Culture and the Courage to Change - Member Profile - AAMC

Culture and the Courage to ChangeBut we also need to be honest about how the culture of academicmedicine has led to some very specific behaviors and structures thatmay no longer serve us as well as they did a decade or so ago, especiallygiven the future we face.“The descriptors I heard included words likeindividualistic, autonomous, scholarly, expertcentered,competitive, focused, high-achieving,and hierarchical.”In education, generations of medical educators have focused on theindividual accumulation of factual knowledge. But is this the best wayto create lifelong learners who have the skills to acquire and use dynamicallychanging and exponentially expanding information?On the research side, we have a history of training researchers to achievethe status of independent investigators, with the R01 standing asvalidation of their independence and expertise. But in a world ofincreasing research complexity, in which science is more and more interdisciplinaryand highly networked, just how well does this model ofautonomous investigators work?In our clinical practices, despite the fact that they have become hugehealth care delivery systems, we often persist in functioning like soloexpert specialists within them. But how can a loose collection ofspecialized experts ever achieve the clinical and operational coordinationneeded to create a seamless system delivering patient-centered care?We have lived in a culture in which our medical schools, laboratories,teaching hospitals, and faculty clinical practice plans often evolved asstructures designed first and foremost to support our autonomouspursuits. Perhaps most tellingly, we have held tenaciously to the grandtradition of rewarding the demonstration of combined independenceand expertise with that treasured status of tenure, the top rung of ourhierarchical professional ladder. And despite whatever struggles we6Association of American Medical Colleges