Conflict of Interest Policies at German medical schools - A long way to go

Background: Most medical students are in contact with the pharmaceutical or medical device industry during their studies. Medical schools play an important role in protecting students from undue commercial influence and educating them about pharmaceutical marketing practices. Such influence has been shown to affect later prescribing behaviour with potential adverse effects for patient care. While in North America, many medical schools formulated and implemented conflicts of interest (COI) policies, only few such institutional policies have been reported in Germany. We aimed to analyze the quantity and quality of policies and curricula on COI at medical schools across Germany. Methods: We collected relevant COI policies and teaching activities by conducting a search of the websites of all 38 German medical schools using standardized keywords for COI policies and teaching. Further, we surveyed all medical schools9 dean9s offices and adapted a scoring system for obtained results with 13 categories based on prior similar studies. Results: We identified relevant policies for one medical school via the web-search. The response rate of the deans9 survey was 16 of 38 (42.1%). In total, we identified COI-related policies for 2 of 38 (5.3%) German medical schools, yet no policy was sufficient to address all COI-related categories that were assessed in this study. The maximum score achieved was 12 of 26. 36 (94.7%) schools scored 0. No medical school reported curricular teaching on COI. Conclusion: Our results indicate a low level of action by medical schools to protect students from undue commercial influence. No participating dean was aware of any curriculum or instruction on COI at their respective school. The German Medical Students Association and international counterparts have called for a stronger focus on COI in the classroom. We conclude that for German medical schools there is still a long way to go.