Exploring the academic context for quality improvement: a scientific discipline in need of a career path.

Physician training typically occurs in an academic context. We examine whether improvement should be a central element in academe--specifically medical school. We observe that quality improvement meets the criteria for a discipline, but that there are many obstacles to career development in this field. Whether the research agenda of quality improvement can be accomplished within centers or institutes or whether this discipline needs its own department to ensure the nurturing of new faculty is still an open question. What is not open is the necessity for a career path in this discipline to exist and flourish.