For some time, the editorial staff and I, with the concurrence of the editorial board and the association’s executive staff, have been increasingly focusing the journal’s content to address the major challenges facing the leaders of academic medicine. One approach has been to solicit articles (including research reports) describing how individual institutions have managed specific challenges. We have also been receptive when individuals have offered to serve as guest editors to assemble articles addressing different aspects of a particular challenge. As a general rule, both types of articles have been well received by those who read the journal on a regular basis, and have brought the journal some new regular readers.
This issue of the journal reflects a variation on those strategies, in that it includes a collection of articles describing how a single institution—the University of Washington School of Medicine (UWSOM)—has addressed a number of different challenges. Last year, Paul Ramsey, MD, vice president for medical affairs and dean of the school of medicine, contacted me to suggest it might be appropriate to feature the UWSOM in the October 2006 issue of the journal, since the association’s annual meeting was to be held in Seattle at the end of that month. I must admit I thought it was a good idea because it provided an opportunity to present a more complete picture of the large number of challenges facing academic health centers. But I also admit that we had some second thoughts about the project, simply because we didn’t want readers to view the issue as a sort of public relations ploy for the UWSOM. Needless to say, in the end we decided to go ahead and work with members of Paul’s staff in making the issue a reality. Tom Norris, MD, vice dean for academic affairs, Marjorie Wenrich, MPH, director of medical affairs special research and community projects, and Erika Goldstein, MD, associate professor of medicine, served as the guest editors for the collection of articles in this month’s journal.
One of the reasons for publishing such a collection of articles is that it may serve as a catalyst for other institutions to consider producing their own collections. The simple fact is that while there are challenges common to all, or to most, of the medical schools and teaching hospitals in this country, there are significant differences in the ways the institutions respond to them. In addition, there are some challenges that are more specific to certain institutions due to differences in their locations, relationships to their parent universities, and the nature of their clinical and research enterprises. Since I believe very strongly that articles describing the experience of particular institutions provide useful lessons for how other institutions might address a particular challenge, I would like to see more institutionally based collections like the one in this month’s journal. But the journal also welcomes individual articles addressing any of the major issues confronting academic medicine, including the issues covered in the UWSOM collection. Let me briefly describe two of these.
As most readers know, the Association of American Medical Colleges has called on its member medical schools to increase enrollments by 30%. It would be extremely valuable to publish reports describing how specific schools have been able to respond to this challenge. I am aware, in a general sense, of a variety of different strategies that schools are employing to accommodate more students in the facilities where the preclinical, nonexperiential elements of the curriculum are conducted, and how they are providing the necessary clinical experiences in a variety of patient care settings. The UWSOM strategy described in this issue of the journal is an interesting approach that builds on the unique nature of the multistate WWAMI program in the region. I hope that schools that have embarked on major enrollment increases will be willing to prepare manuscripts that describe in some detail how they are doing that.
I would also like to see manuscripts describing the approaches that institutions are using to provide students and residents more exposure to global health issues. This is a topic of growing importance not only for those in the health professions, but also for the general public. The development of a global health department at UWSOM, which spans the schools of medicine and public health, is an interesting approach. But how are other schools addressing this challenge, particularly those based in universities that do not have a school of public health?
Needless to say, the challenges facing the academic medicine community are almost endless. I believe the journal plays a special role—indeed, even a unique role—by publishing articles focusing on those challenges and thereby offering key information that academic medicine’s leaders can use to enhance the education, research, clinical care, and community service missions of their institutions. Although each institution’s leaders would like to think that they can, on their own, develop effective solutions to the problems they face, they can also gain greatly by at least being aware of how others have addressed similar problems in their institutions. The community at large benefits when individual members are willing to take the time and make the effort to prepare manuscripts describing their experiences. We at Academic Medicine are willing to do anything that we can to assist that process.
Michael E. Whitcomb, MD