Kanter, Steven L. MD
This is a landmark year for the journal's name. In fact, 2009 marks two anniversaries: Eighty years ago it was first called a journal (it had been a bulletin for its first three years), and 20 years ago it became Academic Medicine, its fourth name. It seems fitting, then, to reflect on how this publication's names reveal the evolution of its mission, and to speculate a bit about what lies ahead.
The idea to create what became the first version of today's journal came in 1926 from the secretary-treasurer of the AAMC at that time, Dr. Fred Zapffe.1 He felt it was important to encourage an exchange of ideas on issues of teaching and school administration among the medical colleges of his day. So, Dr. Zapffe created the Bulletin of the Association of American Medical Colleges as a quarterly publication and served as its editor. On July 1, 1926, in the first issue, Dr. Zapffe wrote:
There has never existed a publication of any sort that was devoted wholly to furthering medical education or to serve as a medium for disseminating views on medical pedagogy. The BULLETIN [sic] will serve these needs…. It will be the only publication of its kind in the world…. Furthermore, it will bridge the gap, the time interval, between annual meetings, thus helping to keep in closer touch with each other those who are interested in this field of activity.2
The Bulletin published articles on medical teaching, papers presented at the AAMC's annual meeting, book reviews, statistics on medical students, and news about individual schools. Publication of the Bulletin was the main expenditure of the AAMC at the time, thus underscoring the importance that Zapffe, especially as the Association's treasurer, attributed to it.
Soon after its appearance, the Bulletin became an international publication. Three thousand copies were circulated widely around the world. Zapffe wrote of the Bulletin, “Its appearance was hailed with delight, and many commendatory letters have been received, making it very evident that a publication of this sort is not only needed but that it is wanted.”3 The Bulletin continued to grow and prosper. And in 1929, signaling its status as a scholarly publication, its name was changed to the Journal of the Association of American Medical Colleges. Dr. Zapffe continued to edit the publication under that name for another two decades.
In October 1950, at the 61st annual meeting of the AAMC, on the recommendation of the editorial board, the name was changed a third time to The Journal of Medical Education, beginning with the January 1951 issue. Dr. Zapffe explained that “these changes are in keeping with the practice that has been followed by medical and other journals during the past several years, i.e., using a name that is significant and descriptive of the contents and the field covered.”4
The new name emphasized that studying the structure and process of physicians' education could and should be pursued as a scholarly endeavor. A new editor secured grant funding to expand the journal and its operations and used these funds to hire the journal's first managing editor, to gain approval to publish ten issues a year, and to develop a new layout. Soon thereafter, in 1953, the journal became a monthly publication and continued to publish scholarly, peer-reviewed articles as The Journal of Medical Education for nearly four decades.
As medicine and biomedical science became increasingly complex, and medical schools and teaching hospitals found themselves grappling with a broader and more tenacious set of issues, the need for more scholarship in these areas became increasingly apparent. Thus, “in 1989 the main intellectual organ of the AAMC, The Journal of Medical Education, was redesigned, restructured, and renamed” to address the full range of issues important to academic medicine.5 The journal's more comprehensive mission was reflected by its new name: Academic Medicine. Simple and to the point, this name for the journal opened the door for scholarly contributions across a wide range of educational, institutional, and policy issues that affect the multiple missions of medical schools and teaching hospitals. About one half of the journal's pages would continue to report the findings of peer-reviewed research on medical education, while the other half, also peer-reviewed, would focus on a wide range of topics across the spectrum of academic medicine as well as on AAMC news and statements of AAMC policy.
In the early 2000s, the mission of the journal and its status as an independent scholarly publication were clarified by reducing its coverage of AAMC communications, expanding treatment of institutional and policy issues, and, in 2006, establishing the Journal Oversight Committee. Since I became editor in 2008, one of my goals has been to reaffirm and sharpen the journal's focus by publishing articles in the following five areas critical to advancing knowledge in academic medicine: education and training issues; health and science policy; organizational administration, management, and values; research practice; and clinical practice in academic settings.
So what may the future hold for Academic Medicine?
First, changes in how individuals acquire information are challenging the traditional concept of a journal as a series of “issues”–that is, a set of articles printed on paper, physically bound together, and sent out every week, month, or quarter. Will there continue to be a print version of this journal issued monthly? Or will it eventually be produced solely in electronic form, with the reader occasionally printing an article, at least until more user-friendly electronic reading devices are available?
Second, advances in social networking are leading to new ways to assure the quality of published content. Will submitted articles continue to be vetted by a single-blinded process of peer review? Or will content be published without peer review and then subject to continuous validation by a next-generation wiki process?
Third, if a postpublication, wiki-type process is used to assure the quality of published content, there will be implications for the journal's relationship with authors. For example, would the journal need a policy requiring that authors must verify the accuracy of their wikiarticles each month for a period of one year, after which the article will be closed to further changes?
Fourth, the issues raised above have implications for the journal as a historical record of the development over time of scholarship in academic medicine. If an article can be modified postpublication, what version(s) of the content should be preserved for historical study? How does the journal preserve the value of a particular article as a record of what was thought and practiced at the time it was written?
While this journal will continue to grow and develop in response to these and other evolutionary forces, I believe that the concept of a journal as a source of trusted, authoritative information that fosters the scholarly exchange of ideas will endure. And after 20 years of the name Academic Medicine, I believe that it is still the right one for this publication, which will continue to serve as an authoritative source on the pressing issues of the day in academic medicine, serving an international audience, and focusing on the principles, policy, and practice of education, research, and patient care.
Although I had not studied the details of Dr. Zapffe's contributions at the time I wrote my inaugural editorial in January 2008 (and I am glad that no one on the interview committee for the editor-in-chief position asked me about him), I came to the same realization that he did some eight decades earlier. In that editorial, I wrote:
I believe that the journal will continue to be successful—and to grow and develop as a trusted and necessary resource—if goals and ideas are shared effectively, if the journal's content serves as a source of rational and empirical guidance for those with leadership responsibility, if we pursue forward-thinking strategies about how individuals acquire and use information, and, ultimately, if the journal's articles and special features enrich the conversations that occur every day in the halls of our medical schools and teaching hospitals.6
These are some of the reasons why I have solicited commentaries on a broad range of issues, developed a new point-counterpoint feature, reinstituted letters to the editor as a formal part of the journal, and introduced the editor's Question of the Year. And, of course, these features continue to reinforce, some 83 years later, Dr. Zapffe's original notion that the journal should be a catalyst of communication and the sharing of ideas.
I wish to deeply thank Jennifer M. Gross for her many contributions to the journal, first as staff editor, then senior staff editor, from April 2005 until the end of January 2009. In addition to her outstanding editing of manuscripts, Jennifer helped create and manage the present-day commentaries feature; became the journal's production editor; and was the staff editor of the June 2006 HPPI supplement, two RIME supplements, and two features, Teaching and Learning Moments and Medicine and the Arts. She designed and oversaw the journal's transition to digital proofs and AMA style and extensively rewrote the “Complete Instructions for Authors,” including a user-friendly online version. Jennifer assisted Anne Farmakidis and me in refining the journal's ethical approval policy, conflict-of-interest policy for reviewers, and criteria for authorship, and, with the other staff, helped the journal make three transitions last year: to a new Web site, to a new online manuscript system, and to me, as the new editor-in-chief. She accomplished all this with great skill, creativity, and collegiality. The staff and I greatly miss Jennifer but cheer her on as she tackles her latest assignments: having her first child and moving to Japan.
Steven L. Kanter, MD