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www.thelancet.com Vol 384 July 12, 2014 117

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Offl ine: Why medicine is killing our universitiesThe refusal of Britain’s leading universities to take part in an international assessment of their performance was reported last week in the Financial Times (“Top universities snub OECD ranking”, July 2). AHELO, or the Assessment of Higher Education Learning Outcomes, hopes to discover reliable metrics that institutions can use to track their strengths and weaknesses. What is worth noting is not the isolationist position of Britain’s foremost universities. What raises an eyebrow is that the report appeared in a newspaper that sees its main role as off ering “unparalleled business coverage”. Moreover, the assessment is not being conducted by an educational institution (eg, UNESCO), but by an organisation concerned with policies to improve the economic wellbeing of nations. The fact is that today our world-class universities are classifi ed as instruments of wealth creation, not institutions for knowledge, enlightenment, or cultural engagement. Universities have not only lost their purpose. They have also lost their soul. And medicine is partly to blame.

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Take one university as an example. It is a great university. The academic faculty is second to none. The students are some of the best in the country. The forces that shape this university are no diff erent to those that shape all global universities today. But those forces are eroding values that have taken centuries to create and refi ne. An insight into what counts for universities today comes from papers circulated to the governing body of this institution. Each packet begins with a set of headlines from the Vice-Chancellor: his judgments about what matters to the university he runs. In the latest collection, he begins with the position of the university in several infl uential league tables. Is the university higher or lower than its competitors? Are its measures of employability good or bad? Next comes the university’s record on women. After that, awards, a national science initiative, student recruitment, the impact of universities on the economy, a report on quality assurance, pay, strategy, appointments, grants won, congratulations (more awards), and fi nally condolences. It is an impressive list of achievements. But you will note that it tells you absolutely nothing at all about the ordinary events that take place in the university every day, about what matters

(or what should matter) to the success of the university as a core institution within our society. There is nothing here about the life of the university—its concerts, plays, exhibitions, sports performances, academic events, or conferences. Nothing about the contributions of students or faculty to local, national, or global aff airs. Nothing about the most important additions to human knowledge from the university’s research community—books published, papers posted, prestigious lectures delivered, or the impact of the university’s research on society. The agenda for the university’s leaders includes important issues, to be sure. Budget. Capital planning. Performance metrics. A blizzard of strategy documents. Minutes of important committees. I don’t minimise these matters. They deserve the fullest discussion and refl ection. But taken together they give a pale and anaemic picture of the university’s personality and endeavour. The result is a climate for decision-making far removed from the most important dimensions that make universities so central to our civilisation.

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The cause of this intellectual disease is the perversion of values. Education and research have become productised—manufactured, packaged, and sold in a viciously competitive market. The university may not be driven by pure profi t, but money metrics rule. I mentioned grants won. Here, the university celebrates research awards above £50 000. Now you discover who really matters in the accountancy of knowledge. Arts and Social Sciences won six awards each. Life sciences won 14 awards. Engineering and physical sciences, 28 awards. And medical sciences? Top, with 43 very substantial grants. A modern university now depends on the medical sciences for its liquidity. The vast sums of money available to universities from medical research funding bodies, together with a political culture that privileges wealth creation above all else, have turned heads. Too many universities now no longer work in the public interest. Too many universities now care about, and measure themselves, according to their own interests. There seem to be no leaders to cure this sickness.

Richard [email protected]