John Church and Dennis Foth

University of Alberta

This paper describes a recent unsuccessful initiative by a health sciences department at a Canadian university to implement a coordinated approach to external training. A conceptual framework, which examines the conflicting cultures of professionalism and bureaucracy in universities, is used to analyze the outcome of the case.

Cette communication décrit l'échec d'une initiative récente au sein d'un département des sciences de las santé d'une université canadienne, initiative visant à mettre en oeuvre la coordination de las formation externe. À l'aide d'un cadre théorique, nous examinons le choc des cultures professionnelles et bureaucratiques au sein des universités afin d'analyser les résultats découlant de cette initiative.

The primary mission of a university is scholarship, functionally defined as discovering and creating new knowledge and integrating it with other knowledge (i.e., research), and imparting that knowledge, together with other knowledge, to people who need it (i.e., teaching). Any activity that furthers the discovery, creation, integration and dissemination of knowledge is worthy of serious consideration by individual faculty members, their departments and their faculties. External training, which in this case study is defined as non-degree training and educational courses and programs for health care researchers, administrators and selected practitioners, constitutes one such activity.

The discovery and creation of knowledge, and its dissemination is done primarily by academics working in large institutions, usually universities. Like doctors and lawyers working in private practice, academics are able, within the norms of the academic profession, to control the nature and content of their research and teaching. In short, they have a great deal of autonomy. Unlike doctors and lawyers in private practice, academics also rely upon a strong bureaucratic organization, the university, to provide them with many of the tools they require to practice their profession: clients (i.e., students), classrooms, laboratories, libraries, printing facilities, state-of-the-art communications and a readily accessible and inexpensive pool of labour, mostly graduate students, to assist them in their endeavors. As a result, the academic professional, usually called a professor, is able to deploy his knowledge and skills with virtually no overhead cost, while being assured of payment.

Universities, in order to provide support for their professors, have many elements of bureaucratic organizations. They are hierarchical in structure and rely upon formal organization and rules for command and control functions. As a result the university has two different cultures -- bureaucratic and professional. The term "professional bureaucracy" has been coined to describe this organizational structure (Mintzberg, 1979). The difference between the two cultures poses a challenge for the professor, who may suddenly find his autonomy challenged by hierarchical decision making and regulation, and the administrator, who is faced with the challenge of ensuring conformity/compliance to bureaucratic goals and norms while enlisting the support of a professional group that is essential to the success of the organization.

The purpose of this paper is to discuss this organizational dilemma with reference to the attempt by one university department to implement a collective approach (a bureaucratic concept) to the planning and delivery of external training activities.

The case

The Department of Health Services Administration and Community Medicine (not its real name) provides graduate level training in health administration and health services research at a major Canadian university. The department is comprised of five separate academic programs, each involving a distinct set of two or more disciplinary affiliations. Faculty members are typically associated with one program, some with two. Primary responsibilities for faculty members consist of research, publication, teaching and graduate student supervision. Participation of faculty in external training or other supplemental activities (e.g., consulting, expert witness) is voluntary, supernumerary, and financially compensated extra to salary.

Historically, the five programs have enjoyed a significant degree of autonomy within broad university guidelines in determining their nature and scope, and graduate student entrance requirements. The role of the department chair, occupied by a faculty member already in the department and rotated every two or three years, was largely to represent the interests of the department in negotiations with the central administration of the university and to attract external resources to the department. External training was not a priority for the department although individual faculty members would generally respond positively to requests to provide instruction when approached by outside agencies or the university's continuing education department.

The appointment of a new chair in 1994 marked a departure from previous practice. For the first time in the department's history, a professional manager was chosen rather than a career academic. The chair was a former CEO of a major urban hospital and a physician specialist. His involvement in teaching and research and the culture of a university prior to coming to the department was limited.

Just prior to the arrival of the new chair, the department and a similar department at another university in the province were approached by the province's Medical Research Foundation (not its real name) to enter into a joint educational venture with the Foundation. The Foundation was interested in training a select group of employees from the regional health authorities in the province to conduct "community health research" for their health authorities. The underlying premise was that through concentrated training sessions taking place over an eight-week period, the basics of community health research could be conveyed to non-experts, who could then conduct field research supported by university resources. The majority of the regional health authorities had contributed resources to support the initiative, with additional funding to come from the Foundation. The role of the two departments was to develop and deliver the educational component and to provide follow up support for up to eighteen months for the participants to complete field-based research projects.

From the outset participating faculty members from the two university departments expressed

concern about it's underlying premise -- that competent researchers could be created through such a short exposure to complex research methods. A question was also raised about how individual faculty members would be reimbursed for time spent responding to telephone calls or more extensive forms of consultation during the eighteen months the participants were doing their research projects. In the opinion of the participating university faculty, while the original project budget provided a per diem rate plus expenses for faculty involvement during the eight week training period, the budget did not provide for follow-up support. The attitude of the Foundation was that the project was adequately funded and that faculty members were expected to undertake this type of activity as part of their commitment to the university and the community.

After extensive internal discussion about the issues, neither of which was resolved, faculty members agreed that participation in the venture was necessary. The Foundation played an influential role in the allocation of large amounts of medical research money in the province and it was thought unwise to risk alienating the Foundation by not participating in the project. In addition, the majority of the department's faculty members did not really concern themselves with the issues surrounding the initiative as only a small cadre of them would be directly involved in delivering the training and the follow-up with the student projects.

From the perspective of the new department chair, an important benefit of involvement in this initiative was funding for a new academic administrative position for at least two years. Accordingly, a Director of External Training was appointed with a mandate to coordinate external training activities, including the new training program funded by the Foundation, and to develop new external training initiatives. The director would also serve as a first-point-of-contact for inquiries from outside clients and stakeholders about external training opportunities. All of the new external training activities were to be considered as a means of generating revenues to fund central administrative and faculty enrichment activities in the department. The generation of revenues was considered important because the department ran an annual deficit. However, ongoing external training activities that existed prior to the appointment of the Director of External Training were allowed to continue independently.

These arrangements and the mandate for the Director of External Training were implemented in a top-down fashion by the new chair following discussion with his executive committee. The full department was not consulted although they were, of course, advised of the efforts to coordinate external training through the appointment of the director.

As the formal training phase of the Foundation initiative was wrapping up, the department was approached by a non-profit agency to undertake a Senior Health Executive Training Program for an Asian client. As with the Foundation venture, the role of the department was to develop and deliver the educational product. The role of the non-profit agency was to market the program and recruit senior executives to come to Canada for training. A discussion was held with faculty who would be involved. Since there was an acceptable level of direct compensation for the participating faculty, they were generally in favour of the initiative. However, some faculty expressed the sentiment that, as was the case with the Foundation program, the direct benefits of this new initiative appeared to be accruing to a small group of faculty members. The benefit of these activities to all faculty members was less evident.

The Director of External Training negotiated the contract with the non-profit agency and coordinated the development and implementation of the educational product. The major weakness with the initiative was the lack of effective marketing by the non-profit agency. The program was eventually terminated because there were too few participants.

Important points to note about the two examples are that both projects were initiated through external agencies seeking department support, the incentives for faculty to participate were well defined (per diems plus expenses), and the number of faculty involved was relatively small.

Although the training program for the Asian client was not sustainable, the Director of External Training entered into further discussion with the client regarding the department providing the program in Asia, rather than having the participants come to Canada. At the same time two faculty members from the department were having independent discussions with the same client on another initiative. The client naturally asked who was speaking for the department. The Director of External Training felt that he had the mandate to be the spokesperson for the department. The two faculty members felt that the initiative of the Director of External Training was a serious infringement upon their individual autonomy. The professional and bureaucratic cultures were now in conflict. In the end the faltering economy in Southeast Asia prevented the client from following through on either initiative.

In an effort to avoid further confrontations, the Director of External Training surveyed the faculty about external training. The result of this was an extensive list of activities, some of which appeared to be generating revenues after all expenses had been paid. The Director used this as the basis of developing a discussion paper designed to allow faculty to explore the desirability of a coordinated approach to external training. The paper was initially circulated to the department's executive committee for comment. The recommendation from the executive committee was that the matter be placed on the agenda for the department's annual retreat. However, the topic was bumped from the agenda due to more pressing business. As a result, the full department has yet to have a discussion about the potential pros and cons of coordinating external training activities. And, as of this writing those faculty members who wish to participate in external training do so individually and independently, just as they did prior to the arrival of the new chair. The Director of External Training has been assigned other responsibilities.


The case demonstrates some of the challenges of mixing bureaucratic (top-down planning and decision making) and professional (non-hierarchical, collegial, consensual) cultures. In a bureaucratic culture planning usually involves some sort of rationale approach. A problem or issue is identified. Goals and objectives are specified. A limited range of options is explored. A decision is made by the chief executive officer or delegated authority on which option best meets the established goals and objectives. The solution is then implemented and evaluated. The decision-making process tends to be hierarchical, centralized, formalized and rule bound. In the professional organization, the decision making process tends not to be hierarchical, is decentralized and is usually less formalized or rule bound. Policy decisions are generally reached by consensus, usually after extensive collegial debate.

Despite the potential to learn from these early experiences, the department has yet to develop a consensus around the coordination of external training activities. Nor has it identified potential product lines, conducted systematic market research and used this information as the basis for developing a comprehensive organizational strategy, all of which are necessary to successfully offer external training programs (Foth, 1999). Individual faculty members continue to develop initiatives that are done primarily for organizations other than the department. The benefit to the department of these latter activities, which bring neither enhanced public profile nor much-needed additional infrastructure resources, is highly questionable. Both the recognition and resources flow to the other organizations and directly to individual faculty members.

Is it possible for the department to coordinate its external training activities, to actually develop a systematic plan and generate revenues to support other endeavors of the department? The probability that such might happen would seem to be contingent upon the department's academics sitting down together to have a collegial discussion about priorities related to external training. Within the academic profession this appears to be the only means of persuading colleagues through rational argument, building consensus and legitimizing decision making (Mintzberg, 1994). Without this process it appears that the structure and incentives of the professional organization make it almost impossible for managers to coordinate the activities of the individual professional. While they can lead the academic horse to water, they cannot make it drink.


Foth, D. (1999). Providing continuing professional education programs. Bulletin of the Inter- university Lifelong Learning Research Institute, 4, 1-9.

Mintzberg, H. (1979). The Structuring of Organizations. New Jersey: Prentice-Hall, Inc.

Mintzberg, H. (1994). The Rise and Fall of Strategic Planning. New York: The Free Press.

Press this button to return to National Conference Archives Main Page.
Return to the National Conference Archives Main Page

Prepared August 3, 1999 by the ACÉÉA/CASAE Internet Working Group