TORONTO - There may soon be no more free lunches - or fridges to store them in - in the student lounges of Canadian medical schools.
No talks given by physicians' experts paid handsomely by pharmaceutical companies. Or unsupervised meetings with drug reps.
The association that represents Canada's medical schools announced Tuesday it is endorsing the principles that lie at the core of rules such as these introduced by its American counterpart earlier this year.
The Association of Faculties of Medicine of Canada said the aim is to limit the influence the pharmaceutical industry has on medical students and residents and assuage the public's concerns about the perceived cosiness between medical schools and Big Pharma.
"There's no question that the environment within which you're trained will have some sort of impact on the way you perceive these issues," Irving Gold, the association's vice-president of government relations and external affairs, said from Ottawa.
"The public has to trust that the doctors that they see do not have any debts to pay to individual pharmaceutical companies or the sector as a whole."
"We have to model good behaviour in this context. And if we want to teach professionalism (to medical students), a part of teaching professionalism is by implementing these sorts of policies."
The board of the association voted in mid-November to endorse the principles espoused in the April 2008 report from the Association of American Medical Colleges. It made public that decision on Tuesday after having informed Rx&D, the industry group representing Canada's research-based pharmaceutical companies.
There have been complaints for years that some members of the medical community have been too close to the pharmaceutical industry. Critics have railed at pharma for providing expensive gifts and freebies to doctors, whether in the form of tickets to sporting events or invitations to educational sessions held at posh resorts where an ample measure of pleasure was mixed in with a bit of business.
In recent years professional bodies have adopted codes of conduct aimed at stopping this type of behaviour, though critics contend there are still plenty of doctors eating plenty of free lunches.
Medical students were never on the receiving end of the most lavish of the largesse. But if medical schools allow it, drug reps have been known to spring for pizzas, buy fridges for student lounges and offer other sorts of services to medical schools themselves.
The U.S. report urged medical schools to bar drug and medical device manufacturers from offering free food, gifts or travel to students and faculty. It suggested faculty and students should be banned from accepting so-called "ghost-writing" services - where someone else authors a paper that is submitted under the recipient's name - and prohibited from accepting payment to attend industry-sponsored events.
Gold said the Association of Medical Faculties of Canada did not endorse the individual recommendations of that report, but the principle underscoring them.
"And there's no question that the next step is (that) each of the Canadian faculties, independently and collectively from AFMC, along with our hospital partners and industry will have to have a discussion now about how do these principles articulate themselves in our context here in Canada," he said.
Gold said the pharmaceutical industry has been invited to be part of that discussion - a fact that worries at least one critic of the industry.
Dr. Gordon Guyatt of McMaster University said the only role pharmaceutical companies should play in medical schools in Canada is as a source of unfettered funding - for instance grants to medical schools with no strings attached.
But Guyatt, who years ago as director of McMaster's residence program instituted a ban on drug reps meeting with medical students, said he is not optimistic the industry's role will be so constrained as a result of this process.
"I think it is unfortunately unlikely," he said, noting though that he thought the report is a step in the right direction.
His view was shared by Dr. Jerome Kassirer, former editor of the New England Journal of Medicine and author of "On The Take: How Medicine's Complicity with Big Business Can Endanger Your Health."
Kassirer has been a vocal critic of the ties between doctors and the pharmaceutical industry. He said steps like this help, but the problem will persist as long as medical schools don't get tough with their faculty.
"I think that the notion of having students be more aware of the dangers of physician-industry involvement is a good thing. But we haven't cleaned up the Aegean stables," he said, referring to one of the tasks placed before Hercules.
