Education
The hidden curriculum of academic medicine
Key Points
Drozd and colleagues rightly identify the structural weaknesses contributing to attrition from clinical academia, including insecure career pathways, fragmented mentorship, and insufficient transition support.1 But there is a more subtle barrier—the hidden curriculum of academic medicine. Access to academic opportunity is often shaped not only by formal training structures but also by familiarity with the unwritten social and cultural rules that govern progression.
Drozd and colleagues rightly identify the structural weaknesses contributing to attrition from clinical academia, including insecure career pathways, fragmented mentorship, and insufficient transition support.1 But there is a more subtle barrier—the hidden curriculum of academic medicine.Access to academic opportunity is often shaped not only by formal training structures but also by familiarity with the unwritten social and cultural rules that govern progression. Knowing which opportunities matter, how to approach senior academics, when to apply for fellowships, and how to develop a visible academic profile frequently depend on informal networks rather than transparent systems. As a result, trainees from less established academic backgrounds may enter research later, with less confidence, and without the same institutional fluency as peers who have been exposed to academia earlier in training.Many resident doctors do not leave academia because they lack curiosity but because the personal cost of participation seems increasingly unsustainable. Academic progression often demands...