Medical Students' Exposure to and Attitudes About Drug Company Interactions

TLDR

Exposure to drug company interactions has been studied among residents, but little is known about medical students’ relationships with pharmaceutical companies. The study aimed to measure third‑year medical students’ exposure to and attitudes toward drug company interactions. The authors surveyed 1,143 third‑year students across eight U.S. medical schools in 2003 and later surveyed student‑affairs deans in 2005 to assess exposure, attitudes, and institutional policies.

Abstract

Context While exposure to and attitudes about drug company interactions amongresidents have been studied extensively, relatively little is known about relationshipsbetween drug companies and medical students.Objective Tomeasurethird-yearmedicalstudents’exposuretoandattitudesaboutdrug company interactions.Design, Setting, and Participants In 2003, we distributed a 64-item anonymoussurvey to 1143 third-year students at 8 US medical schools, exploring their exposureandresponsetodrugcompanyinteractions.Theschools’characteristicsincludedawidespectrum of ownership types, National Institutes of Health funding, and geographic lo-cations. In 2005, we conducted a national survey of student affairs deans to measurethe prevalence of school-wide policies on drug company–medical student interactions.Main Outcome Measures Monthly frequency of students’ exposure to variousactivities and gifts during clerkships, and attitudes about receiving gifts.Results Overall response rate was 826/1143 (72.3%), with range among schoolsof 30.9%-90.7%. Mean exposure for each student was 1 gift or sponsored activityper week. Of respondents, 762/818 (93.2%) were asked or required by a physicianto attend at least 1 sponsored lunch. Regarding attitudes, 556/808 (68.8%) believedgifts would not influence their practices and 464/804 (57.7%) believed gifts wouldnotaffectcolleagues’practices.Ofthestudents,553/604(80.3%)believedthattheywereentitledtogifts.Of183studentswhothoughtagiftvaluedatlessthan$50wasinappropriate, 158 (86.3%) had accepted one. The number of students who simul-taneouslybelievedthatsponsoredgrandroundsareeducationallyhelpfulandarelikelytobebiasedwas452/758(59.6%).Studentsat1schoolwhohadattendedaseminaraboutdrugcompany–physicianrelationshipswerenomorelikelythanthenonattend-ingclassmatestoshowskepticism.Oftherespondents,704/822(85.6%)didnotknowif their school had a policy on these relationships. In a national survey of student af-fairs deans, among the 99 who knew their policy status, only 10 (10.1%) reportedhaving school-wide policies about these interactions.Conclusions Student experiences and attitudes suggest that as a group they are atrisk for unrecognized influence by marketing efforts. Research should focus on evalu-ating methods to limit these experiences and affect the development of students’ at-titudes to ensure that physicians’ decisions are based solely on helping each patientachieve the greatest possible benefit.