Tosteson Supports Conflict Guidelines

A new set of research guidelines at Harvard Medical School should help the school's doctors avoid financial conflicts of interest without impairing their work too greatly, Dean Daniel C. Tosteson '44 said in an interview just more than a week ago.

Speaking one day after the school's Faculty Council overwhelmingly approved the guidelines on March 22, Tosteson said the rules offer a fair solution to the problems posed by increasing ties between industry and academics.

"I think we have a result that is a significant expression of both our commitment to bring discoveries made by members of our faculty to the wide-term benefit of sick people and to our concern for the credibility of members of our faculty and of our institution," Tosteson said.

Under the guidelines, which were drafted by a Tosteson-appointed committee and subsequently amended by the Faculty Council, doctors must notify the Medical School if they are receiving consulting fees from companies for which they are doing research. The Medical School would closely monitor such research.

The original version would also have nearly prohibited Harvard doctors fromowning stock in companies for which they wereconducting clinical trials. The amended version,however, allows such activities so long as theyare approved on a case-by-case basis by a specialcommittee.

While the guidlines have sparked considerabledebate among the faculty, Tosteson said in theinterview that the new version should satisfy mostHarvard doctors.

"The elected representatives of the facultywere overwhelmingly in support of this position soI'm very encouraged by that sense of coalescencearound what I think is a very reasonable positionwith which to begin working," he said.

All but one of the Faculty Council memberspresent at the March 22 meeting voted in favor ofthe guidelines.

In his first interview with The Crimson inseveral years, Tosteson also defended thephilosophy behind the Medical School's unique NewPathways program, which has been criticized bymany medical scholars.

In the New Pathways program, students spendmore time than usual in smaller learning groupsand make greater use of the case-study method. Atthe same time, the students deal with more ethicaland personal issues that doctors must face inpractice.

Begun as an experiment several years ago, theprogram has become fully integrated into theschool's curriculum.

"We seek to help each student assume personalresponsibility for their own learning. We view theamount of information bearing on medicine to bepractically limitless, and growing rapidly all thetime," Tosteson said. "So it is obvious that theexperiences in four years of medical school mustbe considered as the first steps, not the laststeps in learning medicine."

That is why, Tosteson said, the New Pathwaysprogram emphasizes how to learn, and not justmemorizing vast quantities of information.

Tosteson noted that the program is stillconsidered experimental, and that he wants toexpand its focus to include more programs forthird-and fourth-year students.

Tosteson said that many Medical School Facultyare concerned about the sharp decline inapplications over the last few years.

As interest has dropped nationwide, the numberof applicants to Harvard Medical School has fallenabout 40 percent over the last 10 years.

Tosteson, who chaired an Association ofAmerican Medical Colleges task force convened tostudy the problem, said the situation is some-whatpuzzling.

"I think it is a total anachronism thatinterest in entering medicine as a career shouldbe dropping off. If you want to devote your lifeto helping sick people, it has never been as goodand it is getting better very rapidly all thetime," he said.

"We should be doing all we can to bring thismessage to young people [of college] age," hesaid.

Tosteson said the Medical School's AlumniAssociation is conducting a poll of graduates,from which it will make a report that will "speakto the desirability of medicine as a profession.