Whitcomb, Michael E. MD
In this editorial—my first since becoming editor-in-chief of Academic Medicine—I want to share with the journal's readers information about changes that will unfold in the pages of the journal in the coming months. The changes that are planned are intended to enhance the journal's effectiveness as a source of valuable information for all in the academic medicine community, but particularly for medical educators and those who hold leadership positions in the nation's medical schools and teaching hospitals. To provide a context for the planned changes, let me review a bit of the journal's history.
For the past 50 years, the Association of American Medical Colleges has published a monthly journal. From the early 1950s until the late 1980s, the journal was known as the Journal of Medical Education and published almost exclusively papers reporting the results of medical education research studies. In the late 1980s, the leadership of the Association concluded that the journal could serve the leaders of medical schools and teaching hospitals more effectively by addressing a broader range of issues than those directly related to medical education. To reflect this planned change in the content of the journal, the name of the journal was changed to Academic Medicine.
Since that time, the journal has published two major categories of papers. The larger category of papers published over the years either described innovative approaches to the design, conduct, and management of medical education programs; reported the results of research conducted to elucidate an important issue related to medical education; or discussed the application of educational theory to teaching and learning in medicine. Those papers provided important information and insights that medical educators have used to improve the quality of medical education in this country.
During the same period, the journal published a smaller but still sizable number of papers that addressed important contemporary issues that were seen to be of interest to those holding leadership positions in medical schools and teaching hospitals. Those papers focused largely on the impact of government policies on medical schools or teaching hospitals, or on issues related to the management or financing of those institutions. It is important to recognize that those papers also had value for medical educators, because they addressed issues that had the potential to affect adversely the ability of faculty and administrators to contribute the time, effort, and resources needed to maintain or improve the quality of the institutions' educational programs.
More than a decade has passed since the scope of issues addressed in the journal was broadened in an effort to serve more effectively the leaders of academic medicine's institutions. At present, there are few data available that can be analyzed to evaluate the degree to which the journal has been successful in achieving that objective. Nevertheless, based on the data that are available and on anecdotal feedback from members of the academic medicine community, it is possible to reach several reasonable conclusions about the current status of the journal.
First, it seems clear that the journal has retained and enhanced its status, both in this country and abroad, as the premier journal serving the interests of medical educators. It is important to emphasize this point, since in 1988 the members of the medical education community expressed concern that broadening the focus of the journal would erode its value to those in the medical education community. I suggest that one of the reasons the journal has enhanced its status is that both of the kinds of papers published in it have proven to be of value for medical educators.
Second, it appears that the journal primarily serves only a select group within the medical education community—those who have administrative responsibility for the undergraduate medical education programs at their institutions, and those who are actively engaged in medical education research. Available evidence suggests that those who serve as clerkship directors or residency program directors, or the faculty for whom teaching clinical medicine is a major responsibility, are not regular readers of the journal. This is an issue that the journal needs to address, since those clinical educators are important contributors to the quality of their institutions' medical education programs.
Third, it also appears that the majority of those holding leadership positions in medical schools and teaching hospitals—deans, department chairs, and hospital CEOs—are not regular readers of the journal. There are probably several reasons for this. Perhaps most important, those individuals do not view the journal as a consistent source of information that can assist them in meeting their responsibilities, because the journal has not published a sufficient number of papers that address issues of interest to them. The education-related papers that make up the bulk of the journal each month, particularly the medical education research reports, are generally of little interest to those who have broader leadership responsibilities in their institutions.
If this assessment is correct, the journal and its new editorial board face a number of major challenges. Needless to say, it will take some time to implement all of the changes, both in the operations and in the content of the journal, that are needed if the journal is to meet those challenges. However, changes have already occurred in the operations of the journal, and several changes in the content of the journal will be evident in the next few months.
My appointment as editor-in-chief of the journal is only one of the changes that have occurred in the reorganization of the editorial staff. Perhaps most important is the appointment of a managing editor—Lisa Dittrich—who will be responsible for the day-to-day operations of the journal. The masthead of this issue identifies all of the members of the journal's staff. Three are new to the journal, having joined the staff in the past few months. The other members of the staff are familiar to those who have worked with the journal in recent years. The masthead also provides information about changes in the membership of the editorial board. Two new members have been added to the board since it was reorganized this past spring.
I also suggest that readers, particularly those who may be potential contributors to the journal, read carefully the revised instructions for authors, which appear in this issue and on the journal's Web site, 〈www.academicmedicine.org〉. There are a number of very important changes in those instructions, some of which reflect major changes in the ways that submitted papers will be managed by the staff. Those changes—including the new requirement that all manuscripts be submitted online—will ultimately make the submission and review process easier for all concerned, thereby expediting decisions for authors. The instructions also contain information about changes that have occurred in the formatting of the journal.
As noted above, several changes in the content of the journal will be evident in the next few months. One change that I particularly want to note is that the February issue will mark the last time that the National Policy Perspectives column will appear. The editor of that column, Dick Knapp, made a valuable contribution to readers over the past 13 years by bringing to their attention a wide variety of perspectives on policy issues in articles written by leaders in government and other segments of society.
In making other changes in the journal's content, I will work closely with the editorial staff to pursue three major objectives.
First, the journal will publish more papers that address the serious contemporary issues now facing the leaders of medical schools and teaching hospitals, issues that do not appear at first to be directly related to medical education. This presents a real challenge, because most of the scholars who write about these issues do not presently submit their work to Academic Medicine. Thus, to ensure that papers that address those important issues are published in the journal, the journal will begin to solicit manuscripts from individuals who have special insight into those issues.
Second, the journal will present information about important contemporary issues—both those of interest primarily to medical educators and those of interest to the leaders of academic medicine's institutions—more comprehensively and, therefore, more effectively. To accomplish this, multiple papers that address different dimensions of a particular topic will be clustered in a single issue of the journal. On occasion, an entire journal issue (a theme issue) may be devoted to coverage of a single topic.
Third, the journal will present competing views about particular issues in a more timely manner. To accomplish this, commentaries on papers selected for publication will be invited and will be published in the same issues of the journal in which the original papers appear. On occasion, an editorial responding to a paper accepted for publication may appear in the same issue of the journal as the original paper. These approaches are intended to stimulate debate in the Web and print pages of the journal, thereby allowing readers to evaluate more clearly the data, information, or viewpoints presented in the original papers.
My intent in this editorial has been to provide readers with information about some of the changes that will unfold in the pages of the journal in the coming months. I would be remiss, however, if I failed to acknowledge the extraordinary contributions that Addeane Caelleigh made to the journal during her years as editor. During her tenure, she made many changes in the journal that allowed it to retain and elevate its status over the years as the premier medical education journal in this country and abroad. In doing so, she made an important contribution to the effort to improve the quality of medical education. Those of us who have devoted a considerable part of our professional lives in recent years to trying to improve the education of doctors are indebted to her.