Author response: The state of academic neurology departments in the United States, 2016: A national survey.

Abstract

Dr. Meador highlights a growing national problem, which the data in my editorial1 only briefly touched upon: How can the academic missions of teaching and research be adequately met when the clinical workload of our evolving system has grown to monopolize the vast majority of faculty effort? Dedicated academic funding to support student and resident education is used in some institutions, but is often insufficient to cover faculty effort. Research has become ever more dependent on large and uninterrupted grant support for individual researchers, with NIH funding (and its attached larger indirect cost support funds) becoming the mark of success and often the absolute requirement for career survival at many institutions. The health care revolution radically cut clinical reimbursement (a former source of support to all academic missions); in the future, medical education will likely be radically altered to reduce cost and the research enterprise will likely become even more of an “eat-what-you-kill” endeavor. Academic leaders and faculty should start to deeply engage with their own institutions, government, and national organizations to make their voices heard and to secure a seat at the table to help guide how this new order is structured.