This presentation will review academic programs and discuss the pros and cons of academic practice. The role of the academic physiatrist in the future and the requirements for improving academic programs will be addressed.Like any other medical specialty, the viability of physical medicine and rehabilitation depends on its acceptance as an academic discipline. In recent years, there has been a number of positive indicators for strenghtening academic physiatry including: increased educational exposure to medical students, increased number of residency programs and percentage filled and increased emphasis on research activities.Academic practice of physiatry should appeal to the individual with the following goals in life: (1) increase involvement in scholarly activities; (2) be on the cutting edge of new techniques and concepts of practice; (3) become a recognized expert in subspecialization areas; (4) vary practice more evenly between direct and indirect patient care activities; (5) work in an intellectually stimulating environment but with some constraint on one's destiny; (6) obtain adequate but not high financial rewards supplemented by a high benefit package; and (7) make a significant impact on the future of physical medicine and rehabilitation at the national level.Because academic physiatry will significantly influence the determination of what is rehabilitation and who will practice it, we must strive to improve the quantity and quality of academic programs. Areas especially needing attention are research and education to establish the scientific basis of the field and to train qualified personnel. To meet these goals, high quality clinical and scholarly programs with subspecialization, an adequate financial base and good marketing program will be necessary.