Editor - Drug companies target doctors with impressive determination. Up to $11bn (£5.7bn; €8.3bn) is spent annually by the pharmaceutical industry on promoting their products in the United States,¹ with up to $13 000 spent on each doctor a year. This has important implications for doctors, patients, and medical students.

Your article said that “students should critically assess their contact with the pharmaceutical industry” so that we can prescribe drugs in the future without bias.² But the fierce marketing tactics used by the drug industry make this impossible. Professor Claus Pierach said that “if early on a student gets imprinted with drug and company names, chance will be that they'll remember.”

As clinical students, however, we tend to focus on pharmacology and avail ourselves of the free gifts companies have to offer, such as stylish stationary and useful medical textbooks, without much recognition of the company names. The idea of shielding students from such well designed marketing is not realistic, and the solution would be to incorporate the machinery of pharmaceutical marketing into the medical curriculum. Just as we are trained to appraise scientific papers, we should be taught how to interpret information from drug companies.

The Wake Forest programme, run by Raquel Watkins at Wake Forest University is an example of such incorporation.¹ It consists of meetings in which students are presented with patients' views of the practice of doctors accepting gifts from drug companies, as this has implications for the doctor-patient relationship. Other meetings describe statistical methods needed to fully appreciate data presented by drug companies. And the programme also explores marketing strategies and guidelines to accepting gifts.

Although the implications of marketing by drug companies can be negative in terms of not offering the best available treatment to a patient, it cannot be avoided. Consequently, to equip doctors with the objectivity to face this marketing, a first useful step would be to educate medical students in this field.

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