SAMED recently met with Professor Ramokgopa and his department leads and agreed the following joint statement.
SAMED statement on Medtech companies approaching registrars, consultants, and specialists in public health institutions regarding medical technology (medtech) company arranged events and educational grants to attend third party arranged educational events.
The continued professional development of registrars, consultants, specialists, and other healthcare professionals (HCPs) greatly benefits the health sector and patients, as does product specific training. Training provided by institutions, healthcare professional societies, experts, and medical technology (medtech) companies impart essential skills, techniques and product understanding required for operating and innovating within the medical field. Medtech companies also hold events related to product promotion.
Medtech company arranged events be they training or other, should not, however, interfere with or disrupt HCP obligations to their patients, their academic training and/or their employment duties. Such events should also promote equity (impartial, fair, and just treatment without favouritism or discrimination), diversity (including or involving people from a range of different social and ethnic backgrounds and of different genders, ages, etc.), and inclusion (providing equal access to opportunities and resources for people who might otherwise be excluded or marginalized). This is especially true for HCPs in training, such as registrars.
Currently, medtech companies are either approaching registrars directly with training and continued professional development opportunities (workshops, skills labs, congresses, conferences, etc. both locally and internationally) or requesting permission from the academic heads of departments / management after the registrars have already been approached (retrospectively).
This is problematic for several reasons:
- Registrars have a commitment to public service and unapproved opportunities take them away from their patients and employment duties.
- The specialist training programmes for registrars are academically demanding and unsanctioned activities compromise their training and quality of service.
- Management and department heads are uninformed of what training, skills and/or product exposure registrars have received.
- There is often a lack of equity, diversity, and inclusion applied to beneficiaries of opportunities with the most promising and dedicated registrars often overlooked.
- When scrutinised, the relationships between the medtech companies and the registrars may appear unethical / as exerting undue influence due to a lack of separation.
- It shows a lack of respect for the head of department / academic head /management in not following their / the correct processes.
There needs to be a better, more balanced approach to managing these opportunities for registrars.
Medtech companies should contact the head of department, academic head, or management (whichever is relevant for that facility) for approval of opportunities for registrars. Where possible, the medtech company should provide an annual or advanced schedule of opportunities to the head of department for consideration. Opportunities provided while registrars are on leave should also be approved with department heads.
This will enable the head of department / academic head to:
- Manage and track the required approvals.
- Better plan for registrars to meet both their academic and employment requirements.
- Ensure that no one registrar can be unduly influenced through multiple or repeated opportunities from the same supplier(s).
- Track all knowledge, techniques, skills, and products that registrars are exposed to, to better gauge needs and gaps and avoid unnecessary duplication.
Medtech companies should also consider the principles of the Medical Device Code of Ethical Marketing and Business Practice.
- The Principle of Image and Perception: What is the impression given when targeting only certain registrars for opportunities?
- The Principle of Separation: Are repeated or non-inclusive opportunities creating undue or improper advantages? Could the head of department or academic head provide the necessary separation needed to ensure patient needs are foremost? Approaching registrars directly is not aligned with the principle of separation.
- The Principle of Transparency: Is there sufficient transparency if the head of department or academic head does not know what is being offered to their registrars?
- The Principle of Documentation: Are current processes ensuring that the necessary permissions and approvals have been documented?
The same principle applies to sponsoring registrars or other HCPs to third party arranged educational events, be they local or international i.e., SAMED members are prohibited in terms of the medical device code from directly approaching or providing sponsorship (financial or other support) to HCPs to attend such events.
Rather the member company may provide an indirect educational grant to the relevant party e.g. the health facility department / hospital, doctor society or professional congress organiser. However, the member company may not influence who the recipient of the grant is and stipulate grant recipient criteria that targets a particular individual. SAMED has developed guidance in this regard and both HCPs and medtech companies are urged to review this. See our guidance document on the management of indirect sponsorship.
To assist with the right contact person(s) for obtaining approval regarding inviting registrars to company arranged events / training or in terms of offering an indirect educational grant for HCPs to attend third party arranged events, please see contact the office of the Dean of Medicines at the various academic institutions.
|Helen Joseph Academic Hospital
|Dr Aftab Younis – Head of Clinical Unit / Orthopaedic Surgery
|Tel: 082 687 4974
|Charlotte Maxeke Johannesburg Academic Hospital
|Prof. Anthony Robertson – Head of Clinical Department
|Tel: 082 851 7846
|Chris Hani Baragwanath Hospital
|Dr Lufuno Rudo Mathivha – Head of Clinical Department
|Tel: 011 938 1595
|Prof. Mmampapatla Ramokgopa – Orthopaedic Surgery
|Tel: 011 717 2538