I will address the issue of preserving the essence of teaching at a busy research university.
Research can be all-consuming, clinical practice even more consuming.
Yet, many of our faculty do research, see patients, and teach. We must talk about and celebrate this experience more, acknowledge that it takes time, and insist that it be protected. Teaching is less tangible than research or clinical practice, and the end-points are not agreed upon, nor easily measured. Quality teaching takes immense amounts of time, far beyond the classroom. By its very nature, quality teaching is not efficient.