Subscription required for this article – Drug firms to fund residency slots in dermatology pilot program

Faced with a work-force shortage and no new federal funding for resident training, the American Academy of Dermatology is expanding residency slots by using pharmaceutical company donations.

AAD leaders say enough safeguards are in place to prevent conflicts of interest that could arise from the relationship, but critics say such funding compromises the medical profession and leaves it beholden to for-profit corporations.

The academy’s goal is to increase dermatology resident positions by up to 10% — about 30 new slots — per year. A pilot program will fund an initial 10 slots at $60,000 per slot per year for three years starting in July 2006.

Corporate sponsors contributing to the $1.8 million needed to fund the pilot are 3M Pharmaceuticals, Amgen and Wyeth Pharmaceuticals, Delasco Dermatologic Lab and Supply Inc., Galderma Laboratories and OrthoNeutrogena. The AAD also committed to contributing $1 million annually to the fund if pharmaceutical gifts fall short but declined to say how much of its own funds, if any, were being invested in the pilot.

David Pariser, MD, an AAD board member and chair of the pilot task force, detailed the measures the academy is taking to nip possible conflicts of interest in the bud. Members of the Assn. of Professors of Dermatology vetted the pilot and helped draw up guidelines. Corporate contributions are combined in a general fund, and the grants are assigned to specific programs to avoid having individual residents singled out as beneficiaries.

The APD and AAD jointly selected 10 institutions for the pilot from 24 applicants. Pharmaceutical donors were excluded from the selection process. Dr. Pariser said the pilot will not be expanded until the AAD evaluates the results.

This does not pass the “smell test”. It may work, and I do empathisize with the Dermatology community. We do need to train more Dermatologists, and finding funds to support residents remains a challenge.

What this story reminds us, is the problem of how to fund residency positions. Currently, we rely heavily on federal funding through Medicare. This reliance does “handcuff” medicine in its own way. We have fixed numbers of “slots”, which do not necessarily match changing needs and opportunities. The new residents deserve decent salaries, especially consider the debt they have accumulated during medical school. I understand the dermatologists, but I do worry greatly about this approach.

Related posts:

1. Will primary care residency slots make a difference
2. The doctor shortage (hat tip to @FutureDocs and @efalchuk)
3. Just to be sure – an ER slippery slope
4. Beware the slippery slope
5. Catch-22 – what the NY Times op-ed missed

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