What if Medical Students only focused on electives and not core studies? Would they graduate? Would you want them treating you? Would you want medical students who only understand one perspective, only learned about one way of doing something and that way was based on feelings versus science?
Apparently this is what the American Medical Student Association did in releasing their AMSA Pharmafree scorecard evaluating the policies of medical colleges regarding relations with the pharmaceutical and device industry.
The report made the rounds on usual suspect publications: Gardiner Harris at the New York Times, Pharmalot and Wall Street Journal Blog, as some type of important event but was it?
Several things are interesting about the scorecard:
They put a lot of effort into this report and the emphasis is not on scholarship, or strength of teaching, or faculty to student ratio which is how one would normally expect a report like this to be written.
So rather than help incoming students with valuable information on what is important to medical students, they only focus on non important issue: the schools policy for relationships to industry. They focus on the non essential of gifts and individual financial relationships with industry.
These are their categories of importance:
- Gifts and individual financial relationships with industry
1A. Gifts (including meals)
1B. Consulting relationships (excluding scientific research and speaking)
1C. Industry-funded speaking relationships
1D. Disclosure - Pharmaceutical Samples
- Purchasing & Formularies
- Site Access
- Education
5A. On-site Educational Activities
5B. Compensation for Travel or Attendance at Off-site Lectures & Meetings
5C. Industry Support for Scholarships & Funds for Trainees
5D. Medical school curriculum - Enforcement
We asked some doctors what they thought was important for ranking medical schools and these are the criteria they came up with:
A) Location of school (city, suburban, rural)
B) Hospital affiliations (# of hospitals you rotate through, size of hospitals you rotate through, etc)
C) Board scores and matching percentage (how the outgoing seniors did in the match) of attendees
D) Cost…
E) Elective time, set up of rotation schedule, etc (this varies a lot from school to school, as does # of in-house call, etc)
F) Size of school
G) Size of classes
H) Research opportunities
I don’t know about you, but I think the second list is much more useful and balanced and would have been considered core vs elective criteria.
The Wall Street Journal Blog had several comments but my favorite is from a medical student:
This is the reason people detest (pre)medical students so much. With absolutely no experience or perspective, they are all too willing to criticize and preach into their very institutions that educate them.
Then to top it off, they pat themselves on the back for it. Recently at my institution, a group of *students* decided they didn’t like the hospital’s cancer care policy and petitioned to change it.
Yes, students — with absolutely no experience in delivery of care, budgeting, or any other sort of management (90% of which will be at other hospitals in 3 years) — felt they should be consulted when developing hospital policy.
While I find my views in line with these groups occasionally, their manner is incredibly lacking. Students like these are the reason I neglect to mention my training when in the company of real researchers.
The fundamental failure in the studies touted by groups such as nofreelunch.org is that they falsely assume an ideal baseline. They assume that generics are inherently better than newer generation medications and any writ of non-generic RX is solely the result of gifts (most studies simply compare generic vs non-generic RX). A proper study would look at the influence of marketing AND patient outcomes. After all, do we care more about ridding hospitals of free pens and clipboards or pursuing the best patient outcomes?
.
A quick search of pubmed reveals no studies showing negative patient outcomes…
These students with AMSA are looking for excuses rather than focusing on patient outcomes.
Perhaps they should next time put the effort into more important grades which would be useful to incoming doctors and pre-med students instead of electives.