Future prospects and strategies for academic medicine in Quebec.

Complete reorganization of the Quebec health and social services system, as envisaged by a new bill to be studied by the provincial government, is of major importance for the future of academic medicine since it includes all aspects of the training of health care professionals. While the bill aims to stimulate fundamental and applied research to the highest standards of academic medicine, its clearly stated spending limitations are a major concern to academic physicians. With the proposed centralization of all health care institutions, the role of medical schools and universities will be significantly diminished. Scientific programs of international standing and high levels of teaching and training of medical students and residents, on the other hand, can only be achieved with the development of appropriate structures. Effective prioritization, planning and representation of academic institutions must therefore be given as much consideration as the equally important functions of health care, teaching, and research. Programs oriented toward personnel support and the development of research centres and institutes should continue to be fostered. The future of academic medicine, particularly in its clinical components, is closely linked to the health care system. Academic physicians must become involved in the strategic planning of health care delivery since the development of academic medicine will otherwise not flourish.