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AAMC Reporter: August 2006
A Word from the President:
"Extraordinary People in the Real World"
Thirteen years ago, I left Washington and my "inside
the Beltway" life at the National Institutes of Health
(NIH) to work with a most extraordinary group of
people — the men and women at our nation's medical
schools and teaching hospitals. As many of you know,
following almost 13 years at the NIH, I had the rare
privilege of serving as dean of two medical schools —
the Medical College of Georgia (MCG) and the
Pennsylvania State University College of Medicine —
and as chief of their two academic health systems, the
MCG Hospital and Clinics and the Penn State Milton S.
Hershey Medical Center. Having worked side by side
with the dedicated teachers, scientists, and clinicians
at these institutions, and having visited dozens of the
other institutions comprising our AAMC membership,
I learned firsthand how challenging it is in the "real
world" of academic medicine.
In particular I have seen how, on a daily basis, these
deeply committed individuals struggle against growing
time and resource constraints, decreasing federal and
state support, and the burgeoning complexity and fiscal
stresses in our health care system. Yet in the face of so
many challenges, these extraordinary people continue
to bring about remarkable results, becoming lifelong
mentors to students, collaborators on the cutting edge
of biomedical research, and compassionate healers to
patients in the greatest need, regardless of their ability
to pay for that care.
As I write this column in the midst of my first month
back in Washington, I feel strongly that my most important
task will be to keep these wonderful people who do
the work of academic medicine uppermost in my mind
and, even more important, squarely in front of the
nation. So the time seems appropriate, with much of
official Washington on vacation and another academic
year about to start, to give you a preview of what I will
tell policy makers and the public about life on the front
lines of academic medicine.
In talking about medical education, I can say with confidence
that we are doing a better job than ever in preparing
medicine's next generation — effectively blending how
we teach the science of medicine with how we develop
students as caring professionals. I will emphasize why
teaching time is so precious, how it now is in such short
supply at our institutions, and how I stand in awe of the
many faculty members who, despite this constraint,
become role models who are truly beloved by their students.
To help illustrate this point, I need only mention
my repeated encounters with students who tell me of
their inspiration by and admiration for their teachers
and mentors, often choosing their own specialty based
on such a relationship. At every institution where I have
worked or visited, I encounter teachers "par excellence"
— preceptors, community faculty members, clerkship
directors, basic science professors, clinical faculty, small
group tutors, and many others who so rightly garner
"golden apples" and other distinguished awards from
their grateful medical students, graduate students,
and residents.
When the discussion turns to research, my tremendous
admiration for the unyielding focus and perseverance of
basic and clinical scientists — particularly in light of their
struggles to obtain sustaining financial support — will be
clear. I can describe the impressive manner in which
researchers at our institutions have transitioned from
working in a world where science was once primarily an
individual undertaking to one that increasingly requires
teams and collaboration, often on a global scale. It has
been inspiring to watch the spirit of scientific collaboration
coming together, on a spectrum ranging from small
teams focused on the most basic level of a mechanism
or disease to the historic scale of the Human Genome
Project. In reflecting on the latter achievement, it will be
important to note that despite skepticism from many
quarters, researchers at our institutions and from
around the world, with vital governmental support,
succeeded beyond almost all expectations. Most important,
despite all the excitement today of reaping the
benefits from biomedical advances, I will share the deep
anxiety in our community that public support for this
vital research is wavering. This theme promises to be a
focal point of my work ahead.
When it comes to describing patient care at our academic
health centers, the word that will always come
to mind first is "compassion." Speaking as the former
head of two academic health systems, I am the first to
acknowledge that as health care has become more
powerful and effective, it also has become much more
complicated with potential dangers to patients. Yet,my
experience involves countless examples showing that
no matter how technologically intricate medicine has
become, one factor has remained constant: the fundamental
desire of clinicians to ease the suffering of
others. Certainly we face daunting questions, not only
about improving the quality and safety of health care
but also about how we can achieve any kind of financial
sustainability. That being said, I will never fail to point
out that our nation's teaching hospitals and clinics are
staffed by physicians and health care teams with a
deeply held moral commitment to caring.
In my every encounter as your AAMC president, I hope
to tell Washington's policy makers and the citizens of
our nation about the accomplishments of the extraordinary
people working every day in the real world of
academic medicine. And just as all of them — teachers,
researchers, and clinicians — remain firmly committed to
their missions, I will work tirelessly to convey both the
facts and the spirit of their work. It will be my duty and
privilege to represent them and advocate for the public
recognition and support they so richly deserve.
Darrell G. Kirch, M.D.
AAMC President
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