Commentary on competency-based medical education and scholarship: creating an active academic culture during residency

leadership and management canons [2, 7−9]. Authorities within these domains suggest that innovative research and scholarship requires a culture that values these pursuits [2, 9]. Importantly, institutions that are successful in producing exceptional academic scholarship align the culture of their organizations with these goals [7, 9]. For more than a decade, medicine has characterized the academic physician and striven to understand the factors that create a rich academic environment and its converse, an environment that discourages academic pursuit [10]. In 2002, Souba wrote about the factors that contribute to an unpleasant workplace environment for academic physicians. These included heavy workloads with poor compensation, lack of appreciation and recognition, limited time for research and teaching, and failures of collegiality and teamwork. Souba also suggested a solution: engaging physicians in patient care, research, and education through personal and organizational leadership. In other words, creating an institutional culture that supports and facilitates academic engagement concrete commitment to cultural change. Bourgeois and colleagues [3] rightly point out that, despite Souba’s paper [10] being a decade old, physician and resident engagement in scholarly pursuit remains inadequate. The shift towards CBME provides an opportunity for change within the academic medical training system, but CBME’s potential for improving scholarship among trainees will be foiled if the challenges posed by longstanding institutional culture are not addressed.