Academy History

Medical schools have long proclaimed to be their core mission. However, as Kenneth Ludmerer described in his books Learning to Heal and Time to Heal, after World War II the teaching mission at U.S. medical schools became increasingly frayed and undervalued (1,2). Medical educators issued innumerable reports calling on faculties to revitalize the educational mission. However, these efforts invariably failed. At medical schools everywhere, the percentage of institutional budgets devoted to teaching plummeted, as did the amount of time faculties as a whole spent with students. More troubling, criticisms of the medical school curriculum, teaching methods, and tools of assessment grew notably in frequency and intensity, and medical students often complained that their teachers did not even them well or even care about their well-being.

Daniel Lowenstein, an eminent neurologist at the University of California-San Francisco School of Medicine, agreed with Ludmerer’s analysis. Citing Ludmerer, Lowenstein wrote, “The educational mission of U.S. medical schools has been increasingly threatened since the middle of the 20th century, and the situation is more severe now than ever before” (3, p. 783). After considerable discussion of this issue with colleagues at UCSF, particularly David Irby, Molly Cooke, and Haile Debas, Lowenstein proposed the idea of an Academy of Medical Educators as a way to invigorate medical education. He wrote: “This structural problem requires a structural remedy. We suggest that this remedy could include the creation of a new organizational entity [The Academy], dedicated to education” (3, p. 730). In 2001, Lowenstein established the country’s first Academy of Medical Educators at USCF. Later that year, he moved to Harvard Medical School, where he established the nation’s second Academy. Since then, the Academy movement has spread widely. In May 2019, 65 U.S. medical school had established Academies, and a national organization – The Academies Collaborative – had emerged to encourage and nurture their efforts.

Academies vary considerably among each other in their details, such as budget, number of members, criteria for membership, administrative organization, and specific objectives. Lowenstein initially envisioned the Academy as a tool to invigorate undergraduate medical education. Subsequently, many Academies have expanded their scope to include faculty involved with graduate medical education or the education of other health-care professionals. Some Academies emphasize providing salary support for select teachers or helping gifted educators receive promotions; others promote curricular design or research in medical education; and most pursue a combination of these objectives. Their common mission is their effort to elevate education in the value system of U.S. medical schools and to encourage faculty who aspire to teach.

Given the many forces that work against medical education today, the Academy movement remains highly relevant to medical schools and represents a way to protect the soul of academic medicine. The future of the movement will depend on funding. At the moment, Academies depend on the largesse of the medical school each year in the annual budget. Ludmerer believes that the medical school that is the first to endow its Academy will stand to 21st-century medical education as Johns Hopkins did to the 20th century.

References
1. Kenneth M. Ludmerer, Learning to Heal: The Development of American Medical Education (New York: Basic Books, 1985).
2. Kenneth M. Ludmerer, Time to Heal: American Medical Education from the Turn of the Century to the Era of Managed Care (New York: Oxford University Press, 1999).
3. David M. Irby, Molly Cooke, Daniel Lowenstein, and Boyd Richards, “The Academy Movement: A Structural Approach to Reinvigorating the Educational Mission,” Academic Medicine, 79: 729-736, 2004.