Academic medicine: who is it for?

Editor—Detoriorating teaching standards in academic medicine have raised deep concerns all over the world.¹,² Although several highly qualified people have been appointed to high positions in the academic medicine departments of several colleges, not much improvement has been shown over the years.

Teachers are born with a talent, but others can learn teaching skills through rigorous practice and training. The teaching profession has been losing its glory and dignity in recent years because academic medicine is becoming rapidly commercialised. Hire and fire systems are becoming common. Medical teachers need to sacrifice their lucrative practising career to join a teaching post in a medical school.

Hardly any systems of teaching training and evaluation are in place, only students' feedback and individual complaints. Most of the efficient medical teachers cannot tolerate the behaviour of the authorities, find better opportunities, and leave. Frequent changes in teaching patterns by different newcomers result in confusion. Ultimately students suffer.³

Teaching jobs in academic medicine are full of humiliations, dishonour, financial constraints, insecurities, and finally lack of job satisfaction. Non-physician teachers discourage physician teachers from continuing in the teaching profession. Most of the teaching posts in basic medical science are filled with non-physician teachers. Medical students have trouble in coping with two forms of teaching materials and do not perform well in medical school examinations or during their clinical rotations.

We need to develop a group of teachers for training the medical teachers. Berwick in his editorial rightly said that we will meet in the developing world a level of will, skill, and constancy that may put ours to shame. We may find ourselves not the teachers we thought we were, but students of those who work under circumstances that would have stopped us long ago.⁴