Canadian faculties of medicine not in denial

In their Sept. 7, 2010 editorial, Hébert and colleagues touch on a critical subject: the complicated relationship between industry and medical education.1 The authors rightly point out that in many medical schools, “future generations of students are [being] taught by some expert faculty who receive funds from the pharmaceutical industry.” They go on to say that “it is time for medical faculties and academic physicians to stop burying their heads in the sand.”

Far from burying their hands in the sand, the Board of Directors of the Association of Faculties of Medicine of Canada (AFMC), which comprises all 17 deans of medicine and 4 public members, voted to endorse the principles contained in the Association of American Medical Colleges report on industry funding of medical education that the authors reference.2 There can be no clearer signal that the senior leadership of our faculties of medicine is taking action. All of our faculties have reviewed their codes and guidelines relating to conflict of interest and many have made, or are making, substantial advances.

Three important issues must be acknowledged. First, despite the fact that the authors focus exclusively on the pharmaceutical industry, concerns about conflict of interest apply to medical device companies, biotech firms and many other private-sector industries.

Second, AFMC agrees that “medical students deserve a bias-free education.” But bias and conflict of interest are not the same thing. Conflicts of interest do not inherently lead to bias, and bias can certainly exist without conflicts of interest.

Third, guidelines, policies and procedural frameworks must be developed in all settings and contexts in which medical students and faculty function. Conflicts of interest must be addressed collectively by our faculties, affiliated hospitals and research institutes, practice settings, home universities, associations such as the CMA, specialty societies and industry.