Funding for Medical Education: Maintaining a Healthy Separation From Industry

Attitudes and policies about conflict of interest in medical education have evolved rapidly in the last several years. Temporally and conceptually, these changes have paralleled the rise of the relatively new field of behavioral economics in explaining commercial relationships. The traditional view of economics holds that in any transaction, all inputs and outcomes are simply the result of decisions by rational participants making choices that optimize their goals; however, the past decades have seen a reassessment of this “expected utility theory” with the growing awareness that unconscious biases and emotional factors profoundly affect behavior.1 The same insight has begun to influence how we think about medical education and the messages that are sent by and received from industry-sponsored speakers and programs. Because cardiology addresses the most common illnesses in developed societies and employs the most widely used and costly drugs and devices, these issues have been especially acute in this field.Response by Harrington and Califf see p 2228 Unquestionably, the drug and device industries make important contributions to the development of products that reduce the morbidity and mortality of cardiovascular disease. Industry is also a major source of both funding for and collaboration in cardiology research, and it provides substantial support for professional cardiology societies, topics that are beyond the scope of this report. But in the realm of teaching, whether of medical students, house officers, or practitioners, there is growing concern that educational activities should not be supported or influenced by companies whose profitability and very existence depend on the sales volume of the products they make.2Our position that industry should not directly support educational programs is not ideologically driven. Rather, it is based on the expectation that medical knowledge can be transferred most efficiently and with the least distortion if those responsible for this …