Conflict of interest policies at Belgian medical faculties: cross-sectional study indicates little oversight

Medical students encounter pharmaceutical marketing on a reuglar basis from their first year at university onwards. Several studies have demonstrated the impact it has on the perception of students toward the place of pharmaceutical industry in medicine. It also has an impact on the quantity, the costs and the frequency of physicians prespcription with a decrease in the quality. Thereby, importance of managing interactions between pharmaceutical industry and healthcare profesionnals is not to be demonstrated. These interactions happen in a context of decresing public subsidies granted to higher education and healt, which pushes institutions to increase their share of private funding with a risk of endangering their independence. This is to be taken into account, however medical schools should not lose sight of their role of providing the most objective and independent training for their students. Implementation of conflict of interest policies at American medical schools has permitted an improvement of the situation and a diminution of the interactions between students and industry. Since then, studies have been conducted in Australia, Canada, France and Germany to assess the conflict of interest policies within national medical faculties. As little information was available on the situation at Belgian medical schools, we decided to investigate the field and to reproduce the methodology used by foreign researchers in the context of Belgian medical training. We searched the ten medical schools websites for information relative to conflict of interest policies or element of the curriculum addressing this issue. We also surveyed each office of the Dean to ask them for additional information that we might have missed. Despite a relatively high response rate, only one faculty really wished to participate in our study, five of them having expressed their wish not to participate. A ranking of the medical schools was built on the basis of the data collected with criteria assessing the management of conflict of interest and industrial influence. Our results demonstrate the little attention paid by university authorities to the issues of independence in medical training and conflict of interest. This is inconsistent with many recommandations of international organizations and demands formulated by medical students themselves for an independent medical training, free from undue indluence of commercial interests. However, not everything has to be done. Foreign experiences show that it is possible to change the lines in favor of more independence. Many exemples of achievements can serve as a basis for actions in Belgium in order to make medical world and the public in general aware of the importance of a medicine without influence.