According to a report in the latest issue of JAMA, which deals with medical education as a theme, the third year medical students of US medical schools receive on an average one gift or attend one event sponsored by a drug company per week and often feel that sponsored educational events are biased.
Medical students are entering an environment with progressively fewer boundaries between medicine and the pharmaceutical industry, which spends $12 billion to $18 billion annually marketing to physicians (including residents), according to background information in the article.
AdvertisementThis includes 60 million visits annually by pharmaceutical representatives and most of the $1.54 billion spent annually on continuing medical education. Drug company-physician interaction presents information favoring the sponsor's product and increases the likelihood of prescribing that product. Prescribing may be inconsistent with evidence-based guidelines and may reflect the presence of drug samples or patient demand due to direct-to-consumer advertising, even if a drug was not the physician's first choice. 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.
Researchers from Rosalind Franklin University of Medicine and Science had measured the frequency of medical students' exposure to drug company gifts, students' attitudes about gifts, and correlates of these frequencies and attitudes. In 2003 the researchers distributed a 64-item anonymous survey to 1,143 third-year students at 8 U.S. medical schools, exploring their exposure and response to drug company interactions. In 2005, the researchers conducted a national survey of student affairs deans to measure the prevalence of school-wide policies on drug company-medical student interactions.
The overall response rate of the surveys was 72.3 percent (826/1,143). The researchers found that average exposure for each student was 1 gift or sponsored activity per week. Of respondents, 93.2 percent were asked or required by a physician to attend at least 1 sponsored lunch. Regarding attitudes, 68.8 percent believed gifts would not influence their practices and 57.7 percent believed gifts would not affect colleagues' practices. Of the students, 80.3 percent (553/604) believed that they were entitled to gifts. Of 183 students who thought a gift valued at less than $50 was inappropriate, 86.3 percent had accepted one. Nearly 60 percent (59.6 percent) of the students simultaneously believed that sponsored grand rounds are educationally helpful and are likely to be biased.