A generation ago, few thought that universities had much, if anything to do with entrepreneurship. The hard-earned freedom of the university won by the great German philosopher, scientist and scholar, von Humboldt, ensured that the university was not only liberated from the dictates of the church and state, but it guaranteed the value and primacy of “knowledge for its own sake”, rather than knowledge because it provides some value for society or the economy (
1). Shane and Eckhardt (2010) assume that entrepreneurship is an orientation towards opportunity recognition (
2) and that universities have a great role in doing so. University’s entrepreneurial role, taking advantage of opportunities that appear through its customary teaching and research missions as well as an emerging third mission to advance innovation, is fundamental rather than accidental (
3). Etzkowitz focused on the entrepreneurial university concept at the beginning of 1983 in examining academic sciences of America and the use of studies in business environments (
4). The entrepreneurial university is a university where the activities of all members, such as education, research, and so on are managed, administered and executed, so that the university is perceived as an institute or pseudo-economic firm i.e., the orientation of these activities for the profitability and gaining competitive economic advantages (
5). A study by Stanford University in 2012 indicated that the companies founded by this university had an annual income of about $ 2.7 trillion, equal to the wealth of the tenth largest economy in the world (
6). According to the existing developments and the emergence of learning society, presenting new models in higher education is an obvious fact. Development of entrepreneurship at the universities of medical sciences and health services is inevitable as they are the trustees and executors of a wide range of health care at prevention, treatment, rehabilitation and palliative levels and have the important mission of education and research at higher levels of medical sciences with many challenges in their approaches and management system (
7).
Establishing an entrepreneurial university calls for a set of conditions: entrepreneurial strategic management of the organization, creating an environment where all students and employees tend to innovate and progress, universities understanding innovation and developing it as a more vital component of their strategy, the organizational structure of entrepreneurial university being formed of fewer layers, creation of a supportive system for transforming traditional culture into entrepreneurial culture, and payment tailored to performance. Moreover, it needs organizational culture, entrepreneurial cultures as important in empowering university staff enabling them to take advantage of their capabilities, senior management commitment, and management support. The different forms of support are supporting innovative ideas, providing the necessary resources or expertise, and institutionalizing entrepreneurial activities in systems and processes of the organization (
8-
14).
In explaining the causes of the emergence of entrepreneurial university, one can cite the response of universities to global changes and environmental pressures, the status of knowledge as a valuable source creating economic growth, and the move towards a knowledge-based economy as a new function of the university. Moreover, the causes are responding to new socioeconomic needs, new responsibility of the university towards society, social and economic development of the country and educational market (
15-
19).
Iranian universities were education-based up to the first decade after the Islamic Revolution (
20). It seems that medical universities have a huge capacity to create and expand entrepreneurship in health care settings due to the diverse activities in health services. However, most of these universities do not have a specific organizational structure for designing and implementing educational, research and development programs to increase incentives and occasional entrepreneurial activities (
21). The Ministry of Health and Medical Education emphasized the implementation of the project “Entrepreneurship Development Plan of Iranian Universities” at medical universities in March 2006. The board of ministers stressed establishing of the entrepreneurial offices in medical universities to implement the project. However, the implementation was not so successful because establishing an entrepreneurial university requires to initially identify conditions affecting entrepreneurship of universities (
22).
Mahdavi Mazdeh et al. identified 10 conditions as the main indices of an entrepreneurial university: industry, business and management units, facilities and equipment, faculty members’ familiarity with entrepreneurship, training courses (entrepreneurship and related courses), curricula, teaching and presentation methods, entrepreneurship related journals, scientific and promotional conferences of entrepreneurship, learners’ activities, guild and extracurricular activities, and strategies of the university (
23). In a paper about medical universities, Moghadasi et al. (
22) identified nine conditions as effective in the entrepreneurship of universities: entrepreneurship, strategic priority of the university, entrepreneurship management at the university, briefing and entrepreneurship courses, promotion of entrepreneurial spirit and culture, funds, the activity of the society of students, equipment, the extracurricular activities, and academic curriculum programming. Faridi (
24) found that for preparing Shahed University to become a third-generation university the status quo of the indices of goals and mission, management and leadership, entrepreneurship characteristics of teachers, and the entrepreneurial characteristics of employees and students is higher than the average, and more attention is needed to the indices of internal units and structures, relations with industries, financial institutions, commercialization and internationalization of education considering the actions taken.
According to a survey on five leading European universities, Clark (
25) summarized the paths for organizational changes required for entrepreneurial universities: establishing a strong leadership nucleus, expanding structural boundaries, creating diversity in financial resources, establishing a strong academic base, and creating an integrated entrepreneurship culture throughout universities. In their study in America and Europe, Meyers and Pruthi (
26) concluded that an entrepreneurial university consists of five key elements: leadership, a clear definition of entrepreneurial learning goals, directing curriculum, powerful internal and external networks, existence of innovation culture, experiential learning and knowledge transfer opportunities. Ketikidis et al. (
27) conducted a study titled “An entrepreneurship model for higher education institutions: a study at the University of Sheffield International School.” The final model of the study consisted of four concepts of the effective structure of management and operations, the provision of distributed training, entrepreneurship and the spirit of innovation and internationalization as the strategic spirit and core. Furthermore, they understood that the organizational structure of the university and its entrepreneurial culture facilitated the strategic transformation of entrepreneurship in higher education. Garcia Aracil et al. (
15) concluded that environmental indices, teaching, knowledge transfer, staff, financial resources, government, and management form an entrepreneurial university.
As stated, several studies have examined the subject of entrepreneurial university, but each examined one part of the subject. Most of them examined the components of an entrepreneurial university, some mentioned the creator of conditions, some others examined the strategies and operations of entrepreneurial university and others reviewed the achievements and outcomes of an entrepreneurial university.
The subject of entrepreneurship and entrepreneurial university at the present time is one of the important issues in the field of country management. In recent years, health sector has paid special attention to entrepreneurship, including 11 operational transformation and innovation packages in medical education as strategic policies of health education in the Islamic Republic of Iran. For this purpose, one of the topics that should be considered in the package on transformation and innovation in teaching of medical sciences is the focus on the transition package to the entrepreneurial university (
28).
In this regard, universities of medical sciences have a mission to pursue four main goals based on entrepreneurial university model: to review and revise the mission, goals and functions of medical universities, to reform the structure of medical universities, to process engineering of medical universities and finally to develop infrastructures and resources of medical universities (
29).