Academic Medicine: The reason we are still working.

It's the joy we get, not money.

Teaching has been one of the noblest professions in human history. Teaching medicine, a sacred calling, is much more than a profession. It is a way of life, a commitment to transmit lifesaving knowledge and skills, a desire to make difference in lives of countless students, and a responsibility to keep learning throughout one’s life. But this is a road not easy to travel, especially in countries like Pakistan. Academic faculty is highly underpaid, heavily scrutinized, and often blamed for administrative shortcomings and blunders. So, what keeps academic medicine folks motivated?

There is no doubt that even in developed parts of the world, for example in the USA and Europe, compensation in academic medicine is less as compared to private practice. However, that comparatively low compensation is still enough for someone to raise a family of four, live a decent quality life and end up with handsome savings. Of course there is no upper limit of money one can earn, but, one does not have to do any other job apart from teaching medicine to give a reasonable and respectable life to one’s children. The situation is opposite, here in Pakistan. I am fortunate that I trained in USA, worked there for few years before returning to homeland and joining academic medicine here. I have some financial cushion, but most of my colleagues at my stage of career don’t.

Most of my colleagues wake up early morning, around 6 a.m., get ready for the hospital to teach and serve till 2 p.m., go to another hospital to see their private patients in the afternoon, go to another hospital in the evening to attend to few more private patients, and return home after 10 p.m. By the time they reach home, their kids are already asleep. Sunday is the day when they get to spend some time with their families. However, some would travel out of city to nearby smaller towns to see patients on Sunday. There is no easy path for them. If they don’t work like this, they cannot feed their families and maintain a reasonable social status expected of a doctor.

Monetary compensation aside, academic faculty is often blamed for incompetencies and misadventures of health policy makers. Academic departments are understaffed, overburdened, and lacking necessary infrastructure for effective functioning. Yet, they are expected to give results just like USA and Europe. Bureaucratic micromanagement and political interference have paralyzed institutions and demoralized hard working doctors. Status quo have engulfed most places, and authority has been placed with favorites who are not only incompetent but also self-serving.

So currently, given above circumstances and ground realities, what is the source of motivation for someone working in academic medicine? Just yesterday, I was teaching 3^rd year medical students in the ward. They had prepared a case history. We went over the case, analyzed all the details of history, examination and laboratory investigations. They made a preliminary diagnosis and were so excited to know that the diagnosis they made was correct after I showed them final CT scan report. Their faces were full of joy and accomplishment ---they had learnt something new—and I was both happy and humbled just like the parents whose child has taken a first step. I was full of joy too. This joy cannot be measured in terms of money or any form of compensation. Most of my colleagues are in academic medicine because they enjoy teaching medicine, it gives them a purpose in life and a meaning to their souls.