Campaign to revitalise academic medicine: Don't believe us

doi:10.1136/bmj.329.7460.294

BMJ 2004;329:294 (31 July), doi:10.1136/bmj.329.7460.294

Letter

Campaign to revitalise academic medicine

Don't believe us

EDITOR—Rather than add my advice to the deluge that metthe magnificent, international group of young people who cametogether last month to propose improvements for the academicmedicine of tomorrow,¹ I pose a question to them: "Why, on earth,should you take any advice from any of us old farts who (throughinattention, greed, or simple incompetence) got academic medicineinto the simply awful mess in which you find it today?"

We have rejected the provision of continuous, comprehensivecare and middling incomes in favour of huge waiting lists, unethicalself referral for costly diagnostic tests, and industry-consultantshipsthat pervert our science as profoundly as they line our pockets.

We continue to apply curriculums that value memory above thought,promote study by fear rather than reason, and sentence postgraduatesto years of servitude in the educationally "lost generation."

We value the study of adenine, thymine, cytosine, and guaninefar above the study of childhood diarrhoea, Chagas' disease,community health, and patients' decision making. The issue isnot the potential usefulness of basic research at some distantfuture date (although you might even dare question whether itis being oversold). The issue is that basic medical scientistshave hijacked the granting bodies and have erected researchpolicies that place greater value in serving their own personalcuriosities than in serving sick people.

In deciding which of you will "succeed" in academic medicine,we not only reward your selfishness—for example, solopublication, lead authorship, the non-sharing and commercialexploitation of techniques or early results. We demand it. Educationalcontributions receive short shrift at promotion time, and exemplaryclinical care close to none.

We who pontificate on how to improve academic medicine are responsiblefor its demise. Why, on earth, should you accept any of theadvice we'll try to force down your throats?

David L Sackett, director

Trout Research and Education Center at Irish Lake, RR 1, Markdale, ON, Canada N0C 1H0 sackett{at}bmts.com

See also pp 241 and 277-89

Competing interests: See http://bmj.bmjjournals.com/cgi/content/full/324/7336/539/DC1.

References

Kmietowicz Z. Campaign to revitalise academic medicine calls for radical thinking. BMJ 2004;328: 1454. (19 June.)[Free Full Text]

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