Bibliographic record
Abstract
We are pleased to reprint Dr Tugwell's call to arms on the revitalization of academic medicine, which first appeared in the British Medical Journal on March 13, 2004. Dr Tugwell outlines an international project in this area. We hope there will be readers who will join in to volunteer to help revitalize academic medicine. Drs Noni MacDonald and Elizabeth Ford-Jones Co-Editors-in-Chief The BMJ and a range of partners, including other journals published by the BMJ Publishing Group, the Lancet, Canadian Medical Association Journal, Dutch Journal of Medicine, Medical Journal of Australia, Croatian Medical Journal, the Academy of Medical Sciences, and many others have initiated a project to bring people together to debate whether the existing structure of academic medicine is still fundamentally sound and, if not, to propose alternatives to it (1). I have taken on the challenge of coordinating this project, and I invite readers to join me in this enterprise. To achieve the project's broad goals (box 1) we begin from the position that “more of the same” is not enough. We need to be free to propose radical changes to the fundamental nature of academic medicine (is the balance between bench and applied research all wrong?); its name (should it become “academic health care” or should we drop “academic”?); its home base (are hospitals the wrong place to train doctors?); its relation to service (why are they so often far apart?); its methods of training and certification (should medical education be lecture based and far shorter?); and its responsibilities (should it be held accountable for inequities in health care at the global level?). Our approach will be inclusive and is designed to ensure a broad input of opinions. Rather than allowing the process to be taken over by a few experts with vested interests, we will build consensus by inviting a range of global stakeholders to contribute their views. We are especially interested in the views of the “customers” of academic medicine – patients, politicians, the public. Anyone can contribute their views right now, as a rapid response to this article at bmj.com. In addition, our project web page is under development (www.bmj.com/academicmedicine), and this will contain regular updates, news, and collected resources. The proposed structure is as follows. The pivotal group will be an international working party whose composition will include knowledge and competency across the dimensions of global health and basic to applied health-care research, representing the range of constituents (medical students, postgraduates, junior faculty, established academics – especially women). Supported by four advisory groups (box 2) and made up of approximately eight individuals, the working party will begin by answering four questions. Firstly, what are the roles of academic medicine? Secondly, how well is academic medicine carrying out these roles? Responses to the earlier BMJ editorial launching this initiative have already nominated a wide array of (but no clear consensus about) perceived failures, including failing to serve the public good, lack of a global perspective, an unnecessary dichotomy between education and research, various shortcomings in medical education, and inadequate numbers of and career paths for well trained medical academics (2). Thirdly, why is academic medicine failing to fulfil its roles? Reasons might include inadequate leadership, a failure to translate discoveries into benefits for patients, inappropriate incentives to take up or maintain an academic career (especially among women), deficient mentoring for aspiring academics, lack of appreciation of the benefits of academic medicine by elected representatives, and poor integration with other health services. Many of the reasons will be economic but we need to examine ethical and moral explanations as well. Finally, for each failure, what ought to be done about it? Given economic constraints in countries with high and low income, special attention will go to strategies that call for no additional funding. We will, however, welcome strategies that call for the reallocation of funding. We welcome strategies for how academic medicine can contribute to national and global health. These strategies will be combined and formulated into concrete proposals for action. We need your help. To nominate a member of the working party, join a group, or register your views, send a rapid response to bmj.com or contact our project manager, Jocalyn Clark, at jclark@bmj.com.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.051 | 0.117 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.003 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.013 | 0.020 |
| Scholarly communication | 0.031 | 0.029 |
| Open science | 0.005 | 0.030 |
| Research integrity | 0.064 | 0.076 |
| Insufficient payload (model declined to judge) | 0.071 | 0.040 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".