To the Editor: Dr Johns1 addressed many of the reasons why graduate medical education (GME) needs to be reformed. There are 2 additional issues that can readily be addressed and must be resolved if GME is to be truly reformed.
First, I agree with Relman2 that the money and thus the influence of the pharmaceutical industry must be totally removed from GME. If the pharmaceutical industry really intends to "play a leading role in sponsoring continuing medical education,"3 then perhaps they would be willing to give a few billion of the 16 billion dollars per year4 they spend on marketing directly to academic medical centers as unrestricted educational grants so that the fiscal problems provoked by the Balanced Budget Act of 1997 can be ameliorated.
The second issue is the need to rationalize the work hours and the supervision of residents,5 in order to prevent medical errors.6 A significant cause . . . [Full Text of this Article]
