Changing Pharmaceutical Industry Interaction in US Family Medicine Residencies: A CERA Study

J Am Board Fam Med. Jan-Feb 2021;34(1):105-112. doi: 10.3122/jabfm.2021.01.200287.


Background: Pharmaceutical interaction in US residencies is common. This study explores the extent and type of learner interactions in US family medicine residencies with the pharmaceutical industry and compares interactions from 2008, 2013, and 2019.

Methods: We surveyed program directors of 628 family medicine residencies with 8 questions using the 2019 Council of Academic Family Medicine Educational Research Alliance Survey and compared the responses to 2008 and 2013 results.

Results: The survey response rate was 39%; 81% of responding residencies did not allow food or gifts, 86% did not allow drug samples, 84% did not allow industry to interact with medical students or residents, and 81% did not allow industry-sponsored residency activities. These numbers were statistically significantly higher than both 2008 and 2013. In 2019, 151 responding programs (64%) were pharma-free, that is, they answered "No" to all 4 questions about interactions. Pharma-free residencies were increased in 2019 compared with 26% in 2008% and 49% in 2013. University-based family medicine programs were more likely to be pharma-free. Only 21% of responding programs had a formal curriculum that explores the interaction between physicians and the pharmaceutical industry. Factors cited for decreasing interaction included: institutional policy, ethical concerns, faculty input, and local response to national legislation.

Conclusions: Interaction between trainees in US family medicine residencies and the pharmaceutical industry continued to decrease. A changing national legislative landscape combined with institutional policies and concerns about industry influence on prescribing habits may be important factors driving the limiting of interactions.

Keywords: Conflict of interest; Drug Industry; Family Medicine; Graduate Medical Education; Internship and Residency; Marketing; Organizational Policy; Pharmaceutical Economics; Surveys and Questionnaires.