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Medical Students’ Exposure to and Attitudes About Drug Company Interactions
A National Survey
Frederick S. Sierles, MD;
Amy C. Brodkey, MD;
Lynn M. Cleary, MD;
Frederick A. McCurdy, MD, PhD, MBA;
Matthew Mintz, MD;
Julia Frank, MD;
D. Joanne Lynn, MD;
Jason Chao, MD;
Bruce Z. Morgenstern, MD;
William Shore, MD;
John L. Woodard, PhD
JAMA. 2005;294:1034-1042.
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.
Author Affiliations: Departments of Psychiatry and Behavioral Sciences (Drs Sierles and Woodard) and Psychology (Dr Woodard), Rosalind Franklin University of Medicine and Science, North Chicago, Ill; Department of Psychiatry, University of Pennsylvania, Philadelphia (Dr Brodkey); Office of the Associate Dean, and Department of Internal Medicine, State University at New York Upstate Medical University, Syracuse (Dr Cleary); Department of Pediatrics, University of Nebraska School of Medicine, Omaha (Dr McCurdy); Departments of Internal Medicine (Dr Mintz) and Psychiatry (Dr Frank), George Washington University, Washington, DC; Department of Neurology, Ohio State University, Columbus (Dr Lynn); Department of Family Medicine, Case Western Reserve University, Cleveland, Ohio (Dr Chao); Department of Pediatrics, Mayo Clinic College of Medicine, Rochester, Minn (Dr Morgenstern); and Department of Family and Community Medicine, University of California, San Francisco (Dr Shore). Dr McCurdy is now Regional Chairman of Pediatrics, Texas Tech University, Amarillo.
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