This policy covers all residents and fellows participating in ACGME-accredited, postgraduate medical education programs sponsored by the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo-State University of New York (Jacobs School). References in this policy to residents also apply to fellows, unless specifically stated otherwise.
In view of compelling evidence that resident prescribing behavior is influenced by interactions with industry representatives, as well as experience demonstrating that early interactions with vendors forms the basis of later interactions, residents should not have unsupervised contact with representatives. In most circumstances, residents should only interact with representatives in an educational context in which a faculty member demonstrates how to interpret the information that is presented. However, in selected settings it may be permissible for a faculty member to delegate to a device manufacturer representative the task of explaining to residents the actions and operation of the representative’s product when the vendor’s knowledge of its operation is more extensive than the faculty member’s, while the faculty member is otherwise engaged. The faculty member is responsible for ensuring that the interaction is restricted to an explanation of technical details of the product and that no marketing of the product occurs.
UBMD Practice sites
At all sites at which full-time faculty provide clinical services (i.e., UBMD practice sites), including hospitals and clinics, there should be no unannounced or unscheduled contact between industry representatives and individual faculty members or residents. Representatives can schedule appointments with faculty as faculty time and interest permits. Each UBMD practice site will designate an administrative support staff contact person and waiting area separate from patient waiting rooms (where possible) for industry representatives. On a schedule determined by each department, representatives from industry may have an opportunity to present information about their products to interested faculty and residents in a poster session in association with an industry symposium or other bona fide educational activity (see below “Educational Activities”).
Volunteer faculty practice sites
Volunteer faculty members may schedule appointments with industry representatives. However, in all clinical settings, residents may not have any informal contact with vendors, they may not make independent appointments with industry representatives, and they may not interact with representatives without a faculty member present except as noted above (“Contact with Residents”).
Industry Representatives in Clinical Areas
Industry representatives are generally not permitted in patient care areas. At the specific invitation of a faculty member, representatives of device manufacturers may be present in patient care areas for technical procedures such as surgery and device insertion and programming if the representative is needed to explain the use of the product or might be needed to supply replacement parts. Such representatives must be registered at the institution. Identifying information about the patient may be made available to device industry representatives if necessary for device registration and follow-up and if HIPAA and institutional rules are followed. When they are involved in device insertion or maintenance, device manufacturer representatives must not promote the use of their product over other products.
Faculty Industry Liaison
A faculty or staff Industry Liaison (IL) will be appointed at each site at which UBMD provides clinical services to oversee, coordinate, and administer group educational and promotional activities. Each department may have an IL, or departments may share the same IL. This person will be the designated contact person for industry representatives to arrange for group educational activities; distribution of literature, durable goods (e.g., CD ROMs, DVDs), and promotional items; and for accepting samples for resident and hospital clinics. The IL or a designated administrative support staff person will receive all gifts, literature, and other promotional items. These items will then be provided in a centralized manner (see below). All samples for resident services will be received by the IL and managed in accordance with the institutional policies for samples. No samples may be obtained or kept by residents or clinic directors for clinic use, unless designated by the IL or the Chair of the relevant department. Faculty practitioners may keep samples in their offices and are not required to use the IL. Volunteer faculty practicing in their own offices may follow whatever policy they prefer for receiving samples. However, residents assigned to those offices cannot accept any items from industry representatives. Any items for residents should go through the training director.
Resident Invitations to Industry Sponsored Events
Invitations for residents to industry sponsored activities outside of training program functions should not be sent directly to residents. Instead, such invitations should be presented to the department’s residency program director (or their designee(s)), who will decide whether to distribute them to selected residents.
No gifts from industry are permitted.
Educational materials for patients, residents, and others that are developed by industry may be accepted if they are the best source of such materials available and are for the purpose of education and not for the purpose of selling a product. Written materials and illustrations for patients are permitted for products for which the manufacturer’s information and instructions are essential.
Travel support and conference fees
Direct industry support of travel for residents is prohibited.
Industry sponsored meals conducted in association with regular activities of Jacobs School faculty, residents, students and staff at any location for meetings, grand rounds, conferences and similar activities must have a primary educational goal and focus and cannot involve any promotional activity including any presentation by industry representatives. Funding for meals associated with educational events must be paid to the department or practice plan; meals cannot be supplied directly by industry. However, the source of support for the meal may be acknowledged at the beginning of the meeting. Meals will be coordinated and scheduled through the IL, the program director, department chair or designee. The value of any food provided should be ≤ $10 per attendee.
1. Departmentally Supported
Educational conferences sponsored by a department (including Grand Rounds and conferences) must follow Accreditation Council for Continuing Medical Education (ACCME) and other relevant guidelines if continuing medical education credits are to be awarded. Such guidelines are published in the document entitled “CME Activity Guidelines”. In addition to ACCME rules,
a) Industry support for an educational program must be through unrestricted educational grants and not by paying for speaker or other costs directly. Unrestricted educational grants will be accepted by departments or practice plans (not individuals) to subsidize educational activities. Speakers will be paid by the department or practice plan; speakers may not accept additional payments from industry for a departmental or practice plan event supported by an unrestricted educational grant.
b) Industry sponsorship must be requested because it would be prohibitively expensive for the audience to attend without such support.
c) Payment from industry to anyone with a full-time or volunteer faculty appointment is prohibited for presentations, lectures, case conferences or any other activity that is part of the curriculum of any educational program for residents.
d) Industry representatives may be present during grand rounds and during other CME activities but they may not be present in patient care areas before or after such presentations. No promotional activities (including individual contact with residents) or gifts are permissible in this setting. At CME events at which representatives have exhibits for a fee, the exhibits must be located separately from the educational event.
2. Support for Jacobs School-sponsored activities
Departmental, practice plan, or Jacobs School-sponsored retreats, meetings, symposia or other development activities may only be supported by unrestricted educational grants. Promotional materials (including branded items) may not be distributed at these activities.
3. Activity scheduling
Educational and promotional activities (e.g., teleconferences, lectures, etc.) directly sponsored by industry or by a subcontractor to industry must occur outside of regular working hours and outside of assigned activities of full-time faculty and residents.
4. Resident participation in promotional events
Residents must be aware of the limitations on their ability to participate in promotional activities. Promotional activities (including lectures and clinical discussions) are defined by any of the following:
a) Identification as having the purpose of marketing industry products.
b) All industry sponsored mealtime activities and presentations in offices and clinics.
c) Industry generated slides and/or durable materials (e.g., written, CD, DVD, etc.) that are chosen by a company or its subcontractor and not by the speaker.
d) All of the material presented is prepared or vetted by the company or its subcontractor.
e) The agenda, topics of discussion, or cases presented are prepared by the sponsor. Sponsors include manufacturers and for profit third parties who subcontract the development of an event. Because promotional events are by their very nature biased, residents are discouraged from attending such events. Should they choose to attend promotional events, residents must report each event they attend to the program director or designee so that their involvement in promotional activities can be monitored. Residents may not participate as presenters/panelists in promotional activities, including promotional talks and speaker’s bureaus.
Programs must provide annual training to residents on vendor relations and conflicts of interest, including reference to this policy and other relevant institutional policies. Programs should correct actions as needed to ensure that the policies described here are observed.
Many Jacobs School clinical training sites already support policies governing vendor practices and all Jacobs School residency and fellowship program directors, faculty, and residents are expected to observe local policies.
Vendors: The Sponsoring Institution must maintain a policy that addresses interactions between vendor representatives/corporations and residents/fellows and each of its ACGME-accredited programs. (Core)
GMEC approved date: June 21, 2022