The fault lines of academic medicine

Unprecedented advances in biomedical research and the upheaval in health care economics have converged to cause seismic changes in the traditional organization of medical schools and academic health centers. This process is particularly evident in departments of internal medicine. The activities and functions of academic medicine are in the midst of separation and realignment along lines that do not honor historical departmental and divisional boundaries. The organization of a successful medical school or department must be dynamic, constantly serving its constituents to accommodate progress and change and to promote optimal structure for academic productivity.     

Mentors and role models for women in academic medicine.

Senior mentors and role models have a positive influence on the career advancement of junior professionals in law, business, and medicine. In medicine an increasing number of women are pursuing academic careers, but available senior mentors to provide career guidance are often lacking. We report on the results of a national survey of 558 full-time faculty women, aged 50 years and younger, in departments of medicine in the United States, regarding their experience with role models and mentors. Women with mentors report more publications and more time spent on research activity than those without mentors. Women with a role model reported higher overall career satisfaction. This report, with illustrative examples, may be helpful to other women pursuing academic careers and to physicians who serve as mentors or role models to others.     

An experience in Japanese academic medicine.

The Japanese health care system has been highly praised for its universal access, freedom of patient choice, maintenance of a private system, and creative funding. Japanese citizens enjoy general good health, low infant mortality, and long life expectancy. Nevertheless, aspects of Japanese medical education, both graduate and undergraduate, and the structure of academic departments differ from those seen in the United States. A sabbatical spent teaching general internal medicine in Japan provided the experience for this review of the Japanese system. I describe the structure and function of departments of medicine and observations made at daily clinical teaching exercises in hospitals throughout the country.     

Possible evolutionary futures for mankind

1. With the development of techniques of gene transfer, human genetic defects such as sickle cell anaemia, phenylketonurea, cystic fibrosis, haemophilia, Huntington's chorea, etc. will be eliminated. Ninety nine percent of humans in the year 2500 will be much the same as at present, but healthier. 2. Studies of Comparative Biochemistry and Physiology show that many strategies have been developed in the Animal Kingdom that could be advantageous in furthering human survival. Some of these strategies are discussed in the present article. 3. Commensal algae that will live in the epidermis of domestic animals (pigs, goats, cattle) will be developed enabling these animals to live in dry environments with minimal demands for food and water. Once successful in domestic animals, the algae could be adapted to live in some humans, i.e. the "Green Man". 4. Commensal protozoa and bacteria that digest cellulose and lignin will be developed so that they can live in the human gut and convert the material to sugars, volatile fatty acids and amino acids that can be absorbed and metabolized by Man, thus making many inexpensive vegetable food resources available. 5. Mammalian embryos will be able to develop through to full term in vitro in a cleidoic egg; and the in vitro fertilized egg will have to depend on finding a surrogate mother. 6. Some people will have an altered pattern of sexual activity. Many patterns will be available; one suggested here is of protogynous hermaphroditism, i.e. the individuals would be female for the first 30 years of life and male for the remaining years.(ABSTRACT TRUNCATED AT 250 WORDS)     

The impact of greed on academic medicine and patient care

To what extent is the increasing emphasis on profit generation at US academic institutions shackling intellectual freedom and compromising healthcare?