Between Scylla and Charybdis: a Primer for Navigating a Department of Psychiatry in the Increasingly Complex Waters of Academic Medicine
Academic Medical Centers sit at the cross-roads of two of the most complex systems in the USA: the health care enterprise and the system of higher education . In the past 70 years, the organizational dynamics and organizational structure required to fulfill the mission of a college of medicine to educate students in the health sciences and to produce scholarship to improve health has grown increasingly complicated . Why is this? At most universities, the financial support of the research and education missions of the college of medicine is highly dependent on both the revenue and the training opportunities from the clinical settings of the clinical enterprise. Of 141 accredited medical schools, 43% of the revenue in FY18 was generated by the practice plan, 20% by the hospital, with 21% from grants and contracts, 4% from government and parent-institution support, 4% from tuition and fees, and 8% from other revenue including gifts, endowments, and miscellaneous sources . Even...
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