undergraduate level they demonstrate a need for more multidisciplinary teaching and practical experience in specialist units. Thereafter specialists in pain control must enable practising doctors to keep abreast of new developments. This may require them to devote more time writing for a non-specialist audience and devising short, postgraduate courses.