Headlines: January 5th, 2005

A future for academic medicine in which medical schools are answerable or where patients decide on doctors’ training or even in which academics compete for research grants on television game shows is outlined today by members of the International Campaign to Revitalise Academic Medicine.
Their vision of what the field could look like in 2025 is published simultaneously today by the BMJ, the open access international medical journal PLoS Medicine and the Milbank Memorial Fund. The campaign was
launched in November 2003 by the BMJ and partners.Members have come up with various scenarios. In the first academic medicine has flourished in the private sector and medical research, training and
service have become commercial business activities. Although overall efficiency and effectiveness have improved, equity and innovation have suffered.

Academic medicine has disappeared altogether in the second scenario with teaching, learning, and researching being integrated instead into mainstream health care. Team work would be fostered, but stability and decision making are both threatened. In the third vision members of the public would be in charge. The would determine research priorities through television game shows or citizen’s juries and medical students would receive most of their training from expert patients. In this version scientific advances were subject to fads and there was little regulation of health information.

In two final scenarios, academic medicine is seen to engage fully with all stakeholders and to be focused on improving global health. In this model global networks flourish and medical training is energised but lack of
political will and fears of “dumbing down” hamper progress.Four commentaries, also published by the BMJ today, discuss the implications of the scenarios for the public, patients, practitioners, politicians, and policy makers. The authors say none of the scenarios they have put forward will ever come to exist as it is described but they believe the future will contain some elements from each of them. Their main
hope, they say, is that other groups will find them useful in thinking about both the present and the future of academic medicine. They are not seeking agreement but broader thinking.

All the authors believe the scenarios offer exciting insights into how academic medicine should evolve and they say that if change is going to happen, everyone will have to let go of preconceived notions.