Academic medicine : journal of the Association of American Medical Colleges
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The author introduces questions about the commercialization of science, focusing on fairness and conflicts of interest, and suggests the bases for policy initiatives. First, is it fair for government-supported research to enrich research universities and individual scientists? The belief that it is unfair seems limited to biomedicine and is not shared by other fields and government research agencies. The main concerns, however, are conflicts of interest and of commitment (loss of objectivity, reordering of priorities, degradation of science as an open and collegial enterprise, conflicts of commitment, and exploitation of graduate students and postdoctoral fellows). The author outlines 11 principles that can be used in setting policies about conflict of interest and commitment, including the principles that these conflicts are inevitable, that technology transfer should be supported rather than hindered, that the type and amount of financial reward received by the faculty are not as important as the strings attached by the commercial sponsor, and that trainees must be protected from working in settings where they cannot discuss or promptly publish their work.
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Three distinguished academicians share their thoughts on tenure and its future in academic medicine. Paul J. Friedman, from the University of California, San Diego, School of Medicine, explains and defends tenure as practiced in medical schools. ⋯ Finally, Richard A. Cooper, from the Medical College of Wisconsin, states that tenure should not continue, because the purposes of tenure (e.g., ensuring freedom of expression; providing long-term financial security and stability) should be and can be accomplished in other ways for all faculty, not just tenured faculty. A different system is needed, one that respects the value of all faculty, that responds to their diverse objectives, is fiscally responsible, and fosters the continuing culture and vitality of medical schools.(ABSTRACT TRUNCATED AT 250 WORDS)
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A major impediment to the use of the objective structured clinical examination (OSCE) is that it is a labor-intensive and costly form of assessment. The cost of an OSCE is highly dependent on the particular model used, the extent to which hidden costs are reported, and the purpose of the examination. The authors detail hypothetical costs of running a four-hour OSCE for 120 medical students at one medical school. ⋯ These translate to per-student costs of $870 and $496. The cost of running an OSCE is high. However, the OSCE is uniquely capable of assessing many fundamental clinical skills that are presently not being assessed in a rigorous way in most medical schools.