Does Academic Medicine Matter?

A cademic medicine occupies a spot in that rarefi ed world in which one doesn't have to do much to justify one's existence. The best health care, the best research, the brightest minds on the planet circulate within academic medicine, together conspiring for the benefi t of patients and practitioners. Correct? Perhaps not, as growing concern about a decline in the state of academic medicine around the world threatens this taken-for-granted position [1–6]. In the past few years more and more critics have questioned the role and contribution of academic medicine—to society, to health-care systems, and to patients [7]. Who is academic medicine for? Why does it matter? What added value does it bring to disease prevention, health promotion, and the practice of health care? In order to engage our stakeholders—which include policymakers and the public—we need to demonstrate the benefi ts of academic medicine. Revitalising academic medicine matters because health costs and expectations are rising alongside growing concerns that academic medicine is failing to produce suffi cient gains for patients and funders. As others have argued, it is time for academic medicine to step up to the plate—to take leadership in redressing the gaps between bench and bedside medicine [8] and between the rich and the poor [9,10]. Taking leadership involves better preparation for future health-care demands in terms of attracting suitable and suffi cient human resources, and aligning priorities with global health needs. That said, however, the case for why and how academic medicine ought to lead us forward must be evidence-based. At a time when there is increasing demand for academic medicine to be more accountable, we fi nd that the evidence base for its effectiveness is rather slim. Fortunately there is mounting interest in evaluating the impact of academic medicine across the traditional triad of medical research, education, and clinical care. For example, in May of this year, the Academy of Medical Sciences released its report on the benefi ts of medical research to society (http:⁄⁄www. acmedsci.ac.uk/images/project/ Medicalr.pdf). The Association of American Medical Colleges (http:⁄⁄www.aamc.org) has led work on improving the quality of medical education for the next generation of doctors and other health practitioners. And in a new systematic review in PLoS Medicine , John Ioannidis and colleagues examine the benefi ts of academic health care in terms of clinical outcomes [11]. The International Campaign to Revitalise Academic Medicine (ICRAM), of which we are cofounders …