Abraham Flexner and the reform of American medical education to 1915
Schmotzer, Michael Stephen
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In 1910, at the behest of the Carnegie Foundation for the Advancement of Teaching, Abraham Flexner published a scathing expose, Medical Education in the United States and Canada. Many modern authors have considered the publication of this work—most often referred to as the Flexner Report—to be the beginning of dramatic reform in medical education. Flexner had accurately described the absymal conditions existing in the medical colleges of the United States and had recommended sweeping reforms to rectify the situation. It is the purpose of this paper to assess the actual impact of the Flexner Report on the reform movement. The paper briefly outlines the history of medical education and medical licensing prior to Flexner. It attempts to analyse the impact of modem science on medicine and medical education. Because nineteenth century science was mostly German in origin, a section is devoted to the Germanic influence. Flexner had made his name as an educator before taking up this special project. Therefore, the paper discusses his background as well as the report itself. By comparing the progress of the reform movement before and after the publication of the Flexner Report, the author has found little evidence of any impact made by the report. The reform began shortly after 1900. It was caused by advances in medical science and sustained by the efforts of the American Medical Association. This fact was bom out by the author's research carried out at the archives of the University of Pittsburgh School of Medicine. Flexner was an educational theorist and a publicizer of causes. His work was used by the AMA to aid the cause of reform but he did not start the reform or even change the course of events in any significant way.