Annals of Neurosciences, Vol 16, No 2 (2009)
Annals of Neurosciences, Volume 16, Number 2, April 2009
merit, seniority and science
Meritocracy, in practice, means the selection of the “bests and the brightest” for positions of power and authority, and is usually supposed to be independent of age. The antonyms for meritocracy are nepotism, favoritism, preferential treatment and privilege1. The opportunities for leading medical institutions in India are usually given to individuals based on considerations other than their personal merit. In India, “age” is usually synonymous with “wisdom”. Unfortunately, while experience and performance are important, nothing can really ensure that age will necessarily endow anyone with the skills required of becoming more productive or efficient to propel the country forward in a fast moving field of modern medical research. I am citing two articles from Iran and Greece to show that meritocracy is often the least (and last) important factor for consideration of appointment for academic and administrative heads for medical education and research2,3
Arguably, many academic leaders who lack the required merits or appropriate qualifications, to excel and tend to be conservative which needs to change if the country has to sustain momentum in medical research. Bikmoradi et al2 report that the criteria supporting academic leadership are usually relegated to politicization, informal groups, and external forces in Iran. Perhaps these factors pose limitations among academic leaders and create unpleasant experiences about utilizing their authorities. The advancement of field is seriously compromised when many young brains become hesistant to challenge a decision on distribution of funds or question established research policies and scientific paradigms for want of opportunities to influence decision making. To continue to develop life saving technology, save lives of millions of countrymen who suffer from dreaded diseases, the selection of individuals, irrespective of age, is must for accelerating the development of medical sciences.
Vardas3 observes that apart from the evident decline of the medical education and research as a whole, it is particularly disquieting to see the appointment of administrative leaders within the Greek health system, or even sometimes of university professors, with barely a nod to meritocracy. Often, the choices reflect political friendships, cliques and blocs, which are usually players in a variety of power games. While the relative depreciation of undergraduate studies and degrees is alarming, the failure to appoint the most competent individuals to leadership positions within the system can have potentially devastating medium and long-term consequences. To further complicate matters, the mediocre managers demonstrate day after day their inability to organize models for development, to adapt to modern competitive requirements or to inspire their juniors.
The Hedwig van Ameringen Executive Leadership in Academic Medicine® (ELAM®) Program for Women is an example of an in-depth program focused on preparing women for senior faculty positions as well as leadership positions where they have effectively initiated positive change in the United States. This program is supported and hosted by Drexel University4 which believes that an ideal candidate for the program should be one who
• has attained at least the rank of Associate Professor and has achieved significant administrative experience in personnel and budget matters, preferably both (e.g., Department Chair, Division or Section Chief)
• expresses a clear desire for attaining a leadership position
• embraces strategic risk-taking as part of her career path
• realistically assesses her leadership opportunities, both internal and external
• can expect advancement opportunities, either formal or informal, within her institution, apart from other criteria.
Unfortunately, in India, the above criteria are not defined while promoting or appointing academic administrators or policymakers. Another example of similar initiative is the Academic Administrator, Clinician Educator (AACE) Track5 that was developed as part of a movement towards promoting future academic leaders in clinical care, continuing education, and administration. As part of the application process, the candidate must propose an academic project (e.g., Quality Assurance activity, data-mining investigation, publication of clinical findings, or educational initiative/course/seminar). Such academic leadership programs are also offered globally through the Foundation for Advancement of International Medical Education and Research (FAIMER)6 that was incorporated as a nonprofit foundation of ECFMG (Educational Commission for Foreign Medical Graduates) in September 2000. FAIMER Regional Institutes are modeled on the FAIMER Institute curriculum. They include residential sessions, as well as distance learning sessions. Each participant is also required to propose and implement an education innovation project that is supported by the home institution. To date there are five Regional Institutes, three in India (at GS Medical College, Mumbai; CMC, Ludhiana and PSG IMS & R, Coimbatore), one in Brazil, and the Southern Africa Regional Institute, which began in February 2008. Therefore, it is high time that we overcome the inertia of past and make use of such innovative programs to change the rules used to select key individuals of our research infrastructure to ensure continuing advances in this important area. We cannot rely on foreign entities to fulfill this role, as these entities shall compete with India, not work in conjunction with us, to attain new results. India provides a wealth of opportunity in the arena of medical research as well as a huge patient base to explore innovative approaches. India offers intelligent investigators many of whom have set the example for progress working in other countries. Scientists from the US and other countries have found in India an environment that fosters excellence in identification of therapeutic advance, and India has become in 6 short years a major presence in the world stage of research innovation. Let us not relegate and confine our future advances to the input of investigators from other nations funded by industries and governmental entities that have an admirable agenda, but not an agenda that is directed at advance in our country; at minimizing the diseases and suffering our country’s population experiences; at propelling India functional and intellectual parity with the recognized leading nations in medical research. We are almost there. We possess the initiative, innate intelligence and imagination, population and freedom needed to arrive at this enviable position. We can attain the facilities; the personnel, the funds if we sustain the desire to achieve this goal independently, but only if we face brutal realities that change necessitates. Let us select our administrators after we assess their vision, their competence, their ambition rather than their age.
doi : 10.5214/ans.0972.7531.2009.160202
Suptendra Nath Sarbadhikari,
Editor Journal of Indian Health Informatics,
Department of Biomedical Informatics
PSG Institute of Medical Sciences and Research, Coimbatore 641 004, India
Email: supten@gmail.com
Co-op. Editor : Denis English, Ph.D
Senior Editor
References
1. Saleh JH, On Values and a caring Meritocracy for MIT. http://web.mit.edu/ fnl/volume/182/saleh.htm (August 11, 2009)
2. Bikmoradi A, Brommels M, Shoghli A, Sohrabi Z, Masiello I. Requirements for effective academic leadership in Iran: a nominal group technique exercise. http://www.biomedcentral.com/1472-6920/8/24 BMC Med Educ. 2008; 8:24
3. Vardas PE. The ant, the grasshopper, and meritocracy: where has Aesop’s fable gone wrong? http://www.hellenicjcardiol.org/archive/ fulltext/ 2007/4/2007_4_251.pdf Hellenic J Cardiol. 2007; 48(4): 251
4. Drexel University College of Medicine, Candidate Selection Criteria: http://www.drexelmed.edu/Home/OtherPrograms/ExecutiveLeadershipinAcadem icMedicine/ApplicationProcess/SelectionCriteria.aspx (August 12, 2009)
5. Department of Psychiatry, University of Pittsburgh School of Medicine, Clinical Educator and Academic Administrator Training during Residency - AACE Track: http://www.wpic.pitt.edu/education/residency_training/AACE_TRACK.htm (August 12, 2009)
6. FAIMER Regional Initiatives: http://www.faimer.org/education/regional.html (August 12, 2009)
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