From leadership research to district action: Evaluating conflict-of-interest governance among Canadian medical societies using a novel assessment tool: A cross-sectional study

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Evidence and transfer

Education-related source: verify which participants, institutions and outcomes were actually studied before district adoption. Source publication type: research-article. License and identity checks do not establish study quality or causality.

Original authors’ abstract, reproduced under the source license:

Abstract Background Medical societies shape clinical standards, develop practice guidelines, and provide continuing education to physicians. Many receive funding from pharmaceutical and medical device companies, creating conflicts of interest (COI); however, organizational-level COI governance in medical societies remains largely unexamined. We developed what is, to our knowledge, the first comprehensive tool to assess medical society COI policies and applied it to Canadian medical societies. Methods and findings We identified 68 Canadian medical societies meeting our inclusion criteria and systematically searched the publicly accessible sections of their websites for COI policies. Two researchers independently analyzed policies using our 51-item tool covering nine domains: continuing medical education/continuing professional development (CME/CPD), leadership COI, clinical practice guidelines, industry relationships, research funding, external funding, annual general meetings, staff COI, and society journals. Only 33 societies (48.5%) had any publicly available COI policy, and those with policies addressed an average of only 1.85 domains (20.5% of possible domain coverage). The most frequently addressed domain was CME/CPD (22 societies, 32.4%), followed by leadership COI (12 societies, 17.6%). Within domains where policies existed, societies covered an average of only 32.5% of relevant items. The most common policy item was speakers’ declaration of COI in CME/CPD activities (16 societies, 23.5%). Policies addressing research funding, external funding, annual meetings, and staff COI were rare (1.5–5.9% of societies). Where present, policies were generally restrictive but narrow in scope. Conclusions Most Canadian medical societies lack comprehensive COI governance, and existing policies are fragmented and reactive. More transparent, comprehensive, and enforceable frameworks are needed to protect institutional independence and public trust. The assessment tool may be adaptable for use in other jurisdictions to support international standardization and best-practice development.

Study methods

We defined a medical society as an organization with voluntary membership of physicians structured around either a specific specialty or a specific area of interest. Therefore, organizations that had mandatory membership (e.g., provincial licensing colleges), were open to all physicians (e.g., provincial medical associations), that accredited physicians (e.g., College of Family Physicians of Canada, Royal College of Physicians and Surgeons of Canada) or were open to non-physicians (e.g., Nova Scotia paramedic society) were excluded.

Limitations

Due to the lack of a single consolidated list of Canadian medical societies, some may have been missed. The websites of most societies have password-protected pages and additional policies may have been present on these pages. The tool that was developed has face value and underwent expert review, but it has not been previously used and may have biases that reflect the point of view of the group that developed it. The choice of domains and the items included under each domain was based on what the individuals developing the tool felt were important, but the tool could have included additional domains and items. Our findings do not extend to organizations excluded under our eligibility criteria (e.g., regulatory colleges, accrediting bodies, broad physician associations, or multidisciplinary organizations) or to medical societies in other countries.

A 90-day district inquiry

Days 1–15 · Appraise. Read the source methods, recruitment, comparator, outcomes and limitations. Record how the study setting differs from your district and which claim the design can support.
Days 16–30 · Design. Select one recurring district decision. Publish the decision owner, evidence requirements, consultation process and appeal route; test the process on a bounded low-risk decision. Agree participation, privacy protections, baseline and stopping rules before starting.
Days 31–60 · Observe. Collect the pre-agreed measures, keep a log of implementation changes and invite confidential voluntary feedback. Preserve existing support for staff and learners.
Days 61–90 · Decide. Track decision time, unresolved objections, documented reasons, appeals and access differences. Review whether the process changes who can participate and who carries the burden. Make a dated decision to stop, revise or extend the inquiry.

Board decision brief

Present the local problem, source setting, evidence limits, intervention, responsible owner, total cost, measured changes and uncertainty. Separate staff perceptions, implementation measures and student learning outcomes.

Attribution and reuse

Emily Rickard; Joel Lexchin. Evaluating conflict-of-interest governance among Canadian medical societies using a novel assessment tool: A cross-sectional study. PLOS One (2026-05-14). https://doi.org/10.1371/journal.pone.0348311

Prepared 2026-11-07. Source authorship and DOI are preserved. The abstract and source passages are attributed extracts; this editorial guide is offered under the same CC BY 4.0 license.