WHITCOMB, MICHAEL E. MD
At our February editorial board meetings, the members of the editorial board suggested that I set forth in an upcoming editorial my views on the journal's purpose, so that current and future readers and those who may consider submitting manuscripts would better understand the rationale that governs decisions regarding the content of each month's issue. Given that the journal's content should reflect the journal's purpose, I agreed that it would be worthwhile to put my views in print.
I think the purpose of a biomedical journal can be inferred by determining whom the journal intends to serve — that is, who makes up the journal's primary target audience. For most biomedical journals, the primary target audience is composed of individuals who share a common interest in some realm of science or clinical medicine. To a very great extent, those who submit manuscripts to a journal tend to be members of the same scientific or clinical community served by the journal. By publishing in that journal, they are able to describe the results of their scholarly work to professional colleagues, both in this country and abroad. By disseminating this information, the journal allows its usual readers — its target audience — to stay abreast of developments in their disciplines. In this way, most biomedical journals serve the purpose of advancing a particular realm of science or clinical medicine.
Academic Medicine differs in an important way from most journals in that it attempts to serve two somewhat distinct, but clearly related, target audiences. On the one hand, the journal seeks to serve individuals who hold leadership positions in academic medicine's institutions — medical schools and teaching hospitals. By publishing articles on such topics as mission-based management, improving medical care quality, gene patenting, and many others, the journal enhances the likelihood that the goals these leaders have established for their institutions' patient care, teaching, and research programs will be achieved. In addition, the journal provides an opportunity for them to share with their colleagues in other institutions how they have gone about accomplishing those goals. On the other hand, the journal also serves the members of the medical education community, primarily by allowing those individuals to share with others the results of their scholarly work: medical education research or innovative approaches to the design or conduct of educational experiences. In doing so, the journal disseminates information that contributes ultimately to improving the education of doctors.
Does it make sense for Academic Medicine to strive to serve these two somewhat distinct audiences? Would the journal be more effective if it tried to serve only the medical education community? From 1951 through 1988, the AAMC's journal, then called The Journal of Medical Education, did serve only the medical education community. When in 1989 the journal's name was changed and its focus was broadened, many in the medical education community felt that the change had been made at their expense, because publishing articles of interest to the leadership of academic medicine left less space for medical education articles. As they pointed out then and continue to point out now, articles addressing important issues facing academic medicine are published on occasion in a number of other journals. But, of course, medical education articles are also published in other journals, some of which are entirely devoted to medical education. What Academic Medicine does uniquely is not only to allow members of each community (leadership and educators) to communicate with each other (leader to leader and educator to educator), but also and more important to allow both communities to communicate with and learn from each other.
For example, the journal serves the purpose of improving the quality of medical education not only by having medical educators describe the results of their work to other members of the medical education community, but also by bringing their work to the attention of the leadership of academic medicine's institutions. Because medical education is the core mission of medical schools and teaching hospitals, the leaders of those institutions need to be aware of the work being conducted by the community of medical educators. This is critically important because the implementation of medical education innovations depends on the management decisions made by individuals holding leadership positions. Similarly, the journal exposes members of the medical education community to the challenging issues facing the leaders of medical schools and teaching hospitals. This is helpful because those interested in improving the design and conduct of medical education programs should be aware of the opportunities and constraints that may govern how their scholarly work can be converted to practical ends in the medical schools and teaching hospitals within which they work.
Because we believe the journal serves an important purpose, we are committed to trying to make the journal more visible to potential readers within the academic medicine community. We feel that this is important, because we know that many medical educators, particularly clinical educators (clerkship directors and residency program directors) and many holding leadership positions in medical schools and teaching hospitals, are not regular readers of the journal. At the same time, we want to try to make articles published in the journal much more accessible than they have been in the past to those seeking information about issues related to academic medicine. Our goal is to make the journal more effective than it has been in achieving its traditional purpose of improving the quality of medical education, while at the same time enhancing the ability of medical schools and teaching hospitals to achieve the goals they have set for their patient care, teaching, and research programs. I hope that all who would like to contribute to these efforts, including those who are not members of the leadership or medical education communities, will consider publishing their work in Academic Medicine.