Reversing the decline of academic medicine in Europe

Abstract

Medicine has never been a static profession. The ancient Greeks took medicine out of the realms of magic and gave it a scientifi c, ethical, and philosophical foundation, which continued into Roman times, lasting in all for about 500 years. With the death of Galen (199 AD) during the decline of the Roman Empire, the curtain came down on medical progress in Europe until the re-awakening of scientifi c thought almost 1300 years later. Arguably, it was the collapse of the schools of medicine and the consequent loss of community intelligence that was most important in this decline. During the past 200 years, the prestige of medicine and doctors has grown steadily, peaking in the latter part of the 20th century. Progress of clinical research during this time based on a two-way interaction between “bench and bedside” has been remarkable with developments in imaging techniques, molecular biology, genetics, and therapeutics. 1 However, over the past 20 years, medicine—academic medicine in particular—entered a period of uncertainty and decline which has begun at last to cause widespread alarm. 2–7