I wonder if what I’ve noticed happening to the faculty of United States medical schools applies equally to other segments of the “research university.” Put simply, we are creating two faculties: one devoted to bringing in research grants and publishing as many papers as possible, and the other relegated to handling the teaching load. The separation is not complete, but it is rapidly becoming so, and the vigor of the latter group is not increasing. Many professors will retire in the next decade or so. And when this happens, replacements of quality and dedication will be tough to find as their mission becomes even less prestigious.

Many academic health centers have become increasingly concerned more with their rank in the institutional hierarchy of federal or foundation dollars gained than with the quality of education provided. In medical schools, an additional and more recent ingredient is involved—and indeed is essential for...

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