Study objectives: To determine the extent and diversity of involvement of pharmaceutical representatives in emergency medicine residency programs and to assess chief residents' beliefs and attitudes concerning this activity.
Design and participants: A multi-item survey with cover letter was mailed to the chief resident at each of the 87 Accreditation Council on Graduate Medical Education-approved emergency medicine residency programs in the United States at the time of study conception.
Measurements and main results: Eighty-three percent (72 of 87) of the questionnaires were returned. Ninety-three percent (66 of 71) of responders reported the involvement of pharmaceutical representatives in their emergency medicine residency. The most frequent activities (90%, 63 of 70) were to distribute small gifts (pens, notepads) and to provide meals during department functions such as journal clubs (80%, 56 of 70). Only 32 of 70 responding chief residents (46%) were aware of any established guidelines in their institution or residency program concerning relationships with pharmaceutical representatives, and 14 respondents (20%) believed that accepting gifts from pharmaceutical companies could affect their own prescribing habits. A few stated that pharmaceutical representative-sponsored educational functions were inappropriate.
Conclusion: The interaction of pharmaceutical representatives with emergency medicine residents and residencies is widespread. More than 50% of the institutions supporting emergency medicine residency programs have no formal guidelines with regard to the interaction of their residents with pharmaceutical representatives or their guidelines are not known to the person most responsible for approval and arrangement of the pharmaceutical representative interaction--the emergency medicine chief resident. While most chief residents believed that accepting small gifts was reasonable, they also believed that accepting gifts valued at $100 or more and pharmaceutical representative sponsorship of trips was inappropriate.