Scheffer Paul, Guy-Coichard Christian, Outh-Gauer David, Calet-Froissart Zoéline, Boursier Mathilde, Mintzes Barbara, Borde Jean-Sébastien
Sciences of Education Department, Paris 8 University, Saint-Denis France.
Saint-Antoine Hospital, Paris, France.
PLoS One. 2017 Jan 9;12(1):e0168258. doi: 10.1371/journal.pone.0168258. eCollection 2017.
Medical faculties have a role in ensuring that their students are protected from undue commercial influence during their training, and are educated about professional-industry interactions. In North America, many medical faculties have introduced more stringent conflict of interest (COI) policies during the last decade. We asked whether similar steps had been taken in France. We hypothesized that such policies may have been introduced following a 2009-2010 drug safety scandal (benfluorex, Mediator) in which COIs in medicine received prominent press attention.
We searched the websites of all 37 French Faculties of Medicine in May 2015 for COI policies and curriculum, using standardized keyword searches. We also surveyed all deans of medicine on institutional COI policies and curriculum, based on criteria developed in similar US and Canadian surveys. Personal contacts were also consulted. We calculated a summary score per faculty based on 13 criteria. [range 0-26; higher scores denoting stronger policies].
In total, we found that 9/37 (24%) of French medical schools had either introduced related curriculum or implemented a COI-related policy. Of these, only 1 (2.5%) had restrictive policies for any category. No official COI policies were found at any of the schools. However, at 2 (5%), informal policies were reported. The maximum score per faculty was 5/26, with 28 (76%) scoring 0.
This is the first survey in France to examine COI policies at medical faculties. We found little evidence that protection of medical students from undue commercial influence is a priority, either through institutional policies or education. This is despite national transparency legislation on industry financing of health professionals and limits on gifts. The French National Medical Students Association (ANEMF) has called for more attention to COI in medical education; our results strongly support such a call.
医学院校在确保学生在培训期间免受不当商业影响以及接受有关专业与行业互动的教育方面发挥着作用。在北美,许多医学院校在过去十年中出台了更为严格的利益冲突(COI)政策。我们想了解法国是否也采取了类似措施。我们推测,在2009 - 2010年药物安全丑闻(苯氟雷司,“美蒂拓”)之后可能出台了此类政策,在该丑闻中,医学领域的利益冲突受到了媒体的广泛关注。
2015年5月,我们使用标准化关键词搜索,在法国所有37所医学院校的网站上查找利益冲突政策和课程设置。我们还根据美国和加拿大类似调查制定的标准,就机构利益冲突政策和课程设置对所有医学院院长进行了调查。我们也咨询了个人联系人。我们根据13项标准计算了每所医学院的综合得分。[范围为0 - 26分;分数越高表明政策越严格]。
总体而言,我们发现法国9/37(24%)的医学院校要么引入了相关课程,要么实施了与利益冲突相关的政策。其中,只有1所(2.5%)对任何类别都有严格政策。在任何一所学校都未发现官方的利益冲突政策。然而,有2所(5%)报告了非正式政策。每所医学院的最高得分为5/26分,28所(76%)得分为0分。
这是法国首次对医学院校的利益冲突政策进行调查。我们几乎没有发现证据表明,无论是通过机构政策还是教育,保护医学生免受不当商业影响是一个优先事项。尽管有关于卫生专业人员行业资助的国家透明度立法以及对礼品的限制,但情况依然如此。法国全国医学生协会(ANEMF)呼吁在医学教育中更多地关注利益冲突;我们的结果有力地支持了这一呼吁。