Teaching Safe Opioid Prescribing During the Opioid Epidemic: Results of the 2018 Clerkship Directors in Internal Medicine Survey

  • Mim AriEmail author
  • Michael Kisielewski
  • Nora Y. Osman
  • Karen Szauter
  • Clifford D. Packer
  • Amber T. Pincavage
Original Research



Educating medical trainees across the continuum is essential to a multifaceted strategy for addressing the opioid epidemic.


To assess the current state of internal medicine clerkship content on safe opioid prescribing and opioid use disorder, and barriers to curriculum implementation.


National Annual (2018) Clerkship Directors in Internal Medicine (CDIM) cross-sectional survey.


One hundred thirty-four clerkship directors at all Liaison Committee of Medical Education accredited US medical schools with CDIM membership as of October 1, 2018.

Main Measures

The survey section on safe opioid prescribing and opioid use disorder education in the internal medicine clerkship addressed assessment of current curricula, perceived importance of curricula, barriers to implementation, and plans to start or expand curricula. Descriptive statistics were used to summarize responses, and Pearson’s chi-square and Fisher’s exact tests for statistical comparisons.

Key Results

The survey response rate was 82% (110/134). Overall 54.1% of responding institutions reported covering one or more topics related to safe opioid prescribing or opioid use disorder in the internal medicine clerkship. A preponderance of clerkship directors (range 51–86%) reported that various opioid-related topics were important to cover in the internal medicine clerkship. Safe opioid prescribing topics were covered more frequently than topics related specifically to opioid use disorder. The main barriers identified included time (80.9%) and lack of faculty expertise (65.5%).


Clerkship directors agreed that incorporating safe opioid prescribing and opioid use disorder topics in the internal medicine clerkship is important, despite wide variation in current curricula. Addressing curricular time constraints and lack of faculty expertise in internal medicine clerkships will be key to successfully integrating content to address the opioid epidemic.


undergraduate medical education internal medicine clerkship opioid chronic pain 



The authors wish to thank the Alliance for Academic Internal Medicine (AAIM) and the Clerkship Directors in Internal Medicine (CDIM).

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they do not have a conflict of interest.

Supplementary material

11606_2019_5203_MOESM1_ESM.docx (34 kb)
ESM 1 (DOCX 33 kb)


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Copyright information

© Society of General Internal Medicine 2019

Authors and Affiliations

  1. 1.Department of Medicine University of Chicago Pritzker School of MedicineChicagoUSA
  2. 2.Alliance for Academic Internal MedicineAlexandriaUSA
  3. 3.Department of MedicineBrigham & Women’s Hospital and Harvard Medical SchoolBostonUSA
  4. 4.Department of MedicineUniversity of Texas Medical BranchGalvestonUSA
  5. 5.Department of MedicineCase Western Reserve University School of MedicineClevelandUSA
  6. 6.Department of MedicineLouis Stokes Cleveland VA Medical CenterClevelandUSA

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