Happy centenary, Academic Medicine!

In 2026, Academic Medicine is celebrating its 100th year of excellence in publishing articles and other features to share ideas, knowledge, and wisdom vital to the efforts of the individuals who work and learn at medical schools and teaching hospitals. As we stand at the dawn of the journal’s second century, we have an opportunity to combine a reflective and critical look back at historical successes and lessons learned with a strategic and thoughtful look forward to the future of academic medicine. It is also an auspicious moment to reaffirm the critical role of 3 factors that have contributed to Academic Medicine’s effectiveness and will continue to be important to the journal’s evolution and progress in the years to come. This singular vantage point reveals, in my estimation, that in the last decade alone, medical schools and teaching hospitals, collectively, have generated advances in biomedical science that have revealed more about the human body than has been learned in all of history theretofore. These advances have enabled physicians, educated at these distinguished institutions, to do more for patients today than ever before, in every area of medicine. Progress has been nothing short of astounding, and there never has been a better time to pursue a career in medicine and/or biomedical science. Of course, this remarkable progress comes with formidable challenges. There is no question that economic uncertainty, reimbursement issues for patient care activities, changes in funding from federal agencies, reductions in state appropriations, and other challenges require inspired and innovative leadership to advance the missions of academic health centers. In addition, the best evidence available points to physician workforce shortages under a broad range of potential scenarios.1 Misinformation and disinformation hamper progress and add cost to the health care enterprise. And high levels of education debt leave many medical students with loans they will continue to pay well into middle age and that may influence career-related decisions during their professional journeys. But daunting challenges reveal new opportunities and can focus our attention on new ways to advance thinking and practice in medical schools and teaching hospitals. From its inaugural issue in 1926, this journal has played a key role in that endeavor, providing the academic medicine community with a central repository of scholarly articles, a platform for the exchange of ideas and the dissemination of best practices, and a shared knowledge base for discussing and debating the pressing issues of the day. In its early years, under the name Bulletin of the Association of American Medical Colleges, the journal’s focus was almost solely on medical education and medical school administration. To clearly identify its status as a scholarly publication, the journal’s name was changed in 1929 to Journal of the Association of American Medical Colleges and then in 1951 to Medical Education (for the January and March issues) and again to Journal of Medical Education (for the May and subsequent issues). (For more of this history, see Kanter.2) Over the ensuing decades, medical schools and teaching hospitals experienced significant growth, formalizing and codifying their relationships to establish academic health centers. Leaders at these institutions recognized that they were working in a new model of medical education, biomedical research, and patient care, and that management of the whole was more encompassing and more complex than the sum of managing each of the parts. As academic health centers evolved, so too did the journal, in both mission and name. The journal’s owner, the Association of American Medical Colleges (AAMC), made this announcement in its 1987-1988 annual report: Pushing the boundaries of knowledge is the core of the academic medical community’s mission. Research and resulting publications provide a forum for exploring and discussing new ideas necessary for the advancement of knowledge and the improvement of medical training. Over the past year, the Association undertook an extensive study and review of the AAMC’s peer-reviewed journal and concluded that an expanded journal could better serve the academic medical community. The inaugural issue of Academic Medicine—the reorganized, redesigned, and renamed Journal of Medical Education—will appear in January 1989. It will carry a broader range of articles and offer wider opportunities for authors. As the oldest English-language journal in medical education, Academic Medicine will continue to publish peer-reviewed articles on research in medical education. A large pool of specialist reviewers will critique all research submissions. For the first time, the journal will solicit articles on major policy issues affecting academic medicine to be written by leading medical educators, political scientists, economic and social researchers, and government leaders. Formal essays on controversial or sensitive issues in health care and medical training will promote discussion of these topics within the journal.3 In addition, on November 14, 1988, at the AAMC’s Council of Deans annual business meeting in Chicago, Illinois, medical school deans were informed that the “new AAMC Journal will appear in January, be handsome, interesting, lively, and wide-ranging in scope.”4 And so, in January 1989, the journal was published for the first time under its current appellation, Academic Medicine. In the years that have followed, the journal has acted as witness to and driver of innovations, developments, and advances in academic medicine. As it begins its journey into its second century, it is well-positioned to continue to pursue this role. The journal’s longevity and success are due to many factors. While it is beyond the scope of this editorial to present an exhaustive review, I would like to highlight 3 factors that were important to the journal’s growth and maturation in its first century and will be vital to its continued progress in the coming years. These factors, which guide and protect the journal, are editorial independence, strong publication ethics, and a robust peer-review process. Editorial independence ensures that journal editors have autonomy to make decisions about selecting, reviewing, and publishing submitted manuscripts. It is central to maintaining an environment in which scholarship can be advanced free of undue influence. Editorial independence is rooted in the fundamental notion that the scholar seeks truth, whereas the advocate seeks change. While the scholar’s work has the potential to inform and enrich advocacy, the advocate’s work has the potential to adversely and unduly influence scholarship.5,6 Recognizing this natural tension between scholarship and advocacy, the AAMC, as this journal’s owner, acknowledges, supports, and protects the journal’s editorial independence by maintaining a Journal Oversight Committee, which is responsible for supervising and evaluating the performance of the editor-in-chief. This approach maintains the integrity of the journal as a scholarly publication, keeps the journal at “arm’s length” from the AAMC, and fosters a healthy relationship between the association and the journal. Publication ethics comprises the policies and practices that promote the quality, validity, and credibility of the publication process. It encompasses the integrity of the research reported in a manuscript, the criteria for authorship, the disclosure of conflicts of interest, the conduct of the peer-review process, the approaches to correcting errors in papers, the use of artificial intelligence, and other concerns. Publication ethics must be dynamic and evolve with the times. Two notable developments for this journal were the establishment in 2009 of a policy requiring ethical approval for studies involving human participants7,8 and in 2023 of a policy on the use of artificial intelligence tools.9,10 In years hence, publication ethics will continue to evolve around issues such as the degree to which artificial intelligence may be used in the screening and evaluation of manuscripts, in the selection of peer reviewers, and even in making editorial decisions. Peer review in scholarly publishing is a time-tested and widely used process to evaluate the quality of a submitted manuscript. It includes the evaluation of the significance and relevance of the problem presented, the originality and importance of the work described, and the validity and soundness of the reasoning and arguments offered to the reader. In addition, peer review plays important roles in educating the reviewers themselves and in helping prepare the next generation of researchers and educators. The ways in which participation in the peer-review process strengthens reviewers’ knowledge and skills is an area that could benefit from further study. Occasionally, peer review has been criticized as time consuming for reviewers, costly for journals, and frustrating for authors, among other complaints.11 However, to date, no better alternative has emerged. To refashion a phrase12 from Winston Churchill: “[I]t has been said that [peer review] is the worst form of [evaluation] except all those other forms that have been tried from time to time.” In sum, for 100 years, this journal has been a trusted source of knowledge and wisdom for the individuals who work and learn at medical schools and teaching hospitals in the United States and around the world. Academic Medicine has served as a focal point for our community to discuss and debate the pressing issues of the day at academic health centers. It also provides an invaluable historical record of advances in thinking and progress at medical schools and teaching hospitals. As the journal enters its second century, it is well positioned to continue to be a witness to and a driver of innovation and progress. Thank you, Dear Reader, for being part of this extraordinary journey. Here’s to the next 100 years of discovery, learning, and excellence in academic medicine and Academic Medicine! S.L. Kanter is the former editor-in-chief of Academic Medicine. The opinions expressed in this editorial do not necessarily reflect the opinions of the AAMC or its members.