title: Attitudes of medical students towards incentives offered by pharmaceutical companies -- perspective from a developing nation -- a cross-sectional study.
abstract: BACKGROUND
  A training physician has his first interaction with a pharmaceutical representative during medical school. Medical students are often provided with small gifts such as pens, calendars and books, as well as free lunches as part of drug promotion offers. Ethical impact of these transactions as perceived by young medical students has not been investigated in Pakistan before. This study aimed to assess the association of socio-demographic variables with the attitudes of medical students towards pharmaceutical companies and their incentives.
  
  
  METHODS
  As part of a cross-sectional survey, a validated questionnaire previously used for assessing attitude of medical students towards pharmaceutical industry, was modified, pre-tested and distributed among consenting clinical year students at DUHS and AKU. Questions included acceptability of pharmaceutically sponsored gifts, events and tuition fee, and their impact on future prescription. Responses were graded as agree, disagree or neutral which were then scored according to the AMSA guidelines of ethical conduct.
  
  
  RESULTS
  Out of a total of 353 targeted students 303 responded, corresponding to a response rate of 85.8%. Responses indicated that 42.7% students believed in no interaction with drug companies during medical school. However, 81% of students favored pharmaceutical sponsorship of student-body events/seminars at medical colleges. More than one-third of the students were comfortable receiving gifts from drug companies. Overall, the results of this study offer an interesting comparison between the students of a private medical school (AKU) and a public medical school (DUHS); AKU students exhibited a greater degree of mistrust towards drug information provided by pharmaceutical companies compared to DUHS students (p = 0.040). Furthermore, when asked if there was a need to incorporate guidelines in the undergraduate curriculum with regard to interaction with drug companies, 84.2% students at AKU agreed, compared to 54.9% at DUHS. Medical student Attitude Scores are more or less similar to each other independent of their various demographical differences.
  
  
  CONCLUSIONS
  This study highlights that medical students in our population have a high level of acceptability towards incentives offered by pharmaceutical industry and that formal guidance regarding the subject should be incorporated into medical curriculum.
authors.affiliation: Medical student, Medical College, Aga Khan Medical University Hospital, P,O Box 3500, Stadium Road, Karachi, Pakistan. usmantsiddiqui@hotmail.com.
authors.forename: Usman Tariq
authors.initials: UT
authors.lastname: Siddiqui
authors.forename: Amarah
authors.initials: A
authors.lastname: Shakoor
authors.forename: Sarah
authors.initials: S
authors.lastname: Kiani
authors.forename: Farwa
authors.initials: F
authors.lastname: Ali
authors.forename: Maryam
authors.initials: M
authors.lastname: Sharif
authors.forename: Arun
authors.initials: A
authors.lastname: Kumar
authors.forename: Qasim
authors.initials: Q
authors.lastname: Raza
authors.forename: Naseer
authors.initials: N
authors.lastname: Khan
authors.forename: Sardar Mohammed
authors.initials: SM
authors.lastname: Alamzaib
authors.forename: Syed
authors.initials: S
authors.lastname: Farid-ul-Husnain
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D004345:Drug Industry / Q000941:ethics; D005260:Female; D005378:Financial Support / Q000941:ethics*; D037921:Gift Giving / Q000941:ethics*; D006801:Humans; D007400:Interprofessional Relations / Q000941:ethics*; D008297:Male; D009042:Motivation / Q000941:ethics*; D010154:Pakistan; D013337:Students, Medical / Q000523:psychology / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires