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An academic medical center (AMC) is an organization whose mission encompasses emphases on clinical care, research, and education. Typically, it includes the following elements: an accredited medical school, one or more affiliated hospitals in which a majority of the medical staff are physician-faculty members, hospital admissions that are primarily made by physician-faculty members, and an affiliated faculty practice plan that is tax-exempt under federal law or is part of an exempt organization under an umbrella designation.

Background

The modern structure of the AMC has its roots in the highly critical Flexner Report of 1910, which criticized medical education for its lack of an evidence-based approach and paved the way for the modern, more allopathic approach. There was also a concomitant migration from the “commercial” medical school of the time to formalized programs of medical education. Subsequently, the medical education model was characterized by an academic venue, staffed by scientifically rooted faculty practicing in an associated teaching hospital. The ensuing leap in the caliber of medical education has seen highly complex organizational models and intricate connectivity through the multifaceted mission that characterizes today's academic medical centers.

Distinguishing Features

AMCs are differentiated from public health systems, community hospitals, and safety net healthcare complexes in large measure due to distinct characteristics that came about with the advent of the AMC model of the 20th century. Additional distinguishing features, combined with the multifaceted mission of the AMC organization, go well beyond the purely academic elements that serve to differentiate AMC. These include the following.

Technology

AMCs are on front lines of emerging technology. They are the environment in which new clinical treatment methods and scientific advances are typically developed. The nature of translational research efforts and the setting in which tertiary and quaternary care is delivered embolden providers to make critical advancements in care; as such, AMCs are the setting where these advances can most efficiently occur. These advances take many forms, including new device development and testing, as well as diagnostic and treatment protocols and surgical techniques. With the scientific rigor and evidence-based discipline present in this setting, promising clinical developments occur. An example is the discovery of the prostate-specific antigen (PSA), which led to a test that helps detect prostate cancer in men of age 50 and older. AMCs also often curtail the introduction of techniques that are unsafe or lack efficacy. One such example is the Jarvik artificial heart, which was banned when practitioners found that most of the recipients could not live more than half a year.

Prestige

The output of AMCs significantly contributes to the United States' international presence and prestige. Healthcare is often a source of national pride and economic benefit; thus, advances in science and medicine represent a significant portion of a nation's economic and political agenda.

Physician Scientists

AMCs are essential to the development of the United States' base of young scientists. Federally funded programs such as the National Science Foundation's Science, Technology, Engineering and Mathematics (STEM) program leverage AMCs to encourage the study of science, making these centers important settings for training physician scientists.

Preparedness

Along with federal and local government agencies, AMCs play an integral role in the United States' preparedness infrastructure for national emergency and terrorism response. Routinely seen as the tertiary- and quaternary-care centers for the country in the event of any number of national health scenarios (e.g., terrorism attacks, epidemics, bioscientific responses), AMCs play key roles in drill scenarios. Without the involvement of AMCs, the nation's response armamentarium would be substantially less robust.

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