Article Text

Original research
Medical students’ exposure to and attitudes towards product promotion and incentives from the pharmaceutical industry in 2019: a national cross-sectional study in France
  1. Martin Molina1,
  2. Adeline Boëffard1,
  3. Maxime Esvan2,
  4. Benjamin Bastian1,2
  1. 1Department of General Practice, Univ Rennes, Rennes, France
  2. 2Univ Rennes, CHU Rennes, Inserm, CIC 1414 (Centre d'Investigation Clinique de Rennes), Rennes, France
  1. Correspondence to Dr Benjamin Bastian; benjamin.bastian{at}


Objectives To measure medical students’ exposure to pharmaceutical product promotion and incentives nationwide, and to evaluate students’ attitudes towards the pharmaceutical industry, access to education on promotional strategies and knowledge of institutional policies about drug company-student relationships.

Design Cross-sectional survey based on a 48-item anonymous questionnaire.

Setting All 37 French medical schools, from March to April 2019.

Participants French medical students in their 4th year of study and beyond, having studied exclusively in France.

Main outcome measure Cumulative frequency of students’ exposure to pharmaceutical product promotion and incentives.

Secondary outcome measures Exposure within the last 6 months, attitudes regarding interactions with the industry, access to education on pharmaceutical product promotion and incentives and knowledge of institutional policies.

Results 6280 responses were analysed (10.4% out of a total of 60 550 eligible students). 5992 students (96.3% poststratification, 99% CI (96.1% to 96.5%)) had already been exposed to pharmaceutical product promotion and incentives and 4650 (78.1%, 99% CI (77.7% to 78.6%)) within the last 6 months. 5140 students (85.4%, 99% CI (84.8% to 85.8%)) had met a pharmaceutical representative. Regarding attitudes, 2195 students (36.8%, 99% CI (36.0% to 37.5%)) thought receiving a gift could influence their own prescriptions while 3252 (53.6%, 99% CI (53.1% to 54.2%)) thought it could influence their colleagues’ prescriptions. 4533 students (76.0%, 99% CI (75.6% to 76.5%)) reported never having attended any lecture on promotional strategies. Exposure seemed to depend on the year of study and specialty. 5122 (88.1%, 99% CI (87.7% to 88.4%)) did not know whether their faculty had a policy regarding drug company-student interactions.

Conclusion In France in 2019, medical students’ exposure to pharmaceutical product promotion and incentives remains considerable and starts early during medical training. Education on promotional strategies and institutional policies should be improved to ensure responsible and ethical behaviour in prescribing medications.

  • medical education & training
  • ethics (see medical ethics)
  • health policy
  • quality in health care
  • organisation of health services

Data availability statement

Data are available on reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information. Additional data are available in appendix. Extra data are available by emailing

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

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Data availability statement

Data are available on reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information. Additional data are available in appendix. Extra data are available by emailing

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  • Contributors MM, AB and BB initiated and designed the study, searched the literature, interpreted the results. MM wrote the first draft of the manuscript. ME performed the analysis and interpreted the results. BB is the guarantor. All authors critically revised the manuscript for important intellectual content and approved the manuscript. The corresponding author attests that all listed authors have met the authorship criteria and that no other meeting the criteria have been omitted.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests All authors completed the ICMJE uniform disclosure form at and made the following declarations: MM reported one meal financed by a drug company in 2016. AB reported several meals financed by drug companies between 2016 and 2017. ME reported no competing interest. BB is employed by University of Rennes 1, at Rennes Medical School, as a senior lecturer, but did not receive any specific benefit for this work; there were no other financial relationships with any organisations that might have an interest in the submitted work in the previous 3 years; there were no other relationships or activities that could be considered to have influenced the submitted work.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.