“Tradition” comes from the Latin word tradere, meaning “to transmit” or “to hand over.” The word “academia,” on the other hand, is derived from the Latin phrase acadēmīa (Greek: Ἀκαδημία or Akadēmía), which refers to Plato’s “Academy”—a school established among olive trees where teachers and students would gather to teach one another and share knowledge through undefined curricula of lectures, readings, debates, and discussions. “Traditional academia,” then, etymologically describes the passing on of knowledge through similar methods used by our ancestors. In academic medicine, this tradition has remained centered around physician-student relationships (even since the earliest days of medicine), but the manifestation of this relationship and, consequently, the delivery of academic practice and patient care have continually changed over thousands of years.
Over the past half century, traditional academic practices in Western civilizations (such as the United States) and the morphology of the physician-student relationship have largely focused on three educational methodologies. First, attending live “didactics,” in which students (whether medical students, residents, or fellows) step away from clinical obligations during special, protected periods to physically assemble in designated spaces. Here, they gather with their mentors or guest speakers (e.g., invited faculty from another university) to participate in a series of weekly lectures, talks, debates, or discussions reminiscent of Plato’s “Academy.” Second, exploring printed textbooks or journal articles, which are considered by many to be the gold standards for medical information synthesis, as fellow physicians regularly examine these sources to ensure accuracy, validity, and appropriateness. Third, and finally, meeting at national academic conferences, where physicians and students from institutions across the country (or the world) come together for shared collegiality and ordinariness.
For many physicians, particularly those who have spent most of their lives in practice, these teaching methods have recapitulated their primary academic tools for pruning and refining their students for life as fully independent faculty colleagues after training. Since the turn of the 21st century, however, (1) technological advances (including the Internet, smartphone applications, and artificial intelligence), (2) mid-socioeconomic climate shifts (i.e., increasing physician shortages, unequal public access to quality and affordable health care, and increased costs of medical education and living without adequate compensation), and (3) changing perspectives of younger generations of students regarding work-life balance have all called into question the delivery of these decades- and centuries-old “traditional” academic practices. Systemic flaws in traditional academia have continued to accumulate without rapid response or resolution by policymakers or academic leadership, resulting in generational and cultural disagreements over how medical education, physician-student relationships, and ultimately patient care should be conducted.
In reality, many live lectures are boring and long-winded, numerous textbooks and journal articles are cumbersome and expensive to study, and national academic conferences often become substandard networking opportunities for students due to financial and political barriers (i.e., expensive to attend or present at, not conducive to professional development and career advancement). When in-person activities were largely halted due to social distancing restrictions caused by the coronavirus disease 2019 pandemic, these deficiencies were highlighted—they could no longer be hidden or masked. Medical educators and educational programs worldwide were forced to adapt and implore innovative virtual, remote-focused strategies to preserve physician-student relationships and a sense of academia. For example, (1) live lectures were moved to external broadcast sites such as Zoom or Microsoft Teams, (2) instructors recorded videos and made them available to students for self-study, (3) an influx of free online textbook-style web pages and resource guides was created to improve global accessibility of medical knowledge, and (4) physician-student networking, previously primarily conducted at national academic conferences, was increasingly supplemented with flexible, online communication applications such as social media.
With the widespread return to in-person activities following the end of this pandemic, we as an academic medical community are at a critical tipping point. Either we return to the “way it was” before the pandemic—and in the process normalize “traditional” academia—or we use the lessons learned from our years of social isolation and technological advancements during this pandemic to adapt medical education to the modern demands of healthcare in the 21st century and beyond. I, like many, advocate the latter: we must redefine academic medicine, as the “traditional” academia of the former has had its day. It is time to advance the delivery of medical education to ensure mainstreamed medical knowledge creation and dissemination, physician-student relationships, and patient-centered care on a permanent basis.
You see, ‘traditional’ academia is not dying; it is evolving.
Today, at any time, we can pick up our smartphones, log into popular social media applications such as “X” (formerly Twitter) and post, like and share bits of medical knowledge with any physician or student in the world for free in seconds. Others can comment on these posts and share relevant literature, their experiences or additional thoughts in response in real time. If we have exciting ideas that we want to pursue and publish, we can consult with our colleagues online, via email or using chat-based applications such as WhatsApp (by Meta) for transparent and rapid review without having to wait months or years to advance medical knowledge. If we are stuck with challenging cases and in the midst of busy clinic or hospital schedules, we can quickly scan reliable medical web pages on our smartphones or laptops to get quick answers to the questions we need without sacrificing vital time required for superior patient care. We can even attend sensational academic conferences or participate in lively virtual didactics remotely and still be at home without having to be away from our families or personal needs any longer than we already are as physicians (and students).
All of these practices can be maintained and blended with previous “traditions.” We can invoke the best of both worlds in today’s academic world of increased time and cost flexibility that comes with virtual resources and the constant human connection that comes with in-person activities. New, innovative traditions can be enhanced, made more fun, and conducive to what students now need to be successful in their careers, while having the information they need continuously available to do so. Physicians and the entire institution of medical education cannot keep up with the rapid expansion of knowledge. Physician burnout has become a public health emergency that affects all generations; students continue to face significant rates of maladaptive mental health crises related to work stress and pressure to succeed with less financial support; and patients around the world continue to suffer because we as an academic medical community—like all of humanity—continue to resist this evolution due to uncomfortable feelings or biases.
The academy can be both exciting and affordable, taxing and efficient, and flexible and robust, all at once. Physicians and students everywhere must now come together within their respective institutions and online communities and meet each other halfway to improve the future of medical education. Excuses no longer exist or can become an option. Our patients and future generations of students need this now more than ever. Just as in the time of Plato’s “Academy” and for thousands of years to come, we must continue the evolution of the academy. New traditions are here; let us embrace them.
Casey Paul Schukow is a pathology resident.
