It's report card time again

The author, the outgoing president of the AAMC, presents report cards on how the academic medicine enterprise is faring today and how it may fare in the year 2000 by assigning grades to four spheres of activity: Manpower gets a D today, for the following reasons: (1) There are still far too many specialists and too few primary care physicians, and the problem may be worsening; (2) the proportion of underrepresented minorities is still too low in medical schools and the physician workforce, but there are encouraging signs that this problem may be lessening, thanks to schools' efforts to fulfill the mandate of the AAMC's Project 3000 by 2000; (3) student indebtedness is increasing, a situation that affects some students' choices of specialties. By the year 2000, the grade for manpower will rise to a C, since most Americans will have access to care, and there will be some--but not dramatic--improvement in the generalist-specialist balance. Effectiveness of medical school faculties gets a C today, mainly because although faculties have grown with no corresponding increase in students, there has been no significant increase in time or effort devoted to teaching. By the year 2000, the faculty grade will rise to a B, since the faculty will be leaner and may teach better, tenure will have become rare, especially in clinical departments, and faculty practice activities will not usurp academic activities to the extent they do today. Research gets a B+ today for solid accomplishments in the face of major constraints.(ABSTRACT TRUNCATED AT 250 WORDS)