Surgical interns: Preparedness for opioid prescribing before and after a training intervention

Am J Surg. 2018 Feb;215(2):238-242. doi: 10.1016/j.amjsurg.2017.11.017. Epub 2017 Nov 20.


Introduction: Exposure to pain management curriculum in medical school is currently variable. This paper reports on formal prescribing education, self-perceived prescribing readiness, and prescribing practices among incoming surgical residents before and after a pain management training session.

Methods: Pre-residency survey of thirty surgical interns at a single urban medical center, followed by a repeat survey after an educational session on prescription writing and opioid abuse.

Results: Thirty-three percent of respondents had formal education on prescription writing in medical school. Median subjective preparedness to write an opioid prescription was 1.5 (range 1-10) on a 1-10 Likert scale. Ranges of morphine milligram equivalents (MME) prescribed varied from 420-2700 MME for 8 mock surgical scenarios. Post-training, median subjective preparedness increased to 3.5 (range 1-6) and prescription accuracy (the inclusion of a medication, dose, frequency, and duration) improved from 75% to 97% (p < 0.001). Overall, 90% of interns found the training session useful.

Conclusion: Most surgical interns were not trained in prescribing narcotics in medical school. Improved pain management curriculum is necessary to assure safe and consistent opioid prescriptions.

MeSH terms

  • Analgesics, Opioid / therapeutic use*
  • Clinical Competence*
  • Curriculum
  • Drug Prescriptions
  • Follow-Up Studies
  • General Surgery / education*
  • Humans
  • Internship and Residency / methods*
  • Opioid-Related Disorders / prevention & control
  • Pain / drug therapy*
  • Pain Management*
  • Practice Patterns, Physicians'*
  • Surveys and Questionnaires
  • United States


  • Analgesics, Opioid