Extract
The mission of a traditional academic medical center with a medical school
typically includes excellent patient care, education of future physicians, and
the creation of new medical knowledge. In the last twenty-five years, as
academic medical centers rapidly expanded their clinical services, they began
to hire more full-time clinician educators to meet the demands for clinical
services and the education of future physicians.When I started my medical career, traditional academic medical centers
hired a small cadre of physicians who were full-time faculty, who saw patients
for two half-days per week and/or operated one or two days a week, who
supervised inpatient patient care, and who provided education of medical
students and residents. As the competition for research funding intensified in
the last few decades, many of these faculty members devoted even more time to
research and restricted their already limited activities in clinical care and
education. Academic physicians engaged in the traditional triad have rapidly
disappeared, especially in tenure tracks. In academic medicine, the research
portion still predominates in the reward and promotion systems of traditional
academic medical centers. The emphasis on research as the basis for the
promotion of clinician scientists and tenured faculty has left the clinical
care and education to clinician educators. Most clinician educators,
especially surgeons, spend 85% to 90% of their time caring for patients and
teaching residents and medical students. Clinician educators, while excelling
at teaching and clinical care, now have little time to conduct any type of
research.