Intended for healthcare professionals


Drug company gifts to medical students: the hidden curriculum

BMJ 2013; 346 doi: (Published 20 February 2013) Cite this as: BMJ 2013;346:f1113
  1. Aaron S Kesselheim, assistant professor of medicine
  1. 1Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston MA 02120, USA
  1. akesselheim{at}

Policies to restrict promotional gifts to students seem to affect later prescribing behavior

As relationships between healthcare professionals and the drug industry have come under increasing scrutiny in the United States, the industry’s role in the education of medical trainees has emerged as a particularly contentious topic. A linked study (doi:10.1136/bmj.f264) by King and colleagues provides some empirical data to inform the debate.1

Students in the United States have traditionally had a high level of exposure to drug industry sales representatives during their undergraduate medical education.2 3 For example, one survey at eight US medical schools published in 2005 found that, by their third year, 96.8% students reported attending a lunch sponsored by a drug company and 94.1% reported receiving a non-educational gift.4 Students justified accepting meals and gifts by citing their lack of income and large debts, and educators pointed to the valuable support that industry could provide to didactic programs.4 Data on the influence of promotional gifts on physicians’ prescribing patterns were of questionable relevance, however, because students cannot write prescriptions or make decisions about patient care.

Medical schools have recently started to re-examine their policies. Many have stopped representatives …

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