BMJ  2005;331:694 (24 September), doi:10.1136/bmj.331.7518.694-a

Letter

Five futures for academic medicine

Follow the money trail

The first 150 words of the full text of this article appear below.

EDITOR—I was intrigued by the five scenarios of the International Campaign to Revitalise Academic Medicine.¹ Certainly, brainstorming over the future of academic medicine is a fascinating exercise. But, aside from revealing facets of the interaction of medicine in general with (global) society, it is sterile.

Academic medicine—meaning the entirety of academic institutions globally—is heterogeneous and will certainly evolve differently in different societies as a function of local issues and cultures. But, most importantly, in any given location it will evolve in response to its sources of revenue, which are quite varied.

In the large private universities of the United States major funding comes from research grants (federal, pharmaceutical, and philanthropic) and only a small fraction (5-10%) from student tuition. As donors' budget priorities change, so will academic priorities, as will the direction of the academic enterprise.

Certainly, medical schools will remain committed to a basic curriculum of human . . . [Full text of this article]

Stanford University, CA 94305, USA mgp@stanford.edu

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