PharmaFree Scorecard released

The American Medical Student Association just released its PharmaFree Scorecard today, ranking medical schools in the United States according to their policies on conflicts of interest with the pharmaceutical industry. The Scorecard examined policies related to things like gifts, industry-funded speaking engagements or continuing education that limit reimbursement and require the “scientific integrity of information presented.”

AMSA is the largest association of premed and medical students with a history of medical student activism, according to its website. “AMSA is committed to improving medical training as well as advancing the profession of medicine. AMSA focuses on four strategic priorities, including advocating for quality, affordable health care for all, global health equity, enriching medicine through diversity and professional integrity, development and student well being.” Its mission statement includes a commitment to promoting improvement in medical education and involving its members in the social, moral and ethical obligations of the profession of medicine.

AMSA developed the Scorecard with the Prescription Project, a project led by Community Catalyst and created with Pew Charitable Trusts, to “promote evidence-based prescribing” and work to eliminate conflicts of interest in medicine. “The schools that earned ‘A’ and ‘B’ scores are to be commended for setting a high bar and aggressively moving forward to ensure medical education, training and patient care is free of commercial bias,” said Robert Restuccia, executive director of the Prescription Project.

“Medical schools and academic medical centers can play a powerful leadership role in setting new standards for the profession,” says the Scorecard website.

According to AMSA’s president, Dr. Brian Hurley, by “eliminating the gifts and the misleading information that pharma reps currently bring into our schools, hospitals and academic medical centers, physicians will be able to better practice evidence-based medicine. And that translates into better care for our patients.”

Fourteen medical schools got a ‘B’ score and seven got their top-ranking ‘A’ score.

A cautionary note. Nonindustry funding is not an assurance of the scientific soundness of information or research, freedom from conflicted interests, or a measure of evidence-based medical training or clinical care. A quick check of their top A and B ranked and most recommended medical schools revealed that all but two in each category* are members of the Consortium for Academic Health Centers for Integrative Medicine. As reviewed here and here, these are medical schools that have incorporated alternative modalities into their medical schools in return for lucrative funding.

In fact, the AMSA’s Foundation (a public educational foundation with an inter-locking directorate with the AMSA) which works with the AMSA in promoting its mission, was awarded a 5-year grant from NCCAM (National Center for Complementary and Alternative Medicine) to promote and disseminate alternative education curricula and programs at medical schools. The goals of this project were to improve the proficiency of medical students in CAM modalities, promote training in preventive health and holistic care, and incorporated alternative modalities in care. The grant summary includes an outline of the core CAM curriculum the AMSA has created as part of its guidelines and objectives for courses at medical schools, that includes homeopathy, dietary supplements, and mind-body medicine. “Since 2003, AMSA has [also] offered an annual 5-day Leadership Training Program focusing on CAM modalities, research and basic concepts, as well as leadership development skills for students interested in becoming leaders at their medical schools in the movement to introduce CAM curricula.”

The scientific integrity of information and efficacy of medical interventions can never be determined by a score, ranking or funding source alone. Only careful examinations of the scientific evidence and evaluation of clinical trials as fair tests can do that. Is there a medical student organization promoting that?

* Medical schools in the Consortium for Academic Health Centers for Integrative Medicine that received top rankings in the 2008 AMSA Scorecard:

B Score: University of Massachusetts, University of Michigan, University of California at Irvine, Boston University, University of Miami, Vanderbilt University, University of North Carolina at Chapel Hill, Columbia University, University of Texas Southwest, and University of New Mexico.

A Score: Stanford University, Mount Sinai, University of California at Davis, University of California in Los Angeles, University of California in San Francisco, University of Pennsylvania, and University of Pittsburgh.