Survey of Medical Schools Is Critical of Perks

By GARDINER HARRIS
http://www.nytimes.com

Most medical schools in the United States fail to police adequately the money, gifts and free drug samples that pharmaceutical companies routinely shower on doctors and trainees, according to a ranking by the American Medical Student Association.

Only 7 of the 150 medical schools included in the rankings received a grade of A while 14 were given a B. Sixty got a failing grade, and the student association found that 28 schools, or nearly one in five, were in the midst of revising their conflict-of-interest policies.

“These policies are incredibly important to protect the educational experience students have at school and the quality of the education they’re getting,� said Dr. Brian Hurley, president of the student association. Schools that shield students from marketing messages will produce doctors who provide better care to patients, Dr. Hurley said.

The student association will routinely update the grades it gives medical schools, which are listed on a school-by-school basis at amsascorecard.org. The grades will be officially released Tuesday.

Mount Sinai School of Medicine in New York, the University of Pittsburgh Medical Center and University of California schools at Los Angeles, Davis and San Francisco were among those receiving top grades.

The role played by pharmaceutical and device makers in the education of doctors has become an increasingly controversial topic, with some top medical schools placing a growing number of restrictions on the longtime practice of providing free food, gifts and educational seminars to trainees.

The Association of American Medical Colleges advocated in April that schools ban many of these perks. The proposal was the result of a two-year study of the issue by the association.

Dr. Sidney Wolfe, director of the health research group at Public Citizen, a consumer advocacy organization, said the medical college association’s proposal “would be relatively meaningless without this critical surveillance system� created by the students.

“Most of the medical school bureaucracies are getting too much money and other forms of largess from the drug industry to initiate these healthy, long overdue policies on their own,� Dr. Wolfe said.

The student association, which represents more than 67,000 medical students, residents and practicing physicians, began its ranking in November when it requested conflict-of-interest polices from all of the nation’s medical colleges. The association made at least four attempts to receive the policies from every school in the country, but 16 schools declined to submit a policy and 29 did not respond at all. These schools, along with 15 that did submit policies, were given failing grades.

Two graders who were unaware of the identity of the schools did the scoring.

Gabriel Silverman, a medical student at the University of Pittsburgh School of Medicine who oversaw the grading, said medical students were increasingly put off by school policies that allowed drug companies to market their products to doctors and faculty members.

“We see all these pharma sales reps in clinics with free lunches and marketing paraphernalia giving us the hard sell,� Mr. Silverman said.

Dr. David Blumenthal, director of the Institute for Health Policy at Massachusetts General Hospital, said the student survey was important because students were significantly affected by the rules that applied to their faculty.

“In the same way that faculty pay attention to how they’re rated by students in their teaching,� Dr. Blumenthal said, “it seems to me that schools should pay attention to how students evaluate policies in fields that are of substantial importance to the future of the students.�

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