Background and Aim

Academic medicine is based on three interconnected missions: education, research and patient care. Increasing clinical demands, workforce shortages, administrative responsibilities and healthcare system changes raise concerns regarding the sustainability of this model. This study explored academic clinicians' perceptions of the sustainability of the triple mission and identified which component is perceived to be to be most vulnerable.

Materials and Methods

A cross-sectional survey was conducted among academic clinicians involved in teaching and clinical practice in Georgia. Following predefined inclusion criteria, 82 participants were included, of whom 54 (65.9%) were also engaged in research. Participants represented diverse medical specialties, career stages and age groups. The questionnaire evaluated perceptions of workload, triple mission sustainability, institutional support and the impact of professional responsibilities on education, research and patient care. Data were analyzed using descriptive statistics.

Results

Overall, 41.9% of participants agreed that balancing education, research and patient care has become increasingly difficult, while 58.1% were neutral or disagreed. Increased expectations toward academic clinicians were reported by 67.8% of respondents and 64.5% believed workforce shortages negatively affect academic medicine. Although 79.0% reported adequate institutional support for teaching and 82.2% believed they could provide the desired quality of education, only 29.0% reported sufficient time for research, and 24.2% were satisfied with their research productivity. Furthermore, 66.2% agreed that teaching and research improve patient care. Research was identified as the component under the greatest pressure by 50.0% of respondents, followed by patient care (38.7%) and education (11.3%).

Conclusions

Despite increasing professional pressures, academic clinicians perceive education and patient care as largely maintained, whereas research appears to be the most vulnerable component of the traditional academic medicine model. Institutional strategies protecting research time and strengthening the integration of education, research and patient care are essential to sustain academic medicine in times of uncertainty.