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Abbasi's pillars
- Somnath Mukhopadhyay (13 February 2005)
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Furness's dictum and the demise of academic medicine in developing countries
- Hari D Maharajh (9 March 2005)
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Somnath Mukhopadhyay, clinical senior lecturer (honorary consultant) University of Dundee Medical School, Ninewells Hospital, Dundee, Scotland, DD1 9SY
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Peter Furness and Jacqueline Atkinson (letters, BMJ 12 February 2005) have made a number of valuable points that require to be brought to the notice of the Department of Health and the regional health departments of Scotland, Wales and Northern Ireland, if clinical academic medicine of any quality is to be retained within the UK. All the talk about improving recruitment to academic medicine (in the UK) is completely pointless unless Abbasi's pillars of academic medicine - research, implementation of evidence, teaching and improved delivery of healthcare - are restored for the clinical academic. The current situation demands that the university management has to deliver to the requirements of the research assessment exercise. Thus, the only hope lies in the BMA and the Departments of Health influencing the process of the research assessment exercise to allow points to be awarded in a manner that pays roughly equal respect to all of Abbasi's pillars - rather than just one - in relation to the work of the clinical academic. The loss of academic freedom referred to in Jacqueline Atkinson's letter requires further careful analysis and introspection by the powers that are implementing the research assessment exercise. Do we want to go down in history as the generation that screwed up academic freedom in the country that invented it? Competing interests: None declared |
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Hari D Maharajh, senior lecturer psychiatry University of the West Indies, Trinidad, West Indies
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Furness’s article is an insightful response to Abbasi’s discussion on ‘The four pillars of global academic medicine’ (BMJ 2004; 329, 2 October), namely research, implementation of evidence, teaching and improved delivery of service. Furness convincingly argues that Abassi has it wrong, in that the four pillars of academic medicine have been replaced by two: that is, getting large research grants and publishing papers in journals. Furness’s dictum seems to be the policy of developing countries today, where ‘criteria fulfilment’ of accessing grants with ‘guaranteed publication through association’ have become the basis of academic progress. The policy makers have adopted a system inappropriate to the ecology of developing countries. While grants with ‘constructive publications’ are the last crusades of well established universities of the developed world, universities such as the University of the West Indies have not gone full circle to adopt such policies. In addition, to access a grant often relegates the third world professional to the role of a salesman doing the bidding of the grantor.. Wherein therefore, is the free spirit of the university? A university should foster and facilitate the expression of a free spirit. The word university is derived from the medevial Latin ‘Universitas’ which means group of scholars. It is expected therefore, that members at the university should be scholarly or comprise a body of persons who possess competences in a number of areas. They should be free thinkers and ought to be given the opportunity for honest expression in their search for knowledge in the setting of their internal and external environments. A university should tap the many intelligences of humankind or at least attempt to do so. It is evident that Abassi’s four pillars are more appropriate and should be the policies of developing countries where implementation of evidence, teaching and improved delivery of health care should be given more priority. There is a need for scholarly teaching and the planning, organizing and delivery of services to islands within a regional university system. The new Vice Chancellor of the University of the West Indies Professor Harris at his induction at the St Augustine Campus on Saturday February 26 suggests the development of “ high quality programmes for preparing students with knowledge and skills relevant to Caribbean society in the 21st century” and for producing graduates as “agents and leaders of change.” How can these goals be achieved if there are no investments in teaching and programme development with respect to career enhancement? The fact remains that too much emphasis is placed on research when much of the research has no relevance to the region. Financial grants provided by fringe groups and agencies are not vested for the regional good but have agendas of their own. The system it seems is devised to eat the crumbs that fall from the foreign table rather than baking one’s own bread! Does not this system undermine the growth of an academic culture? Teaching, establishing services in rural communities, pro bono work and any other activity that promotes the image of the university should be given equal valence. Any system divided by narrow domestic walls will not flourish. Universities in developing countries ought to take a hard look at itself and reflect on pathways to excellence as determined by its scale of promotion. A leopard cannot climb a chicken run to reach to the top, there should be many paths. References Abbasi K. Editor’s choice. The four pillars of global academic medicine. BMJ 2004; 329.(2 October.) Furness, PN: Academic medicine: who is it for? BMJ 2005: 330: 360 (12 February) Best, L. Sizing up the new Vice Chancellor in Trinidad and Tobago Review, Vol. 27 No 3 March 7, 2005 p 3. Hari D Maharajh, senior lecturer, psychiatry unit, dept. of clinical medicine , UWI. Competing interests: None declared |
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