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BMJ 2010; 341 doi: (Published 22 September 2010) Cite this as: BMJ 2010;341:c5109

Professional distress linked to unprofessional behaviour

When researchers surveyed students at seven US medical schools, more than half the respondents reported burnout, characterised by emotional exhaustion, feelings of depersonalisation, and a sense of low personal accomplishment (1354/2566, 52.8%). In cross sectional analyses, burnout was significantly associated with unprofessional behaviour and attitudes, including cheating at assessments and fibbing about missing test results (35% admitted to ≥1 unprofessional behaviours v 21.9% of students without burnout; odds ratio 1.89, 95% CI 1.59 to 2.24). Students reporting burnout also seemed significantly less altruistic than their peers when asked directly about the needs of the “medically underserved.”

The medical students surveyed were generally ignorant of the American Medical Association’s guidance about links with drug companies, and those with burnout were no more ignorant than others. Almost half of all respondents thought it was acceptable to be wined and dined by a drug company (1176/2532, 46.4%), more than a quarter would accept a free skiing trip (688/2531, 27.2%), and just over a fifth felt $500(£320; €382) would be a reasonable fee for 10 minutes’ paperwork for an industry representative (567/2529, 22.4%). Overall, only 14% (362/2531) of respondents gave answers completely consistent with the AMA’s guidance. The authors conclude that US educators should do a better job teaching future doctors about conflicts of interest. Their survey had a 61% response rate (2682/4400).

Admissions for childhood asthma fell steadily after Scotland’s smoking ban

In March 2006 legislators banned smoking in public places and workplaces across Scotland, a country of five million people. Hospital admissions for asthma among children fell by 18.2% per year (95% CI 14.7% to 21.8%) after the ban, according to a time trend analysis. The reduction was significant and remained significant through adjustments for age, sex, year, month, social class, and urban or rural residence. Asthma admissions fell among schoolchildren (by 20.8%, 95% CI 16.6% to 25.1%) and preschool …

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