Academic medicine is in urgent need of a revolution, say experts in the first report of The BMJ Commission on the Future of Academic Medicine as they set out principles for transforming academic medicine and improving population and planetary health.
For decades, the role of academic medicine has been to train doctors who have led on generating research and provide services to improve health outcomes in a growing global population, explain Commission chairs Sonia Saxena at Imperial College London, Miguel O'Ryan at the University of Chile and Fran Baum at the University of Adelaide.
But they warn that a crisis in the academic workforce alongside challenges to research funding "mean that the goals and success measures of academic medicine are no longer aligned with improving health and wellbeing outcomes in the population."
These longstanding problems are exacerbated by the policies of the current US administration, they add. These have resulted in loss of funding and academic workforce, destruction of data, and restricted freedom of speech, "creating fear, despair, and anger among the global academic community and increasing public mistrust of science."
In the first paper published today, the chairs examine progress and failures against reforms to academic medicine that were envisaged at the start of the 21st century and propose five core principles that should underwrite academic medicine globally for today and the future, irrespective of current disruptive sociopolitical views.
These are a focus on health outcomes of populations and the planet; align goals of academic medicine and health systems; embed ethics, participation, and relevance; deliver equitable health outcomes; and have real world impact.
"Our vision for academic medicine in 2050 is first and foremost about working with other stakeholders to promote the health and wellbeing of people and the planet and will require a revolution to resuscitate our current broken system," say the authors.
As research provides the evidence to underpin efforts to improve health and health equity, "the backbone of our vision will be talent development across the globe to create a sustainable career structure for those who choose academia but also to improve the research capacity and capability across the medical and health professions," they explain.
"Finally our vision is that academic medicine will drive positive change in the real world and no longer be an abstract concept that is misaligned with what matters to patients and the public," they conclude.
Other articles from the Commission will examine regional perspectives from across the world and deal with focused topics including equity, corporate, and other key drivers of the research agenda and the needs of the future generation of clinical and public health academics.
