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A Survey of Internal Medicine Program Directors

Laura L. Loertscher, MD, MPH; Andrew J. Halvorsen, MS; Brent W. Beasley, MD; Eric S. Holmboe, MD; Joseph C. Kolars, MD; Furman S. McDonald, MD, MPH

Arch Intern Med. 2010;170(4):356-362.

Background  Interactions with the pharmaceutical industry are known to affect the attitudes and behaviors of medical residents; however, to our knowledge, a nationally representative description of current practices has not been reported.

Methods  The Association of Program Directors in Internal Medicine surveyed 381 US internal medicine residency program directors in 2006-2007 regarding pharmaceutical industry support to their training programs. The primary outcome measure was program director report of pharmaceutical financial support to their residency. Demographic and performance variables were analyzed with regard to these responses.

Results  In all, 236 program directors (61.9%) responded to the survey. Of these, 132 (55.9%) reported accepting support from the pharmaceutical industry. One hundred seventy of the 236 program directors (72.0%) expressed the opinion that pharmaceutical support is not desirable. Residency programs were less likely to receive pharmaceutical support when the program director held the opinion that industry support was not acceptable (odds ratio [OR], 0.07; 95% confidence interval [CI], 0.02-0.22). Programs located in the southern United States were more likely to accept pharmaceutical support (OR, 8.45; 95% CI, 1.95-36.57). The American Board of Internal Medicine pass rate was inversely associated with acceptance of industry support: each 1% decrease in the pass rate was associated with a 21% increase in the odds of accepting industry support (OR, 1.21; 95% CI, 1.07-1.36).

Conclusions  Although most of the program directors did not find pharmaceutical support desirable, more than half reported acceptance of industry support. Acceptance of pharmaceutical industry support was less prevalent among residency programs with a program director who considered support unacceptable and those with higher American Board of Internal Medicine pass rates.

Author Affiliations: Internal Medicine Residency Office of Educational Innovations, Department of Medicine (Drs Loertscher, Kolars, and McDonald and Mr Halvorsen) Mayo Clinic, Rochester, Minnesota; Department of Medicine, University of Missouri–Kansas City (Dr Beasley); and Quality Research and Academic Affairs, American Board of Internal Medicine (Dr Holmboe). Dr Loertscher is now with the Department of Medicine Faculty Practice, Providence St. Vincent Medical Center, Portland, Oregon. Dr Kolars is now with the Global REACH Program, University of Michigan Medical School, Ann Arbor.

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Arch Intern Med. 2010;170(4):316.
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