The BMJ and a range of partners, including other journals published by the BMJ Publishing Group, the Lancet, Canadian Medical Association Journal, Dutch Journal of Medicine, Medical Journal of Australia, Croatian Medical Journal, the Academy of Medical Sciences, and many others have initiated a project to bring people together to debate whether the existing structure of academic medicine is still fundamentally sound and, if not, to propose alternatives to it.1 I have taken on the challenge of coordinating this project, and I invite readers to join me in this enterprise.

To achieve the project's broad goals (box 1) we begin from the position that “more of the same” is not enough. We need to be free to propose radical changes to the fundamental nature of academic medicine (is the balance between bench and applied research all wrong?); its name (should it become “academic health care” or should we drop “academic”?); its home base …