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The author declares that academic medicine has entered a new and stormy "season" of accountability and social responsibility, due to public concerns about the overall health care system. He reviews earlier seasons, identifying paramount issues or activities that dominated the specific eras the Association of American Medical Colleges (AAMC) has responded to since the twentieth century began. He recommends how the AAMC can achieve several near-term solutions to pressing demands of the current season, such as the needs to manage academic medical centers more efficiently and to restore public confidence in the integrity of biomedical research. Next, he focuses on proposals for academic medicine to provide leadership, through the AAMC, in two major areas: preparing more generalist physicians, and assuring greater access to health care for those who live in underserved urban and rural areas. He describes models of existing, successful programs. The author concludes by proposing to create a "National System of Regional Medical Care." He urges the AAMC to continue its leadership by designating a task force to examine how such a regional system could be established within this decade.

To attract minority students and others to careers in medical practice and biomedical research and to prepare them for such careers, Baylor College of Medicine conducts a variety of summer enrichment programs and other programs to improve how science is presented to students in their preprofessional years from elementary grades through college. These efforts aim to increase the number of competitive candidates for medical school, particularly those from minority groups underrepresented in medicine. They entail close collaboration between the Baylor administration and faculty from Texas public schools and two-year and four-year colleges and universities. The authors discuss the rationale for these programs and comment about the need for institutional commitments of faculty and financial support. They note that these programs are an investment in the future and that longitudinal assessment is needed to determine their ultimate success.

The China Medical Board organized a management conference for the presidents of China's national medical universities. A three-person consulting team arranged by the Association of American Medical Colleges led the conference. Designed as a preliminary examination of the management problems faced by the national medical universities, the conference covered content similar to that of the AAMC Executive Development Seminars, including governance, financial management, faculty practice plans, technology transfer, information management, and organizational diagnosis. China's national medical universities are strategically managed by the Ministry of Public Health in Beijing, and for several years the ministry has increasingly decentralized the management and operational planning and control of these universities. The universities do not have enough properly trained personnel to absorb the additional management responsibilities, and the university presidents feel that they and their senior staffs need extensive training in adapting western-style management principles and practice to the Chinese setting.