Background Pain management remains a neglected yet essential aspect of medical training. Despite the high prevalence of acute and chronic pain in clinical settings, formal education and confidence among residents regarding pain management remain suboptimal.

Objective To evaluate the current knowledge, attitudes, and practices (KAP) of Indian medical residents toward pain management and identify gaps that could inform future educational interventions.

Methods This cross-sectional study was conducted using a structured, anonymous, self-administered online questionnaire. The survey was distributed to postgraduate residents across multiple specialties in India. The questionnaire comprised four sections: demographic data, knowledge (10 MCQs), attitude (8 Likert-scale items), and practice (7 yes/no and frequency questions). Data were collected over 4 weeks and analyzed using descriptive and inferential statistics. Ethical exemption was obtained.

Results A total of 168 residents participated (mean age 28.2 ± 2.5 years). The majority were from anesthesiology (32%), internal medicine (18%), and surgery (15%). Only 44% could correctly identify first-line treatment for neuropathic pain. While 80% agreed that pain is undertreated in hospitals, only 36% reported using standardized pain assessment tools. Merely 14% had ever observed or participated in an interventional pain procedure.

Conclusion There is a significant gap between the perceived importance of pain management and the actual practice among residents. Structured pain medicine education and hands-on workshops are urgently needed to bridge this gap.

The authors have declared no competing interest.

This study did not receive any specific funding from public, commercial, or not-for-profit sectors.

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The Institutional Ethics Committee of AIIMS Gorakhpur waived the need for formal ethical approval for this anonymized, voluntary, non-interventional survey conducted for academic purposes.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

The data supporting the findings of this study are available from the corresponding author upon reasonable request. Anonymized datasets and the full questionnaire can be provided.