Five futures for academic medicine

Editor—Godlee writes that academic medicine lacks vision and leadership in relation to the report from the International campaign to Revitalise Academic Medicine.¹,² Universities are no longer intellectual arenas or places of scientific debate. Drug company money salts most departments. Machines can analyse whatever DNA probe until a “significant” correlation is squeezed like grapes in a wine press. The next scientific meeting is only six months away; abstracts have to be in next week. You can't rush a robust red. The label is hardly on the bottle, and we are all imbibing the next season's Beaujolais.

I recently quizzed a doctoral student by his poster why he chose that interleukin to study. He had lots of data, no real hypothesis, and admitted that his department was just “doing” this cytokine—minutiae with a P value, destined to scientific oblivion in six months.

If you stay in a department long enough you end up with a chair—until death (viz the House of Lords), regardless of how stultifying and irrelevant the professorial output. Few competitors apply. It's jobs for the boys, and it is usually a foregone conclusion who gets the job.

We make the error of assuming an academic is the same as an intellectual. Intellectuals don't last long now in academia as they ask questions and challenge dogma.

Our former great intellectuals would not have got into print for lack of P values, grants, and ethics committee approval. However, we need ideas to be discussed so that they can then go into the scientific melting pot. Scientific writing has stifling conventions. The casualties are style, humour, and the active voice. Homer would have died laughing. Dare anyone say “I,” let alone “the wine dark sea.”

We have become slaves to evidence based conventions. However, we so often hear statements such as “the data had a nearly significant trend to significance.” The negative study is as a rarity. Gaudeamus igitur.