A first-of-its kind national survey of medical students and residents finds that despite recent efforts by medical schools and academic medical centers to restrict access of pharmaceutical sales representatives to medical trainees, medical students and residents still commonly receive meals, gifts, and industry-sponsored educational materials.
The study was completed by a team of researchers led by fourth-year Harvard Medical School student Kirsten Austad and Aaron Kesselheim, M.D., J.D., M.P.H., an internist and health policy researcher in the Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women’s Hospital and is scheduled to publish online this week in the Journal of General Internal Medicine.
“In medical school and residency, as trainees are learning the fundamentals of their profession, there is a need to ensure the education they receive is as unbiased as possible,” said Dr. Kesselheim. “However, it is well known that promotional information and gifts from pharmaceutical companies can encourage non-evidence-based prescribing. Though many institutions have tried to insulate trainees from these effects, trainees’ exposure to industry promotion is still quite high.”
The surveys were completed by a randomly selected subset of more than 2,000 medical students and residents representing every medical school in the United States. Students answered questions about the frequency of their interaction with pharmaceutical representatives, the types of gifts pharmaceutical representatives gave them and whether they thought these interactions affected their learning. One-third of first-year students and more than half of fourth-year students and residents reported receiving industry-sponsored gifts. A majority of students reported that pharmaceutical industry interactions provided them with valuable education, even though a majority of students also acknowledged the interactions opened them up to bias. Additionally, a majority of students supported measures that would further reduce access of industry sales representatives to trainees.
“Medical schools and academic medical centers need to continue to work on separating students from industry promotion at this highly impressionable time in their professional development,” said Austad. “As an alternative, medical schools should provide students with more education about how to interpret clinical trials and ways to approach evidence-based prescribing so trainees can learn to critically evaluate industry promotion when they become practicing physicians.”
This research was funded by a grant from the Edmond J. Safra Center for Ethics at Harvard University. Dr. Kesselheim is supported by a career development award from the Agency for Healthcare Research & Quality and a Robert Wood Johnson Foundation Investigator Award in Health Policy Research.