Guidelines: Relationship Between Physician Trainees, Postgraduate Training Programs and Industry

General Principles

The following principles and guidelines apply to activities sponsored by the University of Toronto. Central to these are the integrity and the fiduciary nature of the physician-patient relationship, the confidentiality of information regarding the patient, and the avoidance of any conflict of interest for the physician-trainee and for the training program.

1. The primary objective of professional interactions between the physician trainee, the postgraduate training program and industry is the advancement of health care. Through education and research, such professional interactions should promote this objective.
2. The relationship between the physician-trainee, the postgraduate training program and industry is guided by the Canadian Medical Association Code of Ethics.
3. The physician trainee has as her/his primary obligation the care and welfare of the patient. Relationships with industry are appropriate if they promote education and research and do not affect the integrity of the physician-patient relationship.
4. The physician trainee and the postgraduate training program must resolve any conflict of interest resulting from interactions with industry in favour of the patient. In particular, the physician trainee must avoid any self-interest in prescribing and referring practices.
5. In any interaction with industry, the physician trainee must maintain professional autonomy and commitment to the scientific method.
6. The physician trainee and the postgraduate training program must disclose the nature of any relationship with industry to patients, to organizers and to audiences involved in educational events or research.
7. The physician trainee must not receive personal rewards from industry, except for educational material of minimal monetary value.

Education

1. The postgraduate training program should determine that an educational event offered on behalf of the members of that training program is appropriate for the curriculum offered by that training program. The educational event must address educational needs of the physician trainee.
2. The postgraduate training program must control the content, organization and funding arrangements for an educational event offered on behalf of the physician-trainees.
3. The postgraduate training program must ensure that a balanced presentation of information regarding therapeutic intervention is offered within any educational event for its physician trainees. Any agent or device discussed must be discussed within the context of the disease or condition and of the available therapeutic interventions. Generic names of agents and devices, where possible, should be used within educational events.
4. Special funds, scholarships and other support to allow physician trainees to attend educational events are permitted, as long as the postgraduate training program administers such funds. Physician trainees may apply equally for such funding support to the postgraduate training program.
5. A description of educational support must be provided to the University, to industry supporting the educational event, and to the attendees of an educational event.
6. The postgraduate training program must include formal training within the curriculum regarding the ethical guidelines for the relationship and interaction of physicians with industry.

Research

1. Physician trainees may participate in research sponsored by industry if the research is ethically defensible, socially responsible and scientifically valid.
2. Participation by a physician trainee in research sponsored by industry must occur within the context of formal approval and monitoring of the research by an appropriate ethics review board, agency or body.
3. A trainee must not accept any remuneration or reward for proposing patients as subjects of research.