ICRAM (the International Campaign to Revitalise Academic Medicine): agenda setting
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《英国医生杂志》
Correspondence to: D Wilkinson, School of Medicine, University of Queensland, Brisbane, QLD 4006, Australia david.wilkinson@uq.edu.au
Following the launch by the BMJ and others of the campaign to promote academic medicine, a working party of 20 medical academics from all over the world was convened to develop a plan of action
Introduction
We feel that currently academic medicine
Undervalues our teaching role
Tolerates the imbalance and lack of communication between basic research and clinical or applied research
Fails to drive innovation and excellence in clinical practice resulting in indefensible variations in practice and outcome
Ignores the essential values of social and global responsibility.
The growth and imbalance of biomedical research institutes creates a challenge. How much of this research will bear a dividend in our health systems, and when? Who will translate this research into health benefit? Communication between basic and clinical and health systems researchers seems to have become increasingly difficult. We seem not to have learned that the greatest health benefits come from applying what we already know to more people. We continue to try to make basic scientists of our best and brightest clinicians: trainees enrolled in PhD programmes are typically seeking another new gene instead of working on clinical safety, quality, and health outcomes. Have we got the balance right?
Box 1: Task groups
Analysing the evidence—This group is collecting and appraising systematically the available evidence on academic medicine and its problems3
Careers and training—This group aims to explore the issues of mentoring and recruitment with a special emphasis on women and marginalised groups, and to set up student and trainee international advisory groups to help explore problems and to propose possible solutions
Communication and dissemination—This group is responsible for internal and external communication strategies and management of publication policies
Stakeholder liaisons and operations—This group is outlining how the working party will operate and is establishing collaborative relationships with relevant regional bodies such as governments, professional associations and universities
Vision and values—This group is developing a discussion paper that seeks to explore current values and then propose a new vision and set of values for academic medicine
Another great failing is the lack of focus on the health needs of populations not normally supported by academic medicine due to race, ethnic origin, social class, gender, or geographical location.
What needs to be done to permit academic medicine to fulfil its roles?
During the meeting the working party analysed these problems and together agreed to work more on several topics:
Proposing how academic medicine could listen better and improve its relationships with its "customers," including patients, policy makers, and practitioners
Exploring/examining what the values of academic medicine should be
Building capacity in academic medicine, including better career paths
Developing a vision of how academic medicine should look in 2020
Planning how to ensure that the campaign achieves change.
Five task groups have been formed (box 1). A member of the working party convenes each task group, and the convenors meet by teleconference monthly.
We are developing a series of regional and stakeholder advisory groups (box 2) to inform and advise the working party through as broad a range of consultations as possible. The regional advisory groups will provide global geographic coverage for the consultations, and the stakeholder advisory groups will represent the interests of the various "customers" of academic medicine. Out of this we see a series of working papers being developed to further stimulate and inform the debate. These working papers will lead to a series of peer reviewed publications. The whole working group will meet in mid-2005 with international policy makers to complete a final report, which will include recommendations for reform in academic medicine and a platform for action.
We are aware that this effort could easily lead to a lot of discussion and little action, with a report produced in 12 months that has minimal impact. Our challenge is to ensure a different outcome. We hope to do this through the task groups outlined here and a range of other consultation processes that we are currently establishing. We invite all of you to join with us in changing the face and future of academic medicine.
Members of the working party are listed on bmj.com
Education and debate p 787-97
Contributors: All authors (see bmj.com) contributed to the conception and content of the paper, contributed to drafts, and approved the final version for publication. David Wilkinson is guarantor.
Funding: None.
Competing interests: None declared.
References
Tugwell P. Campaign to revitalise academic medicine kicks off. BMJ 2004;328: 597.
Clark J, Smith R. BMJ Publishing Group to launch an international campaign to promote academic medicine BMJ 2003;327: 1001-2.
International Working Party to Promote and Revitalise Academic Medicine. Academic medicine: the evidence base. BMJ 2004:329: 789-92.
Following the launch by the BMJ and others of the campaign to promote academic medicine, a working party of 20 medical academics from all over the world was convened to develop a plan of action
Introduction
We feel that currently academic medicine
Undervalues our teaching role
Tolerates the imbalance and lack of communication between basic research and clinical or applied research
Fails to drive innovation and excellence in clinical practice resulting in indefensible variations in practice and outcome
Ignores the essential values of social and global responsibility.
The growth and imbalance of biomedical research institutes creates a challenge. How much of this research will bear a dividend in our health systems, and when? Who will translate this research into health benefit? Communication between basic and clinical and health systems researchers seems to have become increasingly difficult. We seem not to have learned that the greatest health benefits come from applying what we already know to more people. We continue to try to make basic scientists of our best and brightest clinicians: trainees enrolled in PhD programmes are typically seeking another new gene instead of working on clinical safety, quality, and health outcomes. Have we got the balance right?
Box 1: Task groups
Analysing the evidence—This group is collecting and appraising systematically the available evidence on academic medicine and its problems3
Careers and training—This group aims to explore the issues of mentoring and recruitment with a special emphasis on women and marginalised groups, and to set up student and trainee international advisory groups to help explore problems and to propose possible solutions
Communication and dissemination—This group is responsible for internal and external communication strategies and management of publication policies
Stakeholder liaisons and operations—This group is outlining how the working party will operate and is establishing collaborative relationships with relevant regional bodies such as governments, professional associations and universities
Vision and values—This group is developing a discussion paper that seeks to explore current values and then propose a new vision and set of values for academic medicine
Another great failing is the lack of focus on the health needs of populations not normally supported by academic medicine due to race, ethnic origin, social class, gender, or geographical location.
What needs to be done to permit academic medicine to fulfil its roles?
During the meeting the working party analysed these problems and together agreed to work more on several topics:
Proposing how academic medicine could listen better and improve its relationships with its "customers," including patients, policy makers, and practitioners
Exploring/examining what the values of academic medicine should be
Building capacity in academic medicine, including better career paths
Developing a vision of how academic medicine should look in 2020
Planning how to ensure that the campaign achieves change.
Five task groups have been formed (box 1). A member of the working party convenes each task group, and the convenors meet by teleconference monthly.
We are developing a series of regional and stakeholder advisory groups (box 2) to inform and advise the working party through as broad a range of consultations as possible. The regional advisory groups will provide global geographic coverage for the consultations, and the stakeholder advisory groups will represent the interests of the various "customers" of academic medicine. Out of this we see a series of working papers being developed to further stimulate and inform the debate. These working papers will lead to a series of peer reviewed publications. The whole working group will meet in mid-2005 with international policy makers to complete a final report, which will include recommendations for reform in academic medicine and a platform for action.
We are aware that this effort could easily lead to a lot of discussion and little action, with a report produced in 12 months that has minimal impact. Our challenge is to ensure a different outcome. We hope to do this through the task groups outlined here and a range of other consultation processes that we are currently establishing. We invite all of you to join with us in changing the face and future of academic medicine.
Members of the working party are listed on bmj.com
Education and debate p 787-97
Contributors: All authors (see bmj.com) contributed to the conception and content of the paper, contributed to drafts, and approved the final version for publication. David Wilkinson is guarantor.
Funding: None.
Competing interests: None declared.
References
Tugwell P. Campaign to revitalise academic medicine kicks off. BMJ 2004;328: 597.
Clark J, Smith R. BMJ Publishing Group to launch an international campaign to promote academic medicine BMJ 2003;327: 1001-2.
International Working Party to Promote and Revitalise Academic Medicine. Academic medicine: the evidence base. BMJ 2004:329: 789-92.