Sunday, September 23, 2012

Pharmaceutical Industry Great Debate

As admissions requirements for medical school become more and more stringent, admissions interviews may prove more and more rigorous. Ethics and deductive reasoning are becoming ever more critical in the selection process. Premeds might soon find themselves in a "devil's advocate" type of debate with two interviewers, fully expected to argue for and against both sides of a prevailing issue of today. Perhaps one of the most pressing issues of interest to doctors, medical schools and premed advisers is innovation, or the lack thereof, in the pharmaceutical industry.

Some people believe that the pharmaceutical industry has essentially abandoned the pursuit of novel drugs in lieu of cheap, rip-off clones based upon the intellectual property of other companies. Others believe the pharmaceutical industry brain trust is hard at work sixteen hours per day battling issues far too complex to be understood by ordinary scientists. This recent article, "Pharma's Fake Innovation Crisis," is an excellent example of the dichotomy that fuels the debate continuing now for more than a decade.

Who's right and who's wrong?

Joel Lexchin and Professor Donald Light contend that "slowed innovation and stagnant drug discovery" due to biological complexity is a ploy by pharmaceutical industry executives, Congress and the media to generate higher and higher levels of revenue for pharmaceutical R&D funding. The more funding obtained, the more money for company executives and the shareholders.

Organic Chemist Dr. Derek Lowe, on the other hand, argues these are nothing but lies spun to take "pot shots" at the pharmaceutical industry and the genius scientists hard at work in the brain trusts. He argues that the complexity of biology in certain therapeutic indications severely impairs progress at a rate we might find desirable, and hence the lack of innovation in drug design is more a consequence of the continued learning curve endemic to the ever expanding area of molecular biology.

Who's right?

Imagine being at your medical school interview, and there are two people present. One is arguing the point of Professor Donald Light whilst the other is arguing the point of Dr. Derek Lowe (and you thought Organic Chemistry would never rear its ugly head again!). Both are talking while you're listening, and soon you find the question turned to you. You've just heard both points of view argued by two respected interviewers (the ones who will render a decision based upon your immediate performance), and now all eyes are on you. To make matters even more interesting, imagine they're now playing "good cop" and "bad cop."

Just how are you going to respond to this? Which side of the story will you argue? How will you argue it? If you play devil's advocate, then what happens when someone asks you to take a single stand and then defend it? Furthermore, once you take that stand, what will you do if both interviewers begin to argue against you, pressing you to defend your position more and more?

This might sound like it's out of the ordinary, however I guarantee it's not. I've been through highly stressful job interviews where this very tactic was used, albeit with somewhat different subject matter. It's a "shark tactic" designed to weed out the weak interviewers who might cave under pressure. As a future doctor, you will find yourself prescribing medications from key players in the pharmaceutical industry. You will be involved.

The world is becoming more competitive every day. The bar for entrance into medical school has just been raised with the announcement of MCAT 2015, having a heavy emphasis on social and behavioral science. No one yet knows what MCAT 2015 will look like, and no one yet knows what medical school interviews of tomorrow may hold. The best practice for the budding professional with an eye on the keyhole leading to medical school is to be prepared for anything.

I suggest you earnestly dispute this issue with your friends, both for and against each side, and then switch sides for a more holistic understanding of the pharmaceutical industry ethical debate.

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