A Tale of Two Cities: Different Perspectives on the Industry Support of Resident Education Debate
2008, Volume 1, Number 2 55 Vignette A small residency program in the Midwest is con-tacted by a major pharmaceutical company about sending the program's residents to an industry spon-sored course on intraocular surgery to be held off campus. The course content and faculty were selected by the sponsor. The industry sponsor has offered to pay for the resident travel expenses and the course registration was waived for all participants. Dr. Dunn's Perspective I am reminded of two quotations in preparing this edi-torial. The first is from H.L. Mencken, that Baltimore writer and icon, who wrote that, For every complex problem, there's a simple solution- and it's wrong. The second is from an anonymous professor at Har-vard Medical School who, while describing the uni-versity's goals for joint research with private enter-prise, said, We want to get pregnant without really losing our virginity. Setting aside for the moment that the latter quote was made before fertiliza-tion made pregnancy eminently feasible without the need for something as sinful as sex, both of these statements apply to the current dilemma. One can ar-gue that the simple solution to the potentially corrupt-ing influence of industry in residency training is sim-ply to ban industry representatives from the ivory tower. One can also argue (IVF notwithstanding) that it is no more possible to work productively and ethi-cally with industry than it is to have immaculate con-ception. The underlying support for these approaches is, I feel, both impractical and unwise. Residents often joke that their ophthalmology pro-grams should be called the [Insert name of company here] Institute of Ophthalmology , depending on which surgical equipment is used in the operating rooms or which company sponsors the majority of CME courses. My own institution is no exception. Drug companies have endowed chairs, provided free post-operative eyedrops, and taken residents out for countless meals, among other things. Well-known clinicians are frequently asked by non-peer reviewed ophthalmology journals (the throwaways ) to affix their names to articles that are written by professional writers that tout a particular topical antibiotic, glau-coma drug, or phacoemulsification machine, and are paid handsomely for ghostwritten and guest-authored articles. As a resident and then a cornea fel-low in the 1980's, I saw a generation of intraocular lenses explanted when the long-term complications of pupil-fixed and rigid anterior chamber lenses, touted just a few years earlier by ophthalmologists with strong ties to industry, were shown to cause pseudo-phakic bullous keratopathy. It is naïve to think that the pharmaceutical industry sponsors the type of in-traocular surgery courses discussed here for residents solely to promote their education. Companies have a vested interest in promoting their own products- hard-ware, software, and pharmaceutical- by means overt and covert that will increase the chances that these products will be used by the residents once they enter private practice or academic medicine. Just last year, A Tale of Two Cities: Different Perspectives on the Industry Support of Resident Education Debate Alfredo A. Sadun, MD, PhD 1* and JP Dunn, MD 2* 1 Program Director, Doheny Eye Institute, University of Southern California, Los Angeles, CA 2 Program Director, Wilmer Eye Institute, The Johns Hopkins Medical Institution, Baltimore, MD * Corresponding Authors & e-mail: asadun@usc.edu and jpdunn@jhmi.edu Accepted for publication Aug 08, 2008 2008; 1:55-59 Available via open-access on the web at http://www.academic-ophthalmology.com The author(s) have no personal financial interest in any of the products or technologies cited herein. 2008