Pain education in Brazilian medical schools: a national curriculum analysis

Abstract Pain is a leading cause of disability worldwide, yet undergraduate medical education remains insufficient to prepare future physicians for its assessment and management. The International Association for the Study of Pain (IASP) has proposed a competency-based curriculum framework; however, its implementation in Brazilian medical education is unclear. The aim of this study was to evaluate the availability of pain education in Brazilian medical schools and assess its alignment with the IASP Curriculum Outline on Pain for Medicine. We conducted a national cross-sectional documentary analysis of all medical schools registered in the Brazilian Ministry of Education database between May 2024 and December 2025. Institutional websites were systematically screened for publicly available curricular documentation, and data were independently extracted by 2 reviewers. Variables included the presence of pain-related content, existence of a dedicated pain course, course workload, timing within the curriculum, and type of offering. Among 447 identified schools, 277 (62.0%) provided accessible curricular information. Only 47 institutions (16.9%) offered a stand-alone pain course, and 29 had detailed syllabi for item-level analysis. Most analyzed courses were mandatory and delivered in the early years of training. Alignment with IASP competencies was incomplete across all domains, with greater coverage of neurobiological and pharmacological content and limited inclusion of pain assessment and measurement, psychosocial and behavioral management, public health, ethics, and care for special populations. Pain education in Brazil is inconsistently structured and only partially aligned with international recommendations, indicating the need of comprehensive, competency-based curricular reform.