Academic medicine: time for reinvention
http://www.100md.com
《英国医生杂志》
EDITOR—Since we launched our international campaign to promote and revitalise academic medicine, over 60 rapid responses to the cluster of articles published on 1 November 20031-5 have been received. Many were sent from England, several from medical students and trainees, and a notable number came from outside the United Kingdom—reminding us that concern about the fate of academic medicine is very much a "universally relevant" issue. Nearly everyone agreed that academic medicine is suffering, and all offered opinions as to why.
Most criticised the lack of adequate government funding of universities and research centres, which was said to foster a dependency on industry. If academic medicine is not valued publicly, argued a general practitioner from Australia, the pursuit of knowledge and truth for its own sake will not be respected. Academic clinicians were said to be poorly remunerated compared with their non-academic peers unless they partner with industry. While many decried the "tainting" of medical research and education by "the profit motive of industry," at least one commentator felt that a free market within academic medicine should be allowed to flourish.
Several commentators drew the distinction between clinician academics and non-academics; we were told not to forget about doctors in the NHS, for example, who do some research or teaching in addition to their clinical duties. Doctors in most countries seem to be struggling to maintain a commitment to research and teaching as well as meeting the ever increasing demands of service delivery. At least two responders emphasised the inextricable link between academic medicine and a functioning healthcare system. They said that without a revival of academic medicine our health systems cannot function as needed.
The situation for academic medics may be more dire for those from traditionally marginalised groups (including women) and working in developing countries. Several respondents appealed for our campaign to be as inclusive and global as possible.
A retired clinical scientist points out that the same issues vexing academic medicine today were identified a quarter of a century ago, so in terms of a revitalisation strategy, "more of the same" will clearly not do.
To continue the dialogue about how best to revitalise academic medicine, we are publishing a theme issue in October 2004. Please send us your submissions by 30 April 2004.
Jocalyn Clark, assistant editor and project manager, academic medicine campaign
BMJ
References
Stewart PM. Improving clinical research. BMJ 2003;327: 999-1000. (1 November.)
Bhutta Z. Practising just medicine in an unjust world. BMJ 2003;327: 1000-1. (1 November.)
Clark J, Smith R. BMJ Publishing Group to launch an international campaign to promote academic medicine. BMJ 2003;327: 1001-2. (1 November.)
Chalmers I, Rounding C, Lock K. Descriptive survey of non-commercial randomised controlled trials in the United Kingdom, 1980-2002. BMJ 2003;327: 1017. (1 November.)
Bell J. Resuscitating clinical research in the United Kingdom. BMJ 2003;327: 1041-3. (1 November.)
Most criticised the lack of adequate government funding of universities and research centres, which was said to foster a dependency on industry. If academic medicine is not valued publicly, argued a general practitioner from Australia, the pursuit of knowledge and truth for its own sake will not be respected. Academic clinicians were said to be poorly remunerated compared with their non-academic peers unless they partner with industry. While many decried the "tainting" of medical research and education by "the profit motive of industry," at least one commentator felt that a free market within academic medicine should be allowed to flourish.
Several commentators drew the distinction between clinician academics and non-academics; we were told not to forget about doctors in the NHS, for example, who do some research or teaching in addition to their clinical duties. Doctors in most countries seem to be struggling to maintain a commitment to research and teaching as well as meeting the ever increasing demands of service delivery. At least two responders emphasised the inextricable link between academic medicine and a functioning healthcare system. They said that without a revival of academic medicine our health systems cannot function as needed.
The situation for academic medics may be more dire for those from traditionally marginalised groups (including women) and working in developing countries. Several respondents appealed for our campaign to be as inclusive and global as possible.
A retired clinical scientist points out that the same issues vexing academic medicine today were identified a quarter of a century ago, so in terms of a revitalisation strategy, "more of the same" will clearly not do.
To continue the dialogue about how best to revitalise academic medicine, we are publishing a theme issue in October 2004. Please send us your submissions by 30 April 2004.
Jocalyn Clark, assistant editor and project manager, academic medicine campaign
BMJ
References
Stewart PM. Improving clinical research. BMJ 2003;327: 999-1000. (1 November.)
Bhutta Z. Practising just medicine in an unjust world. BMJ 2003;327: 1000-1. (1 November.)
Clark J, Smith R. BMJ Publishing Group to launch an international campaign to promote academic medicine. BMJ 2003;327: 1001-2. (1 November.)
Chalmers I, Rounding C, Lock K. Descriptive survey of non-commercial randomised controlled trials in the United Kingdom, 1980-2002. BMJ 2003;327: 1017. (1 November.)
Bell J. Resuscitating clinical research in the United Kingdom. BMJ 2003;327: 1041-3. (1 November.)