Scholarship in the medical faculty from the university perspective: Retaining academic values

Academic medicine and research universities have enjoyed a close relationsh ip that has strengthened both, spawning an era of discovery and scholarship in medicine that has earned the U.S. academic medical enterprise a high le vel of public trust and a deserved leadership position in the world. Howeve r, changes in the financing of medical care and in the organization of heal th care delivery have dramatically affected the medical school-university p artnership. The growing emphasis on delivery of clinical services and the c oncomitant decrease in time for tenured and clinician-educator faculty to t each and do scholarly work jeopardizes both the potential for continued dis covery and the education of the next generation of medical scholars. The background of the medical school-university relationship and the factor s leading to the development of clinician-educator faculty tracks are revie wed, and recent trends that impact faculty scholarship are discussed. Both tenure track and clinician-educator medical faculty, as members of the broa der university community, should expect from their university colleagues a continued demand for scholarship and educational activity that reflects the underlying philosophy of the parent university. As a corollary, the univer sity, through its medical school, must provide these faculty the time and t he financial support necessary to fulfill their academic mission. The size of the clinician-educator faculty should be determined by the academic need s of the medical school rather than by the service demands of its associate d health care delivery system. To accomplish this, academic medical centers will have to develop cadres of associated or clinical faculty whose primar y focus is on the practice of medicine.