Introduction

In 2003, the BMJ and 40 other partners launched the International Campaign to Revitalise Academic Medicine (ICRAM). Led by a core working party of medical academics representing 14 countries (box), the campaign aims to redefine the core values of and contribute to the evidence base for academic medicine; develop strategy around reformed academic training; and stimulate a public debate on the future. As part of this process ICRAM created a team to develop a vision for the future of academic medicine. This resulted in five future scenarios, which are summarised here. A fuller description is being published this week in the Public Library of Science Medicine.1 The full report of the scenario building workshop, with full details, references, and background, is also being published simultaneously by the Milbank Memorial Fund.2

Academic medicine today

Academic medicine might be defined as the capacity of the healthcare system to think, study, research, discover, evaluate, teach, learn, and improve. As such, little could be more important—particularly as new discoveries in science offer tremendous opportunities and emergent diseases pose huge threats. Indeed, academic medicine has been responsible for enormous gains in human health and development over the past century. Yet currently there is persistent concern that something is not right with academic medicine.3^–13 At a time of increasing health burden, poverty, globalisation, and innovation, academic medicine seems to be failing to realise its potential and global social responsibility. It also seems to be becoming a less attractive career option.

ICRAM started with only two premises: it was necessary to think globally, and “more of the …