Last weekend, the President and CEO of the American Association of Medical Colleges (AAMC), David Skorton, MD, addressed over 4,200 leaders in academic medicine on the “four things that keep me up at night.” These include structural and cultural inequities in academic medicine, deteriorating student wellbeing, external threats to the doctor-patient relationship, and a lack of mutual respect. On these challenges, Skorton called for collective action. “The health and mental well-being of our communities and our colleagues are at stake. Through meaningful, open, and honest dialogue, partnership, and collective action, we can and will tackle these problems in service of the greater public good,” he said. Below, we summarize his concerns.
Diversity, equity, and inclusion and anti-racism. Within academic medicine, Skorton noted that this work includes diversifying medical schools’ student populations, faculty, and staff. It also goes further. Each academic institution should review their culture to ensure that the climate supports every student with the “opportunity to excel.”
Student well-being and mental health. Skorton notes that medical students show higher rates of depression and risk of suicide than their age-matched peer populations, and that the comparisons have worsened in recent years. He encouraged academic leaders to prioritize the mental health and wellbeing of students by understanding their existing stressors (financial, academic, and social) and reducing them, as possible. Medical school faculty and staff should also ensure that they make mental health and wellbeing resources accessible to students.
External threats to the doctor-patient relationship. While not speaking to abortion rights specifically, Skorton spoke to the more generalized threat that legislation and/or judicial opinions can impose on a physician’s ability to exercise clinical judgment in partnership with the patient. He encouraged leaders to “stand firm” against such external action in order to protect the doctor-patient relationship.
Humility and mutual respect. While Skorton emphatically noted that physicians are duty-bound to speak out against racism or hate speech, he called for greater mutual respect. He noted that leaders in academic medicine should show humility in their interactions and discourse, and called for physicians to model using an open-mind and empathy in encounters with those holding differing viewpoints or conflicting ideologies.