“Tradition” comes from the Latin word tradere, meaning to “transmit” or “hand over.” In contrast, the word “academia” is derived from the Latin phrase acadēmīa (Greek: Ἀκαδημία or Akadēmía), which refers to Plato’s “Academy” – a school residing by olive trees where teachers and learners gathered to educate each other and share knowledge through undefined curricula of readings, lectures, debates, and discussions. “Traditional academia,” then, etymologically describes the passing down of knowledge through similar methods done by our ancestors. In academic medicine, this tradition has remained centered around physician-pupil relationships (even since medicine’s earliest days), but the appearance of this relationship and, consequentially, the delivery of academic practices and patient care have been continually changing for thousands of years.
Over the last half-century, traditional academic practices in Western civilizations (like the United States) and the morphology of the physician-pupil relationship have been largely focused on three educational methodologies. First, attending live “didactics,” where pupils (whether medical students, residents, or fellows) step away from clinical obligations during dedicated, protected periods to physically congregate in designated rooms. Here, they gather alongside their mentors or guest speakers (e.g., invited faculty from a different university) to engage in a series of weekly readings, lectures, debates, or discussions reminiscent of Plato’s “Academy.” Second, exploring print textbooks or journal articles, which many consider to be gold standards of medical information synthesis since physician peers frequently scrutinize these resources to ensure accuracy, validity, and appropriateness. Third, and finally, meeting at national academic conferences, where physicians and pupils from institutions throughout the country (or world) flock together for shared collegiality and commonplace.
For many physicians, particularly those who have been in practice for the greater half of their lifetimes, these educational methods have summarized their core academic means of pruning and refining their pupils for lives as fully independent faculty colleagues after training. However, since the turn of the 21st century, (1) advancements in technology (including the Internet, smartphone applications, and artificial intelligence), (2) mediosocioeconomic climate shifts (i.e., rising physician shortages, inequitable public access to quality and affordable health care, and increased costs of medical education and living without adequately adjusted pay), and (3) transitioning viewpoints of younger generations of pupils regarding lifework balance have all challenged the delivery of these decades- and centuries-long “traditional” academic practices. Systemic flaws in traditional academia have continued to accumulate without prompt response or resolution by policymakers or academic leadership, resulting in generational and cultural discordance toward how medical education, physician-pupil relationships, and, ultimately, patient care should be carried out.
In reality, many live lectures are boring and lengthy, numerous textbooks and journal articles are cumbersome and costly to explore, and national academic conferences often become subpar networking opportunities for pupils 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 because of social distancing restrictions brought on by the coronavirus-2019 pandemic, these flaws were spotlighted – they could not be hidden or masked any longer. Medical educators and education programs worldwide were forced to adapt and implore innovative virtual, remote strategies to maintain physician-pupil relationships and a sense of academia. Thus, (1) live lectures were moved to remote broadcasting sites like Zoom or Microsoft Teams, (2) educators created video recordings and supplied them to learners for independent study, (3) an influx of free online textbook-style web pages and resource guides were created to improve worldwide accessibility to medical knowledge, and (4) physician-pupil networking previously performed largely at national academic conferences was increasingly supplemented by flexible, online communication applications like social media.
Now with the widespread return to in-person activities after the conclusion of this pandemic, we as an academic medical community find ourselves at a critical inflection point. Either resume back to the “way things were” before the pandemic – and, with this, re-normalize “traditional” academia – or use lessons learned from our years of social isolation and technological improvements during this pandemic to make medical education conducive to the modern demands of 21st-century health care and beyond. I, like many, favor the latter: we need to redefine academic medicine since the “traditional” academia of the former has had its day. The time has come to move the delivery of medical education forward to ensure mainstreamed medical knowledge creation and dissemination, physician-pupil relationships, and patient-centered care permanently.
You see, “traditional” academia is not dying; it’s evolving.
Today, we can pick up our smartphones at any time, log onto popular social media applications like “X” (formerly Twitter), and, in seconds, post, like, and share bits of medical knowledge with any physician or pupil in the world for free. Others can engage with these posts and share relevant literature, their experiences, or additional thoughts in reply in real-time. If we have invigorating ideas that we want to pursue and publish, we can consult our peers online, via email, or using chat-based applications like WhatsApp (of Meta) for transparent and fast review without needing to wait months or years to advance medical knowledge. If we are stuck on challenging cases and in the middle of busy clinics or hospital schedules, we can go on our smartphones or laptops and quickly peruse reliable medical web pages to get answers to questions we need fast without sacrificing vital time necessary for superior patient care. We can even remotely attend sensational academic conferences or participate in lively, virtual didactics and still be at home without needing to be away from our families or personal needs longer than we already do as physicians (and pupils).
All of these practices can be maintained and blended with prior “traditions.” We can implore the best of both worlds in today’s academia of improved time and cost flexibility that comes with virtual means and continued human bonding that comes with in-person activities. New, innovative traditions can be strengthened, made more enjoyable, and conducive to what pupils need now to be successful in their careers while having the information they continually need available to do so. Physicians, and the entire establishment of medical education, cannot keep pace with how fast knowledge is expanding. Physician burnout has become a public health emergency and affects all generations; pupils continue to face significant rates of maladaptive mental health crises related to job stress and pressures to be successful with less financial support, and patients throughout the world continue to suffer because we as an academic medical community – like all of humankind – continue to resist this evolution because of uncomfortable feelings or biases.
Academia can be both exhilarating and affordable, taxing and efficient, and bendable and firm, all at the same time. Physicians and pupils worldwide need to mutually come together within their respective institutions and online communities and meet each other halfway now to improve medical education’s future. Excuses no longer exist or can be made an option. Our patients and future generations of pupils need this now more than ever. Just as was done during the times of Plato’s “Academy” and throughout the thousands of years afterward, we must continue the evolution of academia. New traditions are upon us; let’s embrace them.
Casey Paul Schukow is a pathology resident.
