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Healthy Skepticism Library item: 2425

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: Journal Article

Sierles FS, Brodkey AC, Cleary LM, McCurdy FA, Mintz M, Frank J, Lynn DJ, Chao J, Morgenstern BZ, Shore W, Woodard JL
Medical Students’ Exposure to and Attitudes About Drug Company Interactions
JAMA 2005 Sep 7; 295:(3):281-282 doi: 10.1001/jama.295.3.281-b
http://jama.ama-assn.org/cgi/content/abstract/294/9/1034


Abstract:

Context While exposure to and attitudes about drug company interactions among residents have been studied extensively, relatively little is known about relationships between drug companies and medical students.

Objective To measure third-year medical students’ exposure to and attitudes about drug company interactions.

Design, Setting, and Participants In 2003, we distributed a 64-item anonymous survey to 1143 third-year students at 8 US medical schools, exploring their exposure and response to drug company interactions. The schools’ characteristics included a wide spectrum of ownership types, National Institutes of Health funding, and geographic locations. In 2005, we conducted a national survey of student affairs deans to measure the prevalence of school-wide policies on drug company–medical student interactions.

Main Outcome Measures Monthly frequency of students’ exposure to various activities and gifts during clerkships, and attitudes about receiving gifts.

Results Overall response rate was 826/1143 (72.3%), with range among schools of 30.9%-90.7%. Mean exposure for each student was 1 gift or sponsored activity per week. Of respondents, 762/818 (93.2%) were asked or required by a physician to attend at least 1 sponsored lunch. Regarding attitudes, 556/808 (68.8%) believed gifts would not influence their practices and 464/804 (57.7%) believed gifts would not affect colleagues’ practices. Of the students, 553/604 (80.3%) believed that they were entitled to gifts. Of 183 students who thought a gift valued at less than $50 was inappropriate, 158 (86.3%) had accepted one. The number of students who simultaneously believed that sponsored grand rounds are educationally helpful and are likely to be biased was 452/758 (59.6%). Students at 1 school who had attended a seminar about drug company–physician relationships were no more likely than the nonattending classmates to show skepticism. Of the respondents, 704/822 (85.6%) did not know if their school had a policy on these relationships. In a national survey of student affairs deans, among the 99 who knew their policy status, only 10 (10.1%) reported having school-wide policies about these interactions.

Conclusions Student experiences and attitudes suggest that as a group they are at risk for unrecognized influence by marketing efforts. Research should focus on evaluating methods to limit these experiences and affect the development of students’ attitudes to ensure that physicians’ decisions are based solely on helping each patient achieve the greatest possible benefit.

Keywords:
medical students attitudes gifts


Notes:

Ralph Faggotter’s Comments: Medical students often lack ethical direction but have the potential, under the right influences, to develop desirable ethical values. If left unattended however, as they generally are,they tend to readily fall prey to the corrupting influence of pharmaceutical gifting.
Even third year medical students are receiving one gift per week from the pharmaceutical industry.
This process leads directly to the ongoing sense of patrician entitlement which characterises their senior colleagues.
The good news is that early intervention can change the pattern.

 

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