How to Approach your Dean

Step-by-Step Guide

This Project-in-a-Box gives you the tools to approach your Dean and ask that he or she establish a committee to draft a comprehensive policy regulating industry interactions with faculty, staff, trainees, and students. As you go through the steps of this plan, stay in touch with your regional PharmFree Coordinator for support and advice.

Please read our advocacy primer on organizing a successful campaign, such as developing your support base, and analyzing power relationships.

Good luck!

Step 1: Assess your school's situation

Investigate your school's conflict-of-interest policy
• AMSA Scorecard 2008
• IMAP database
• Retrieve policies from administration or school website

Gather a few core student allies

Step 2: Contact your dean in writing

Request a meeting to discuss the schools current policy situation
Resource: Letter to Dean Template

Step 3: Suggested preparation for meeting with your dean

Read key materials
• 2008 AAMC Guidelines on Industry Funding of Medical Education
• Brennan et al., ABIM Policy Proposal for Academic Med Centers (JAMA 2006)
• Rothman & Chimonas, New Developments in Managing Industry Relationships (JAMA 2008)

Write a comparative analysis of your school's policies (optional)
Resource: Comparative Analysis Template

Prepare talking points
Resource: Talking Points

Prepare for potential objections
Resource: Q&A on Developing Conflict of Interest Policies

Step 4: Meeting with your Dean

Drop off a packet of information for the Dean to look over before your meeting
• Cover letter signed by you and allies [Resource: Letter to Dean Template]
• School's assessment on AMSA PharmFree Scorecard
• Brennan et al., ABIM Policy Proposal for Academic Med Centers (JAMA 2006)
• Rothman & Chimonas, New Developments in Managing Industry Relationships (JAMA 2008)
• 2008 AAMC Guidelines on Industry Funding of Medical Education

The Meeting: Key items to cover
• Get commitment to initiate process of policy reform
• Get commitment to involve students in this process
• Discuss covering both students and faculty.
The strongest policies will obviously cover not just medical students, but faculty. This has been a sticking point in the past. Although it may seem the path of least resistance to push first for a student policy, it is in the interest of those desirous for change to hold out for an all-encompassing process.
• Discuss inclusion of affiliated hospitals.
A policy will be much stronger if it can cover over industry interactions at affiliated hospitals. Often medical schools do not own the teaching hospitals they work with, but it is well worthwhile to attempt to engage leadership at the hospital(s) to create either a joint policy or cooperating policies to ensure coverage of all institutions. This will ensure faculty and students are protected wherever they work, and will cover the clinical issues of vendor site access and pharmaceutical samples.

Step 5: If meetings are productive

Propose formation of a committee to oversee policy reform
• Ask that there be 2-3 student representatives on the committee
• Recommend interested faculty to serve
• Try to involve representatives from affiliated hospitals
• Don't expressly avoid incorporating skeptics - convincing outspoken critics of the merit of your efforts can be an important element of a successful reform process.

Propose a timeline for reform

Draw on further practical resources
AMSA Policy Recommendations
Prescription Project Toolkits for Academic Medical Center Policy Development
Q&A with UC Davis on their policy development process
AMA-CEJA Report on Industry Funding of MEdical Education
Pharm-Free Annotated Bibliography

Step 6: Dealing with pushback

If Dean/leadership stonewalls
• Discuss with allies what may have happened
• Analyze Dean's feedback

Pushback on specific issues
Resource: Q&A on Developing Conflict of Interest Policies

Build external pressure
• Hold events to build support base. See Holding Events
• Bring evidence of community support to dean [Resource: Student Survey Guide]
• Use the press. LTEs and Op-Eds.
• Connect with local legislators
• Approach department heads individually to establish department-wide policies (e.g., Internal Medicine, Family Medicine, Surgery, Oby/Gyn, Peds, Psychiatry, etc.)

Consider alternate routes
• Approach department heads individually to establish department-wide policies (e.g., Internal Medicine, Family Medicine, Surgery, Oby/Gyn, Peds, Psychiatry, etc.)

Direct action
• Hold a press conference or rally, conduct a pen drop, get creative!

Whatever happens...
• Keep your chapter leaders and national leaders in the loop
• Thank your allies
• Celebrate your successes and hard work!