Razack S, Arbour L, Hutcheon R
Ann R Coll Physicians Surg Can. 1999 Mar;32(2):93-6.
Medical residents in training are as much targets of pharmaceutical-industry marketing as are physicians in practice. This interaction is often subtle and takes the form of sponsorship of meals at academic events, support for conference travel, books, and items such as pens and notepads. Most residency programs direct little time towards training in ethics and the critical analysis of pharmaceutical-industry marketing. We propose a model for the relationship between residents and residency programs, and the pharmaceutical industry that addresses the need for such interaction to be viewed in light of the patient-centered ethic of professional conduct and the ideal of unbiased medical practice. A committee of residents at different levels of training and two staff physicians received the mandate to examine this issue. The committee developed a set of guidelines and a proposed schema for the handling of funds from pharmaceutical companies (still not implemented). Each residency program would develop a common fund for money donated by pharmaceutical companies. This fund would be administered by a committee with defined priorities. The presence of residents on this committee under staff preceptorship would serve as a springboard for education on the subject. Guidelines for acknowledgement of sponsorship, solicitation of funds, gifts for care of patients, ongoing education, and the wider applicability of these proposals were also developed. Residents' interaction with the pharmaceutical industry during training could have lifelong influence on medical practice. We hope that our model will promote critical appraisal of the potential risks and benefits of this interaction.
接受培训的住院医师和执业医师一样，都是制药行业营销的目标对象。这种互动往往很微妙，形式包括赞助学术活动中的餐食、支持会议差旅、提供书籍以及钢笔和笔记本等物品。大多数住院医师培训项目几乎没有花时间进行伦理培训以及对制药行业营销进行批判性分析。我们提出了一个住院医师与住院医师培训项目以及制药行业之间关系的模型，该模型考虑到需要根据以患者为中心的职业道德伦理和无偏见医疗实践的理想来审视这种互动。一个由不同培训阶段的住院医师和两名 staff 医师组成的委员会受命审查这个问题。该委员会制定了一套指导方针和一个关于处理制药公司资金的提议方案（仍未实施）。每个住院医师培训项目都将设立一个由制药公司捐赠资金组成的共同基金。这笔资金将由一个有明确优先事项的委员会管理。住院医师在 staff 医师指导下加入这个委员会，将成为该主题教育的一个跳板。还制定了关于赞助认可、资金募集、患者护理礼品、持续教育以及这些提议更广泛适用性的指导方针。住院医师在培训期间与制药行业的互动可能会对医疗实践产生终身影响。我们希望我们的模型将促进对这种互动潜在风险和益处的批判性评估。
