In the first decade of the 21st century, the nation, the states, and colleges and universities began to grapple with the challenges of globalization, changing demography, the implications of the digital era, and of a less expansive public sector. Although not a transformative period for higher education, the decade saw significant innovations in…

In most countries, it is the state that has been taking over the support of universities and of teaching hospitals, a trend that has accelerated rapidly over the past 25 years to meet the expanding needs of higher education and of health care. In medicine the problem of university autonomy is further complicated by the long-standing custom that…