Halifax, Nova Scotia, Dalhousie University.
Soc Sci Med. 2014 Aug;114:113-20. doi: 10.1016/j.socscimed.2014.05.052. Epub 2014 Jun 2.
In this article I report on an investigation of the pharmaceutical industry's influence in medical education. Findings are based on fifty semi-structured interviews with medical students in the United States and Canada conducted between 2010 and 2013. Participant responses support the survey-based literature demonstrating that there is clear and pervasive influence of the pharmaceutical industry in medical education. They also challenge the theory that medical students feel entitled to industry gifts and uncritically accept industry presence. I investigate how medical students who are critical of the pharmaceutical industry negotiate its presence in the course of their medical education. Findings suggest that these participants do not simply absorb industry presence, but interpret it and respond in complex ways. Participants were uncomfortable with industry influence throughout their medical training and found multifaceted ways to resist. They struggled with power relations in medical training and the prevailing notion that industry presence is a normal part of medical education. I argue that this pervasive norm of industry presence is located in neoliberal structural transformations within and outside both education and medicine. The idea that industry presence is normal and inevitable represents a challenge for students who are critical of industry.
本文报告了一项对制药行业在医学教育中影响的调查。研究结果基于 2010 年至 2013 年间对美国和加拿大的医学生进行的 50 次半结构化访谈。参与者的回应支持了基于调查的文献，表明制药行业对医学教育有着明显而普遍的影响。它们还对医学学生认为自己有权接受行业礼物并不加批判地接受行业存在的理论提出了挑战。我调查了那些对制药行业持批评态度的医学生如何在医学教育过程中应对其存在。研究结果表明，这些参与者并非简单地接受行业的存在，而是以复杂的方式对其进行解读和回应。在整个医学培训过程中，参与者对行业的影响感到不安，并找到了多方面的抵制方式。他们在医学培训中的权力关系以及行业存在是医学教育正常组成部分的观念方面感到挣扎。我认为，这种普遍的行业存在规范存在于教育和医学内外的新自由主义结构转型中。对于那些对行业持批评态度的学生来说，认为行业存在是正常和不可避免的观念是一个挑战。
