Nurturing Passion in a Time of Academic Climate Change

Without passion man is a mere latent force and possibility, like the flint which awaits the shock of the iron before it can give forth its spark. Henri-Frederic Amiel, 1821–1881 For most physicians, medicine as a professional journey is driven by passion. Medical student essays speak passionately about healing the sick; comforting the bereaved; discovering new insights; and developing new paradigms for diagnosis, prognostic markers, and therapeutics. Academic health centers (AHCs) provide the home for this passion to be nurtured and honed among its trainees, and fueled among its faculty. However, in response to enormous pressures over the past 40 yr, ACHs have increasingly shifted the focus from faculty-relevant issues to strategic considerations about competitive market forces, reimbursement shortfalls, increasing regulatory oversight and compliance requirements, and extramural funding levels. As increasingly complex enterprises, AHCs have been slow to adjust with regard to revising promotion and tenure policies, establishing mentoring and faculty development programs, and creating bridge funding mechanisms, leaving relationships between academic leadership and faculty strained. Under the weight of all these forces, faculty passion and career satisfaction has steadily diminished, particularly among the most junior members. Recent reviews of academic medical faculty indicate that approximately 42% are seriously considering leaving academic medicine in the next 5 yr and that 40% reported that their career was not progressing satisfactorily (1). Career satisfaction is threatened by the lack of time for teaching, scholarship, and personal and professional self-renewal (2–6). In addition to the rapidly changing economic and regulatory environments, AHCs are also affected by the evolving social environment, in which generational differences define distinct approaches to career and family (7). By and large, department chairs and senior faculty are Baby Boomers. Born between 1945 and 1962, Boomers work hard out of loyalty, expect long-term employment, pay their “dues,” …