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What Residents Don't Know about PhysicianPharmaceutical Industry Interactions

Watkins, Raquel S. MD; Kimberly, James Jr. MD

Academic Medicine:
Special Theme Research Report

Purpose. Little is known about the knowledge and skills internal medicine residents need to interact appropriately with pharmaceutical industry representatives. The authors conducted a needs assessment of current knowledge and preferences for potential components of a new educational initiative among residents.

Method. In 2001, a two-page questionnaire using a five-point ordinal scale was mailed to all internal medicine residents and faculty at one institution. Analysis included use of Wilcoxon two-sample test.

Results. Response rates were 97% (85/88) for residents and 79% (86/109) for faculty. Residents and faculty's knowledge about formal position statements or literature on the impact of marketing strategies on prescribing patterns, drug marketing costs, or how pharmaceutical representatives are trained to interact with physicians was very limited. Most responders felt residents should learn to critically interpret promotional materials, recognize potential for conflict of interest, and consider how patients perceive the physician–pharmaceutical industry relationship. More faculty than residents valued including position statements (66% versus 39%, p < .001) and literature exploring the impact of marketing on prescribing patterns (70% versus 41%, p < .001) in education. Only one-half or fewer favored small-group discussions, lecture series, critical-reading skills seminars, or panel discussions.

Conclusions. Internal medicine residents and faculty reported low levels of knowledge about physician–pharmaceutical industry relationships. Some consensus about educational components existed, but optimal educational formats remain uncertain. A six-hour curriculum to address this complex, emotionally charged topic was developed, implemented, and evaluated.

Author Information

Dr. Watkins is assistant professor and Dr. Kimberly is assistant professor, both in the Department of Internal Medicine, Wake Forest University Health Sciences (School of Medicine), Winston-Salem, North Carolina.

Correspondence and requests for reprints should be addressed to Raquel S. Watkins, MD, Department of Internal Medicine, 1 Medical Center Boulevard, Winston-Salem, NC 27157; telephone: (336) 716-6274; fax: (336) 716-7359; e-mail: 〈〉.

© 2004 Association of American Medical Colleges