Academic medicine: the evidence base

Introduction

Much has been written about academic medicine and its ailments. The International Campaign to Revitalise Academic Medicine (ICRAM) immediately recognised the importance of an evidence based approach to the ongoing discussion about academic medicine.1 A task group was developed to systematically collate and evaluate the available evidence. We initially targeted major themes that were readily identifiable as being important and for which data would be reasonably straightforward to collect. The type of evidence (box 1) differed for each research question. Here we present a summary and future research agenda.

Where are the problems?

The Oxford English Reference Dictionary defines academe as “the world of learning,” and academic as “scholarly: to do with learning.” Scholarship is encountered as a key principle of academic medicine,^w1 and it entails the discovery, integration, and application of knowledge, and teaching.^w2 Academic medicine practitioners are expected to demonstrate systematic and sustained scholarly effort, with recognisable outputs valued by peers.

Many doctors teach (for example, over 40% of UK general practitioners host medical trainees2) or participate in research sporadically, and the role of such practitioners in the academic enterprise requires more study. Patients are also increasingly involved in clinical research,3 education,4 and service5 and are important academic allies. Finally, scholarship in fields related to health care and medicine is often pursued by non-physicians (nurses or laboratory scientists, for example) who may also encounter the “triple jeopardy” of trying to excel simultaneously in teaching, research, and clinical practice.6 However, policies addressing academic medicine careers typically do not expand the definition to …