Although students' ability to enter notes in patients' records is believed to be important for student education, only about half of all hospitals allow all students' notes in the EMR. Policies regarding placement of student notes should be implemented to ensure students' competency in note writing and their value as members of the patient care team.

Mission-based budgeting has been touted as the preferred method of assessing and assigning departmental budgets in academic medical centers. Mission-based budgeting in its simplest form is a methodology that allows an institution's finance department to align costs with actual activities (typically clinical care, administration, research, and teaching). Despite its intuitive appeal, a minority of the academic medical centers across the country have embraced it. Mount Sinai School of Medicine was among the first to incorporate this approach, and we have almost a decade of experience with its risks and benefits. This article focuses on the education component of mission-based budgeting. We review all aspects of mission-based budgeting, including (1) the many variables that must be factored into a metric and how those variables differ among institutions, (2) the metric itself and how it reflects institutional philosophy, (3) the impact of mission-based budgeting on faculty and chairs of departments, (4) existing processes that ensure the quality, reliability, and validity of the different mission-based budgeting systems, and (5) a comparative perspective.