Changing the Culture of Academic Medicine

In an era where the well-being of our medical educators and researchers is crucial together with their scholarly and clinical contributions, the current landscape within U.S. medical schools reflects a need for urgent change. The National Initiative on Gender, Culture & Leadership in Medicine (C-Change) confronts this challenge head-on, striving to enhance the culture of academic medicine and foster a collaborative and trustworthy environment for its faculty, leadership, and physicians in training.

Faculty physicians and scientists in U.S. medical schools hold a multitude of leading roles in American health care by educating physicians, driving and applying research in biomedical and behavioral sciences, and providing sophisticated clinical care for patients, often to underserved groups. As such, faculty physicians and scientists are a critical resource and a national investment that must function optimally.

Several studies of faculty in academic medicine report 40% burnout and high levels of dissatisfaction, attrition, and unethical behavior in research.

In response to this, the National Initiative on Gender, Culture & Leadership in Medicine (C-Change) designed the Learning Action Network (LAN), a geographically diverse and representative five-medical school consortium that aimed to change the organizational culture of academic medicine through dialogue and leadership.

The C-Change Faculty Survey (CFS) is an instrument developed to assess the organizational culture in medical schools and academic health centers. C-Change fielded the CFS to a stratified random sample of faculty in 26 representative U.S. medical schools. With this rich dataset, C-Change’s research team collaborated on multiple published studies that revealed serious fissures in academic medicine including feelings of moral distress at work, low vitality, lackluster mentoring, and poor institutional support.

The validated CFS has been refined over time, adding several new measures and adapting it to assess the learning environment for residents and medical students. The validated CFS has been used successfully in dozens of studies in U.S. medical schools as well as internationally, and was selected by the NIH to be a primary evaluation tool for the 19 institutions receiving Faculty Institutional Recruitment for Sustainable Transformation (FIRST) awards.