Gifts, Blind Spots, and Gray: Canadian Student Pharmacists’ Perceptions of Pharmaceutical Industry Interactions

OBJECTIVE: To evaluate Canadian student pharmacists' interactions with the pharmaceutical industry and their perceptions of potential bias, implications for future behavior as pharmacists, and conflicts of interest (COI). METHODS: A national, cross-sectional survey was administered to students enrolled in accredited Canadian PharmD programs. The 31-item instrument examined acceptance of industry gifts, attendance at sponsored events, educational exposure to COI, and institutional policy awareness. Recruitment was conducted via email through student liaisons and associations. RESULTS: Of 4878 eligible students, 563 initiated and 483 completed the survey (response rate: 9.9%). A majority (88%) reported accepting small gifts, and 39% accepted larger gifts (eg, conference funding). Most students (75%) had attended pharmaceutical-sponsored educational or social events. Despite high participation, only a minority (6-17%) viewed these interactions as problematic regarding the impact on their behavior as future pharmacists. About one-third had never considered the implications of accepting gifts or awards. Over half of respondents believed pharmaceutical representatives were valuable information sources, and nearly one-third planned to meet with them in practice. Instruction on COI was inconsistent; only 31% received annual education, and over half were unaware whether their faculty had a COI policy. Observed behaviors of faculty and leaders appeared to normalize industry relationships for many students. CONCLUSION: Canadian student pharmacists report frequent interactions with the pharmaceutical industry and limited awareness of associated impacts on future professional behavior. These findings highlight the need for more robust, curriculum-based education on COI and industry influence to promote critical reflection and professional integrity.