Challenges and opportunities for medical education and clinical research in a changing healthcare environment.

The current economic crisis in medicine has led to a restructuring of the way in which physicians utilize their time. Considerably more time is being spent on clinical services and less on teaching and clinical research. Multiple opportunities exist, however, for mentoring and clinical research in the current system. Academic behaviors can be integrated into the daily clinical experience. Scientific methodology can be used to address important questions that pertain to a large segment of their practice and, by so doing, lead to improved means of delivering healthcare and a reduction in healthcare expenditures. The inclusion of residents into such clinical research programs is to be encouraged. Should physicians continue to pay less and less attention to the maintenance of their professional diversity, future generations of physicians will be the recipients of a more dilute system of medical education.