Prevalence and extent of industry support for program directors of surgical fellowships in the United States

Financial Relationships in General Surgery Education: Recent Trends in Industry Payments to General Surgery Residency Leadership

INTRODUCTION

Residency programs and their directors frequently receive funding from industry payers. Both general surgery residency program directors (PDs) and assistant program directors (APDs) receive industry funding for various reasons, including educational advancement. This study investigates recent trends in industry payments to both PDs and APDs to better understand the financial relationships among leaders in residency education.

METHODS

We compared industry payments to general surgery residency PDs and APDs from 2019 to 2021 utilizing the U.S. Centers for Medicare & Medicaid Services (CMS) open payments database. In addition, secondary analyses were performed among PDs to assess differences based on gender, practicing surgical specialty, and geographical region.

RESULTS

During the study period (2019-2021), PDs received payments amounting to 2,882,821 USD. PDs were found to receive more funding than APDs, with each receiving average funding of 10,045 vs. 323 USD (p < 0.01), respectively, over the study period. There was a significant decrease in total payments from 2019 to 2020 (1,512,190 vs. 868,811 USD; p < 0.01). Total payments made in 2021 were similar compared to 2020 (905,836 vs. 868,811 USD; p = 0.1). We found that male PDs received significantly more in-industry payments when compared to female PDs (11,702 USD per PD vs. 3971 USD per PD, p < 0.01).

CONCLUSION

This study presents initial data that residency program leadership has robust biomedical industry relationships, and further research is warranted to investigate the impacts of these payments on program resources, educational opportunities for residents, and program outcomes. Male PDs received significantly more industry payments when compared to female PDs. Leaders in the surgical training community must cautiously ensure that these industry relationships are appropriately navigated.

Information and Guidance on the Adoption of Surgical Innovation and Technology in Urogynecology

ABSTRACT

The development of new technology and techniques (NTT) is an integral component of contemporary medicine. In surgery, rapidly advancing technology offers opportunities to innovate and study new approaches to help improve the quality and effectiveness of therapies. The American Urogynecologic Society is committed to the responsible implementation and use of NTT prior to the broad application of clinical care for patients, which includes not just new devices but application of new procedures. The aim of this document is to present a framework by which AUGS and its members can address future NTT development. Core areas of patient advocacy, industry partnerships, postmarket surveillance, and credentialing were identified to provide both a perspective and pathway for responsible use of NTT.

Industry payments made to academic endodontists: Sex differences and other insights into financial relationships

BACKGROUND

Industry payments made to health care providers can create competing interests. The purpose of this study was to define the overall financial relationships between industry and academic endodontics faculty members, detail any variation in such payment data as related to individual faculty member characteristics and leadership position by institution type, and comment on the potential impacts from conflicts of interest (COIs) created by such relationships.

METHODS

The author identified and characterized academic endodontists from information on their institutional websites. The author obtained reported industry payments from 2013 through 2019 from the Centers for Medicare & Medicaid Services Open Payments database. The author also noted the distributions of academic endodontists and industry payments by institution, academic rank, sex, and residency program director position. The author subjected the data to descriptive and nonparametric analyses.

RESULTS

Of the 302 academic endodontists included, 240 (80%) accepted reported industry payments totaling $4,260,316.97. Overall, the median of total industry payments for all 302 faculty members was $217.89 (interquartile range [IQR], $34.06-$3,070.00). Among those accepting payments, the median amount was $382.80 (IQR, $110.40-$6,234.00). The top decile of paid academic endodontists received $3,669,291.47 in industry payments (86% of the total), with a median payment of $24,013 (IQR, $17,043-$91,190). Significant sex-associated industry payment differences were seen among the overall faculty and among those with the residency program director position.

CONCLUSIONS

Most academic endodontists accept industry payments. Significant sex differences exist in overall faculty member academic rank distribution, leadership role, and accepted median industry payment amounts. COI issues have the potential to arise among academic endodontists when such industry payments are accepted.

PRACTICAL IMPLICATIONS

Existing sex disparities in academic endodontics within the United States ideally should be acknowledged. COI issues can arise when academic faculty members accept industry payments. Public knowledge of these conflicts could negatively affect individual faculty members, their institutions, and related areas such as academic publishing. Appropriate faculty member COI disclosure, attestation, annual updates, and transparency are important mitigation measures.