Industry Payments Received by Residents During Training

Area of Science:

• Medical Education
• Professional Identity Formation
• Conflicts of Interest

Background:

• Medical education stakeholders, including specialties, institutions, and program directors (PDs), influence trainee professional identity.
• Potential conflicts of interest arise from industry payments to residents.

Purpose of the Study:

• To determine the extent to which training environment factors correlate with resident acceptance of payments from pharmaceutical and medical device companies.
• Investigate the association between specialty, institutional ownership, and PD behavior with resident acceptance of industry payments.

Main Methods:

• Cross-sectional, retrospective study of residents in primary care (internal medicine, family medicine, obstetrics/gynecology) and surgical (general surgery, orthopedic surgery, urology) specialties (2020-2021).
• Analysis of Open Payments Program (OPP) data using modified Poisson regression to assess relative risk.
• Examined specialty, sponsoring institution ownership (nonprofit, for-profit, government), and PD payment acceptance.

Main Results:

• 13.4% of 65,992 residents received $3.9 million in industry payments.
• Residents in for-profit institutions were 3.50 times more likely, and nonprofit institutions 2.00 times more likely, to accept payments compared to federal institutions.
• Elevated risk of payment acceptance was observed in orthopedic (3.21x), urology (2.95x), general surgery (1.21x), and OBGYN (1.30x) specialties compared to internal medicine.

Conclusions:

• Resident acceptance of industry payments is significantly associated with their specialty, institutional affiliation, and program director's interactions with industry.
• Findings underscore the influence of the training environment on potential conflicts of interest among residents.
• Specialties and institutional structures play a role in shaping residents' engagement with industry funding.