I talk a lot about practicing in an academic medical setting but have not spent much time explaining what that actually means…

What exactly is academic medicine? 

This area of medicine combines teaching, research and treating patients. It typically occurs at centers that are associated with a medical school and/or university. There are both advantages and annoyances that come with academic medicine.

But before we dig into these I want to share a little story… 

Despite not growing up in a medical family and surrounded by the corn and soybean field part of Illinois, I grew up obtaining nearly all my medical care within academic medicine. 

How? 

In the early 1970s, the University of Illinois College of Medicine established a campus in Rockford. Our family’s long time pediatrician who cared for my mom and her 5 siblings through the 50’s and 60’s transitioned his practice to teaching at the medical school by the time my sister and I arrived in the mid 80’s. 

As we grew a bit older, we transitioned to a University-run clinic that was established in our small town. It was staffed by medical students under the direct supervision of attending physicians and exposed my sister and I to the possibilities that a career in medicine may hold. 

So what are the top 3 advantages available (and annoyances) at academic medical centers? 

1. All the people!

Typically at an academic center, you will encounter team-based care. The physicians may consist of medical students, residents, fellows, and the attending (supervising) physician in addition to the bedside or clinic based nurses and medical assistants. Additionally you may encounter clinical pharmacists, nurse practitioners, physician assistants, dieticians, therapists, social workers and research coordinators. 

Yes, this is A LOT of people but they are also working in coordination in your care.  Vast majority of physicians that are in academic medicine choose to be here and in large part accept significantly lower pay than in private practice because we love the academic environment.    

What does this mean? It means, you may be telling your story over and over again. As the medical trainees run your story by the supervising physician, you may find your appointments take longer.  That said, you may end up with more face to face time with someone who can listen directly to your story and be less rushed. 

2. Access to the latest and greatest treatments, facilities and research opportunities.

One of the biggest advantages to those with rare conditions or very serious conditions is having the ability to obtain care that is cutting edge. In part due to its rigorous nature and need for safety and ethical considerations, medical research can be notoriously slow. If you have a life threatening cancer or similar condition, you may not have the time to wait for some of the cutting edge options to make it to your local medical center or hospital.  Academic centers are often where research studies are conducted if you have exhausted conventional treatments. 

But…

Because building and maintaining these facilities costs an immense amount of money, they are not easily accessible to everyone. Many will require significant travel which can add up quickly when you need to consider lodging, food and parking. Many centers will have programs in place to help patients with some of these expenses so I recommend reaching out to their patient assistance departments to find out about discounts and other programs that may help defray the additional costs.  

3. One stop integrated shop.

Most larger academic centers will have nearly every specialty and program one can imagine. This can be incredibly helpful for patients with complex conditions that affect multiple organ systems- especially those with inflammatory and autoimmune conditions. With the advent of electronic medical records, this also facilitates communication between various departments that may be housed in different areas of the medical center. Additionally, some centers are known for multidisciplinary clinics that cater to specific diseases. For instance, Ohio State University has a clinic that focuses on vasculitis, blood vessel inflammation. More often than not, autoimmune in nature, vasculitis can affect the lungs, kidney and other areas of the body so coordinating care with specialized pulmonologists, nephrologists and rheumatologists makes a lot of sense. 

All these people and clinics add up to one giant system that can be immense and incredibly intimidating. I will never forget my first few months working at Ohio State and Nationwide Children’s Hospitals as an intern- there were so many people to meet, so many different locations and it was A LOT. I couldn’t imagine arriving there in pain, worried or confused as a patient. That said, great signage and friendly staff and volunteers always did their best to help guide patients, visitors and new employees to their intended destinations.