Medical Residents and the Pharmaceutical Industry

To the Editor.—  I read the article by Lichstein et al¹ on the impact of pharmaceutical company representatives on internal medicine residency programs with interest. The accompanying editorial by Girard² suggests that the time has come for guidelines and that "The Association of Program Directors in Internal Medicine must act."In a family medicine training center, an informal survey demonstrated that residents, students, faculty, and staff members were constantly bombarded with drug advertising paraphernalia including pens, note pads, drug samples, educational materials (pamphlets and posters), and other trinkets (pushpins, key rings, clocks, calendars, paper clip holders, cups, and bags).³The primary-care residency program at the University of Connecticut Medical School, Storrs, developed a program to teach their residents how to interact with drug company representatives.⁴ Nevertheless, the program director concluded that the pharmaceutical industry will continue to play a major role in the education of practicing