Dean's Significant Conversations

There seems to be little disagreement that “academic medicine” is in crisis, with many, including the BMJ Commission on the Future of Academic Medicine and the Association of American Medical Colleges (AAMC), characterizing the crisis as existential. This crisis stems from severe structural strains on its core threefold mission: training future doctors, conducting scientific research, and providing complex patient care. These strains range from financial and regulatory issues (e.g., federal disinvestment in science, narrowing margins for teaching hospitals, and economic burdens for students) to workforce challenges (e.g., unsustainable teaching and research expectations, plummeting MD-PhD graduates, fewer students entering the basic sciences, and burnout for clinical faculty due to the ever-increasing demands for clinical productivity).

Given the current environment, where do we (Case Western Reserve University School of Medicine) stand, what are our current excellences, and what might those tell us about the way forward not just in responding to crises but in creating and shaping our future?

Program:
5–5:30: Defining “Academic Medicine,” Responding to Current Challenges and Highlighting Our Local Excellences (Stan Gerson)

5:30–6: Panel discussion (Stan Gerson, Mark Jackson, Lia Logio, Grace McComsey and William Schiemann)

6–6:30: Open conversation with the panelists on shaping our future

6:30–8: Reception

The ongoing crisis in academic medicine has manifested in medical education and clinical practice. As we discussed in the first conversation of this series, physicians at academic teaching hospitals are increasingly leaving academic careers for better-paying and less stressful settings even as physicians, more generally, exit the practice of medicine. Despite increases in medical school enrollments, the Health Resources and Services Administration (HRSA) projects to leave us with a national shortage of over 141,000 physicians by 2038. This projection comes even as advancements in artificial intelligence promise to improve the efficiency, productivity and efficacy of clinical practice, transforming it in ways that presently we can only imagine. How might global polycrises, changing demographics, rising healthcare costs and declining average life expectancy in the United States and globally combined with advances in technology and breakthrough innovations for prevention and treatment of diseases reshape the practice of medicine in the future? What are the implications for medical education? And how can we build on our existing strengths to create and reshape medical education to meet the expected demands of medical practice in the coming years?

Program:
5–5:30: Responding to Current Challenges and Highlighting Existing Excellences (Lia Logio)

5:30–6: Panel discussion (Lia Logio, Shari Bolen, Gregory Hall, Kathryn Miller, Oliver Schirokauer, Gary Schwartz and Monica Yepes-Rios)

6–6:30: Open conversation with the panelists on shaping our future

6:30–8: Reception

Conversation III: Research and Discovery

March 24, 2027

Due to federal funding cuts, the traditional modes of research and discovery in academic medicine are at risk. At the same time, fewer students are entering the basic sciences and pursuing research and discovery in its traditional academic setting. The reasons for this are many, but well before the current crises, the traditional paradigm that dominated research and discovery from the end of WWII forward was being challenged. For example, the Bill & Melinda Gates Foundation offered a scathing critique of traditional research for being too slow, overly risk-averse, and poorly aligned with the specific, urgent needs of the developing world as early as 2014. More recently, Bloom et al. have argued that new ideas, and the attendant growth they precipitate, appear to be increasingly harder to find. Widespread fraud (made orders of magnitude easier by the rise of AI) has led to an epidemic of retracted peer-reviewed articles and questionable grant proposals, itself raising questions about the insularity of the academic peer-review process. In this milieu, where does the School of Medicine stand, what are our existing strengths, and how can we build on them to shape and claim our future?

Program:
5–5:30: Responding to Current Challenges and Highlighting Existing Excellences (William Schiemann, Grace McComsey and Mark Jackson)

5:30–6: Panel discussion (William Schiemann, Agata Exner, Andrew Pieper, Sudha Chakripani, Sandy Markowitz, Mark Jackson, Xin Qi, Fulai Jin and Grace McComsey)

6–6:30: Open conversation with the panelists on shaping our future

6:30–8: Reception

Conversation IV: Reimagining and Claiming Our Future

April 28, 2027

In this series, we have considered the current crisis in academic medicine which, as many have suggested, constitutes an existential threat to the entire endeavor, from training future doctors to conducting scientific research and providing complex patient care. We have also looked at how the School of Medicine is responding to this crisis, the particular excellences it can build on, and how we might shape our future. In this fourth and final Conversation of the 2026–2027 Academic Year, we will try to pull on the threads that have run through the first three sessions to weave together a tapestry that evinces the reimagined future that we will seek to claim.

Program:
5–5:45: Threads, Themes, and an Achievable Reimagined Future (Stan Gerson)

5:45–6:30: Open conversation with Stan Gerson and all previous panelists on reimagining and claiming our future 

6:30–8: Reception