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To the Editor: The Special Communication on physician-industry conflicts of interest by Dr Brennan and colleagues¹ proposes sweeping and long-needed changes but neglects a new type of potential conflict of interest: pharmaceutical industry financing of graduate medical education (GME). Although the authors address continuing medical education, recommendations regarding GME are not included. With current pharmaceutical industry funding of entire rheumatology fellowships² and dermatology residencies,^3-4 the authors should expand their recommendations to include this new potential source of conflict of interest.

In articles about a controversial industry-funded residency program developed by the American Academy of Dermatology (AAD), Dr Kassirer, one of the authors of the Special Communication, has commented on this issue.^3-4 Terming the program a "disgrace," he pointed out that these unrestricted grants may not be unencumbered and might create feelings of reciprocity. He also wondered whether this type of funding was a new way for pharmaceutical companies to influence . . . [Full Text of this Article]

Orin M. Goldblum, MD
omg@adelphia.net
Pittsburgh, Pa

Michael J. Franzblau, MD
Department of Dermatology
University of California, San Francisco
San Rafael

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