When money was plentiful, few medical schools worried about the constraints of tenure and the spiraling costs of faculty salaries. But those issues are being raised now with some urgency as the schools find their revenue sources in jeopardy. His group organized a special meeting on tenure and compensation at the Ritz-Carlton here last week, which attracted 232 academics representing 80 medical schools, as well as 18 lawyers.
Medical schools are an oddity in academe.
Unlike most academic units in a university, which live off tuition, grants, and appropriations, the country's 125 medical schools rely heavily on revenues from patient care. Their faculties, far larger and better paid than other university units, work under a bewildering array of job titles. Medical schools now face flat growth in financing for research, along with declining clinical revenues as a result of competition from managed-care companies. We don't have systems that recognize that we pay you such high salaries due to market forces, and if the market is going south, we need to adjust what we pay you. Although tenure was supposed to be on the table here, few of the 250 participants seemed to favor abolishing it outright.