2026 American Academy of Neurology Abstract Website

Objective:

To evaluate national trends and specialty-specific variation in pain management and addiction education across ACGME-accredited residency and fellowship programs from 2020–2024.

Background:

Chronic pain and opioid misuse represent converging public health crises demanding physician competence in multimodal pain care and substance-use disorder (SUD) management. Graduate medical education (GME) is foundational for cultivating these competencies, yet prior studies show inconsistent curricular integration across specialties.

Design/Methods:

We abstracted program-level data from ACGME Data Resource Book tables for academic years 2020–2021 through 2023–2024, encompassing 31 core specialties plus the total training pipeline. Outcomes were proportions of programs teaching non-pharmacologic pain management, pharmacologic pain management, opioid prescribing, and recognition, referral, and treatment of SUD. Communication and stigma-reduction training were analyzed where available (2022–2023 onward). Linear regression models assessed temporal trends; Cochran-Armitage tests confirmed monotonic increases. Statistical significance was set at p<0.05.

Results:

All six core domains demonstrated statistically significant growth (p≤0.027). Non-pharmacologic pain management rose from 81% to 89% (p=0.007), pharmacologic management from 88% to 93% (p=0.003), opioid prescribing from 88% to 92% (p=0.027), and recognition of SUD from 87% to 94% (p=0.008). The steepest improvements occurred in referral (76%→86%, p=0.002) and treatment (51%→65%, β=+4.67 percentage-points/year, p=0.001) education. Communication (39%→61%) and stigma-reduction training (35%→56%), introduced in 2022–2023, expanded dramatically in one year (both p<0.001; Cohen's h≥0.43). By 2023–2024, Anesthesiology, Family Medicine, Emergency Medicine, and Internal Medicine achieved ≥97% coverage, while Medical Genetics (62%) and Dermatology (80%) remained significantly below the pipeline mean (p<0.001).

Conclusions:

Pain and addiction education expanded significantly across specialties from 2020–2024, though notable heterogeneity persists. Sustained ACGME monitoring appears to drive meaningful curricular progress. Standardized, interdisciplinary GME curricula may enhance physician preparedness to address the ongoing opioid epidemic.