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BMJ 2004; 328 doi: (Published 01 April 2004) Cite this as: BMJ 2004;328:0404160
  1. Upasana Tayal, fourth year medical student1
  1. 1Magdalen College, Oxford

Do you rush off to attend a free lunch and talk on hospital placements? Or is your white coat weighed down by a pocket full of free pens? Upasana Tayal looks into the cost of these freebies

Holding your Viagra pen, you start your essay on your Suscard Buccal paper, with your Imigran ruler, Pulmicort pencil, Diflucan rubber, and Ziagen highlighters close at hand. All is going well as you type up your masterpiece, then drama strikes. In a bid to answer your ringing Adalat phone, you knock over the Combivir cup containing your caffeine boost. No worries though, you mop up the mess with your Tylex tissues.

Clearly drug company spoils can come in rather useful for the impoverished medical student, but they hide a murkier reality. As innocuous as pens and pencils seem, they are but a precursor to a more ostentatious world of gold plated pens, fancy dinners, and lavish holidays. Although we are uncomfortable with the latter,1 many see little problem with the former. After all, it's just a cheap plastic pen; isn't it?

No free lunches

That old adage, “there's no such thing as a free lunch” could not hold truer than for the relationship between big pharmaceutical companies--known as Big Pharma--and medical students. Drug companies are not totally bad guys, but they are business oriented companies driven by monetary gains. In the United States, drug promotion is estimated at $19bn (£10bn; a15bn) and, in Australia, Peter Mansfield's group estimates the total to be about $A1.5bn (£0.6bn; $1.2bn; a0.90bn).2

The benefits for drug companies include influencing attitudes towards them in the hope that medical students will use them as a source of drug information and one day prescribe based on this information and brand recognition. One Canadian study compared trainee residents from two university hospitals, one …

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