Interactions between pharmaceutical representatives and doctors in training
A thematic review
Received: 02 June 2004 Revised: 14 October 2004 Accepted: 15 February 2005 DOI:
Cite this article as: Zipkin, D.A. & Steinman, M.A. J Gen Intern Med (2005) 20: 777. doi:10.1111/j.1525-1497.2005.0134.x Abstract Medical school and residency are formative years in establishing patterns of prescribing. We aimed to review the literature regarding the extent of pharmaceutical industry contact with trainees, attitudes about these interactions, and effects on trainee prescribing behavior, with an emphasis on points of potential intervention and policy formation. OBJECTIVE: We searched MEDLINE from 1966 until May 2004 for English language articles. All original articles were included if the abstract reported content relevant to medical training and the pharmaceutical industry. Editorials, guidelines, and policy recommendations were excluded. DESIGN: Contact with pharmaceutical representatives was common among residents. The majority of trainees felt that the interactions were appropriate. A minority felt that their own prescribing could be influenced by contact or gifts, but were more likely to believe that others’ prescribing could be influenced. Resident prescribing was associated with pharmaceutical representative visits and the availability of samples. A variety of policy and educational interventions appear to influence resident attitudes toward interactions with industry, although data on the long-term effects of these interventions are limited. Overall, residents reported insufficient training in this area. MEASUREMENTS AND MAIN RESULTS: The pharmaceutical industry has a significant presence during residency training, has gained the overall acceptance of trainees, and appears to influence prescribing behavior. Training programs can benefit from policies and curricula that teach residents about industry influence and ways in which to critically evaluate information that they are given. Recommendations for local and national approaches are discussed. CONCLUSIONS: Key words medical students interns and residents medical education drug industry
The authors have no conflicts of interest to report regarding products or institutions discussed in this article.
Grant support: Dr. Zipkin has received no funding for the work on this manuscript. Dr. Steinman is supported by a VA Research Career Development Award, and part of this work was supported by a fellowship grant from the VA National Quality Scholars Program.
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