As Academic Medicine marks its centennial, academic medical centers (AMCs) face a defining inflection point driven by the convergence of generative artificial intelligence (AI), machine learning, computational biology, digital health platforms, autonomous systems, and increasingly continuous streams of clinical and behavioral data. Together, these technologies are transforming how health professionals are educated, how biomedical knowledge is generated, how care is delivered, and how health outcomes are measured. In this Commentary, the authors argue that these changes require more than technological adoption; they demand a redefinition of the mission and responsibilities of academic medicine. AMCs must move beyond their traditional roles in education, research, and clinical care to become leaders in responsible innovation, ethical governance, workforce transformation, public trust, community engagement, health equity, and global stewardship. The authors examine implications for individualized education, AI-enabled clinical care, accelerated scientific discovery, and the democratization of health knowledge across diverse settings. The authors contend that AMCs must deliberately redesign curricula, research ecosystems, care models, and institutional incentives to ensure that technological advances strengthen rather than diminish human judgment, compassion, and equity. The next century of academic medicine will be defined not by whether AMCs adopt emerging technologies, but by whether they shape their development and use in ways that preserve the human relationships and societal responsibilities at the heart of medicine.
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