Open letter to the leader of academic medicine

BMJ 2007; 334 doi: (Published 25 January 2007) Cite this as: BMJ 2007;334:191
  1. John P A Ioannidis, professor1,
  2. Tahmeed Ahmed, scientist2,
  3. Shally Awasthi, professor3,
  4. A Mark Clarfield, Sidonie Hecht professor of geriatrics4,
  5. Jocalyn Clark, director of knowledge translation5,
  6. Lalit Dandona, chair, health studies area6,
  7. Amanda Howe, professor of primary care7,
  8. Juan M Lozano, professor of clinical epidemiology and paediatrics8,
  9. Youping Li, director9,
  10. Hardi Madani, medical student10,
  11. Ana Marusic, professor11,
  12. Idris Mohammed, professor12,
  13. Gretchen P Purcell, assistant professor of surgery and biomedical informatics13,
  14. Margaret Rhoads, final year medical student14,
  15. Karen Sliwa-Hähnle, associate professor15,
  16. Sharon E Straus, associate professor16,
  17. Tessa Tan-Torres Edejer, scientist17,
  18. Peter Tugwell, director18,
  19. Robyn Ward, professor (conjoint)19,
  20. Michael S Wilkes, vice dean20,
  21. Richard Smith, chief executive21
  1. 1Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina 45110, Greece
  2. 2Clinical Sciences Division, ICDDR, B: Centre for Health and Population Research, Dhaka 1212, Bangladesh
  3. 3Department of Pediatrics, King George's Medical University, Lucknow, India
  4. 4Ben-Gurion University of the Negev, Beer-sheva, Israel
  5. 5POWER Study Centre for Research in Inner City Health, St Michael's Hospital, University of Toronto, Toronto, Canada
  6. 6Administrative Staff College of India, Hyderabad-500 082, India
  7. 7Institute of Health, University of East Anglia, Norwich
  8. 8School of Medicine, Javeriana University, Bogotá, Colombia
  9. 9Chinese Cochrane Centre, West China Hospital, Sichuan University, Chengdu, China
  10. 10Royal Free and University College London Medical Schools, London
  11. 11Department of Anatomy, Zagreb University School of Medicine, Zagreb, Croatia
  12. 12Department of Medicine, Federal Medical Centre, Gombe, Nigeria
  13. 13Vanderbilt Children's Hospital, Nashville, USA
  14. 14Imperial College London, London
  15. 15Department of Cardiology, Baragwanath Hospital , University of the Witwatersrand, Johannesburg, South Africa
  16. 16Department of Medicine, University of Calgary, Calgary, Canada
  17. 17Health System Financing, World Health Organization, Geneva, Switzerland
  18. 18Centre for Global Health, Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada
  19. 19Department of Medical Oncology, St Vincent's Hospital, Sydney, Australia
  20. 20University of California, Davis School of Medicine, Davis, California, USA
  21. 21United Health Europe, London
  1. Correspondence to: J P A Ioannidis jioannid{at}
  • Accepted 4 November 2006

As their campaign comes to a close, ICRAM presents a challenge to academic medicine's invisible leaders

We are not sure who you are. Unsubstantiated rumours suggest that you may not exist at all. We wonder where academic medicine is getting its lead from. Is it some of the many serious scientists, clinicians, and educators? Is it people with illnesses, those who wish to remain healthy, or society at large? Is it political leaders of uncompromising principles and vision? Is it selfless benefactors and visionary entrepreneurs? Or is it self interested compromisers carrying embellished titles acquired through anything but merit? Maybe it's corporate industry escorting academic medicine to the dance tonight?

You might ask who we are. We are participants in the International Campaign to Revitalise Academic Medicine, a group of mostly young academics from around the world who feel that academic medicine needs reinvention (box). We have gathered evidence systematically, consulted and debated globally, and given thought to how the future might look. Here is what we think.

What is ICRAM?

The International Campaign to Revitalise Academic Medicine (ICRAM) was launched in 2003 by BMJ and 40 other partners concerned about a decline of academic medicine globally. A working party of 20 mostly young academics was created under the leadership of Peter Tugwell in the summer of 2004 to foster a debate on the future of academic medicine worldwide. Readers will find additional information about ICRAM's efforts in our collected resource at

An academic dys-ease

Academic medicine entails critical thinking, research, innovation, teaching, learning, and leadership in improving health care. If this really is the job description, then few human activities are more essential for the future of humankind. So why does the mere term “academic medicine” bring to many people a feeling of long standing malaise? This malaise reflects an absence of a compelling …

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