1. Principles

• Family Practice Residencies exist to train residents to provide responsible, high quality care for patients.
• An important educational goal for residents is the acquisition of the basic and advanced knowledge of pharmacotherapeutics, as well as the ability to critically evaluate new information about medications. Residents should learn to use unbiased, published reviews of therapeutic options as the primary basis for drug choice, and be able to evaluate commercially sponsored programs for their scientific accuracy and integrity.
• It is the responsibility of the residency director and faculty to ensure the quality of the residency program's educational structure and content.

2. Faculty

• Faculty should model behavior consistent with ethical guidelines developed by responsible professional organizations (AMA, AAPFP, ACCME) and which discuss appropriate relationships between physicians and pharmaceutical companies.
• To promote high quality, objective resident education, faculty are encouraged to avoid any appearance of conflict of interest. Consistent with this objective, faculty should disclose to peers and residents general financial or other relationships between a faculty member and pharmaceutical companies which might effect resident education.
• Faculty are encouraged to not accept honoraria directly from pharmaceutical or other proprietary companies for speaking at residency associated or sponsored educational meetings.
• Faculty may serve as consultants to pharmaceutical or proprietary companies for clearly defined professional services.
• Faculty and residents should conduct or participate in pharmaceutical company-sponsored research only if the research: is scientifically valid, would be justifiable research even if company funding were not available, results are not subject to censorship and the sponsoring company is publicly identified. goto top

3. Educational Conferences and Activities

• Residency programs should develop written policies delineating the conditions for acceptance and use of pharmaceutical or other proprietary companies' financial support of residency educational activities, including meals at conferences.
• Pharmaceutical and other proprietary companies' support of residency educational activities should occur via educational grants to the residency program. The faculty and residents should control use of such funds and selection of speakers.
• Presentations should be primarily based on published or other research data and emphasize generic drug names when discussing medications.
• Residencies should publicly acknowledge all contributions to their educational fund. goto top

4. Gifts

• Residency programs are encouraged to develop written policies concerning the acceptance of any gifts from pharmaceutical or other proprietary companies. Such policies should delineate whether or not the residency program chooses to accept gifts which may support patient care and are of minimal value (pens, notepads, calipers, pregnancy dating devices, etc.) as well as educational materials of modest values, such as books, which may support residency education.
• To help avoid potential conflicts of interest, residents, faculty and staff affiliated with the residency program are encouraged:
  • not to directly solicit or receive personal gifts from pharmaceutical companies.
  • not to allow pharmaceutical representatives to conduct contests, drawings, raffles, or other activities that lead to personal gifts for residents or faculty.
  • not to display gifts or other promotional materials directed to the physician and that advertise brand names for pharmaceutical products in patient care or waiting room areas.
• Residents and faculty may receive competitive national awards and scholarships funded by pharmaceutical companies if all control of recipient selection rests with an independent professional organization (e.g. AAFP, STFM). goto top

5. Detailing

• Residency programs should develop their own written policies concerning direct contact between residents/faculty and pharmaceutical or other proprietary representatives for the purpose of discussing specific products, i.e. detailing.
• For residency programs that allow detailing activities, the policy should include:
  • Specified times and locations for detailing activities.
  • Assurances that detailing will not interfere with patient care or other educational activities.
  • Provisions for residents to decline personal contact with pharmaceutical representatives if desired.
  • Recognition that the use of personal appeals, factually incorrect or misleading information in detailing is unprofessional.
  • Recognition that detailing is only one component of an educational program designed to help residents critically assess new and existing information about products.
• Residencies that allow pharmaceutical or other proprietary representatives to make presentations about products at residency-sponsored conferences are encouraged to have faculty present at such conferences to offer analysis of the information presented by the representatives.
• Residency programs are encouraged to develop educational programs that assist residents in learning about promotional techniques used by industry representatives and that assist them in developing appropriate responses.
• If a residency program permits detailing activities, access should not be conditioned on the giving of gifts or other incentives to the program by the pharmaceutical or proprietary company. goto top

6. Samples

• Residencies should have policies that delineate whether the program accepts sample medications that are given at no charge to patients.
• Residency programs that accept sample medications are strongly encouraged:
  • to establish protocols or other programs that help ensure that drug selection for patients is primarily based on efficacy and cost. Such programs should assist residents in learning about the potential impact that availability of samples has on long-term prescribing practices.
  • to stock their sample supply based on a formulary or other policy. A formulary should be based on drug efficacy and cost, with both residents and faculty having input in its establishment and maintenance.
  • to control the supply, distribution and arrangement of all medications in sample storage areas.
  • to label all samples with the patient's name, date, amount dispensed, physician's name, and directions for use. Such information should be appropriately documented in the patient record.
• Residencies should develop their own policy concerning sample use by staff and/or physicians. Such use should not be encouraged, but if it is allowed, documentation should occur, showing to whom the sample was provided, who prescribed it, sample name, amount, and date.
• Infant formula products should be subject to all the guidelines previously mentioned. Programs choosing to distribute infant formula sample products should acknowledge that breast-feeding is the preferred form of newborn and infant nutrition. goto top

7. Literature

• To help promote high quality patient education, patient education materials provided by pharmaceutical and other proprietary companies should be reviewed by appropriate faculty, residents and/or office staff before distribution to patients. Residency programs are encouraged to select patient education materials that are accurate, that are written at appropriate patient readability levels, and that present balanced and objective information. goto top

8. Medical Students

• When medical students spend time rotation or working within the residency program, they should be made aware of and follow the residency guidelines on the relationship with pharmaceutical and other proprietary companies. Faculty and residents should help teach medical students about the unbiased acquisition of pharmacotherapeutic knowledge including new medications, as well as the many roles that the pharmaceutical industry may play in undergraduate and post graduate medical education. goto top

9. Other

• Residencies do not control faculty and resident activities outside of working hours and during their non-residency time. Nonetheless, residencies should help teach residents about the potential marketing intent of outside activities such as proprietary sponsored "educational", social or sporting activities.
• Residency resources should not be used to support proprietary sponsored activities which occur independent of the educational structure of the residency program. goto top