For more than a decade. . .
…there has been a growing chorus of voices comprised of citizens, politicians and healthcare leaders calling for attention to the conflicts of interest (COI) between physicians and the drug and device industry. These conflicts of interests have led to an erosion of trust that is the foundation of the doctor-patient relationship. While the relationships between academic physicians and industry benefit medical research and treatment, they can bias medical education and clinical decisions in favor of specific products. Studies have shown that industry influence—whether in the form of gifts, commercially supported education, or simply visits with pharmaceutical representatives—can lead to more expensive and less evidence-based prescribing practices.

As awareness of conflict of interest in healthcare has increased, attention has been focused on the policies regulating industry and physician relationships in medical schools.  Leaders in medical school administrations have been too slow to strictly regulate industry funded activities, such as the provision of gifts and meals, industry funded continuing medical education, speakers bureaus and the presence of sales representatives on campus.

In 2002, AMSA established the PharmFree Campaign, a national program intended to engage students on the issue of COI reform in medical education and practice. AMSA began assessing COI policies in 2007 with a simple questionnaire which graded schools based on the presence or absence of “a comprehensive policy that restricts pharmaceutical company representatives access to both the medical school campuses and the AMC.” In 2008, AMSA collaborated with the Pew Prescription Project to create a more elaborate scorecard which analyzed 11 COI policy domains. Since 2011, the Scorecard has been revised and expanded with support from a grant from the Oregon Attorney General Consumer and Prescriber Education Program. Close collaboration with the Pew Prescription Project yielded improvements to the methodological framework of the Scorecard. The 2014 AMSA Scorecard reflects changes to the scoring methodology, based on recommendations produced by an expert task force convened by Pew, that better assess the nuances of academic medical center and industry relationships, and enhance the instrument’s methodological rigor. The AMSA Scorecards for US Medical Schools and US Teaching Hospitals can be viewed at www.amsascorecard.org.

Today, the Just Medicine Campaign (formerly, PharmFree Campaign), which houses the AMSA Scorecard, is a student-run education and advocacy program of the American Medical Student Association and AMSA Foundation.  Over a dozen pre-medical and medical students from around the country make up the Steering Committee and many more participate in conferences, workshops, and lectures. The Campaign supports examination and learning of pharmaceutical industry issues in monthly teleconferences and direct student action through events held locally and nationally.  Although the scope of the Steering Committee’s collective interests may shift on a year to year basis, the fundamental core principle of the Campaign stays constant.  Trust and integrity are the foundation of professionalism in medicine, and the influence of the profit-based pharmaceutical and medical device industries is a threat to sound and ethical patient care, medical education, research, and health policy.

Students – physicians-in-training – can be leaders in efforts to protect the patient-centered heart of the profession.
With a vast capacity for leadership, passion, and creativity, students must be engaged to prepare for leadership in medicine.  The American Medical Student Association, through the Just Medicine Campaign and the AMSA Scorecard, seeks to develop and connect future physicians for leadership on these critical issues.