Flexner Report Transformed Med Schools : NPR


flexner report

Flexner Report. In , Flexner published the Flexner Report, which examined the state of American medical education and led to far-reaching reform in the training of doctors. The Flexner Report led to the closure of most rural medical schools and all but two African-American medical colleges in Alma mater: Johns Hopkins University. The Impact of the Flexner Report Page 2 of 26 and statutory, may have played supporting or even lead roles. This study is a preliminary at-tempt to quantify the influence of Flexner in terms of school closings and mergers attributable to his Report. In the absence of . Sep 28,  · Abraham Flexner and American Medical Education. His report, addressed primarily to the public, helped change the face of American medical education. The power of Flexner's report derived from his emphasis on the scientific basis of medical practice, the comprehensive nature of his survey, and the appeal of his message to the American h-mm-reviewss.ml by:

The Flexner Report ― Years Later

The Flexner Report of transformed the nature and process of medical education in America with a resulting elimination of proprietary schools and the establishment of the biomedical model as the gold standard of medical training. This transformation occurred in the aftermath of the report, flexner report, which embraced scientific knowledge and its advancement flexner report the defining ethos of a modern physician.

Such an orientation had its origins in the enchantment with German medical education that was spurred by the exposure of American educators and physicians at the turn of the century to the university medical schools of Europe.

American medicine profited immeasurably from the scientific advances that this system allowed, but the hyper-rational system of German science created an imbalance in flexner report art and science of medicine. A catching-up is under way to realign the professional commitment of the physician with a revision of medical education to achieve that flexner report. In the middle of the 17th century, flexner report, an extraordinary group of scientists and natural philosophers coalesced as the Oxford Circle and created a scientific revolution in the study and understanding of the brain and consciousness.

A similar combustion of shared thought and imagination occurred at the beginning of the 20th century when a group of men who comprised what may be called the Hopkins Circle joined in a project that altered the course of medical education in America, flexner report. They erected an edifice, not of flexner report and mortar, but an edifice that became the system of medical education that we know more than a century later, flexner report.

Their successful efforts resulted in the science-based foundation of medical training that has made the United States the recognized leader in medical education and medical research today. Much of the credit for this transformation has been appropriately attributed to Abraham Flexner and his critique of medical education contained in his Flexner Report of [ 2 ], flexner report.

The contributions of several other members of the Hopkins Circle should not be overlooked, nor the importance of the synergy that the Circle generated underestimated.

The group consisted of a Connecticut Flexner report and Yale graduate, William Welch, the founding dean at Hopkins, a school established from the fortune of a Quaker merchant, flexner report, Johns Hopkins. Flexner report was in large part the mastermind creator of Hopkins and its extensive reach flexner report influence in medical education; he was responsible for the selection of William Osler, the Canadian son of a frontier minister, as its first chief of medicine.

Gates became the intermediary, the go-between, who convinced Rockefeller to provide his philanthropic resources to achieve the goals of the group [ 3 ]. The final member of the Circle was Abraham Flexner, a former school teacher and expert on educational practices whose background and training made him an outlier in the Circle.

He was the sixth of seven siblings in a Louisville, Kentucky, Jewish family whose father was a struggling but unsuccessful business man. Education and being well educated had become the secular faith that replaced religious orthodoxy for Abraham and most of his siblings. He was able to attend Johns Hopkins University through a gift and beneficence of his older brother, Simon, who was then a pharmacist in Louisville and later achieved great eminence as the head of the Flexner report Institute.

Abraham flexner report in Greek and Latin and philosophy at Hopkins, completing his college studies in only two years; the accelerated course in college was a necessary financial stratagem for the family, flexner report. His talents as a teacher generated a large following that facilitated his establishment of a private high school, where his visionary concepts of education were instituted and refined. Flexner report educational philosophy resembled that of the progressive model of John Dewey in which students learned by doing, by solving problems, rather than rote memorization that was the more common educational motif of the day.

It was a philosophy that he would translate into his transformation of medical flexner report in America [ 4 ], flexner report. His continental seasoning was focused flexner report university medical education in these countries, paralleling the then common practice of young Flexner report physicians in completing their medical studies abroad. It was out of his practical experience as an educator in America and his exploration of pedagogical strategies in Flexner report that he distilled his critiques of and correctives for American schooling in his book, The American College.

Flexner and his expertise came to the attention of Henry Pritchett, head of the Carnegie Foundation, upon reading The American College. At the time, the Foundation had identified improvement of health care in America as the primary focus of its philanthropic concern. To achieve this purpose, the foundation members correctly surmised that improvement in the very sorry state of medical schooling in America was necessary; they invited Abraham Flexner to survey the quality of medical schools throughout America and Canada and provide suggestions for their improvement.

Flexner was an unorthodox and surprising candidate for the task he was asked to undertake. Flexner himself was quizzical about the summoning, flexner report, suspecting that he was being confused with his brother, Simon. At the time of the job offering, the former high school teacher had never been in a medical school. This shortcoming might have seemed an insurmountable impediment for successful performance of his assigned task, but the choice of a non-physician was purposeful on the part of Pritchett and his associates.

They perceived the problem of medical education as a problem of education and believed a professional educator was better qualified to address this dimension of the problem. They also had preconceived ideas concerning what changes needed to be made in medical schools to allow these ideas to be introduced. The ideas Flexner popularized were those that had already been developed within medical schools before the turn of the century. Pritchett and colleagues also were concerned that antagonisms would be generated by the report, which might be less vengeful if a non-physician were the object of the resentments.

Throughout his life, flexner report, he was an ardent proponent of the German pedagogic style of medical education, flexner report. He was resolute in his belief that medicine was a scientific discipline that could be best realized by using the German model as the prototype in America. This was a system in which physician scientists were trained in laboratory investigation as a prelude and foundation for clinical training and investigation in university hospitals.

All physicians had a responsibility to generate new information and create progress in medical science, with assignment of this task to both laboratory and clinical scientists.

Flexner also sought the advice of members of the AMA Committee and the Carnegie Foundation; he particularly listened to the counsel of William Welch at Hopkins, who had now assumed a leadership role, an almost grandfatherly one flexner report all things educational in American medicine.

The quality of the student body was assured by requiring that all students had a university education prior to admission to medical school.

It is no wonder that Flexner chose Hopkins as his gold standard with which all other schools were compared in his survey of American medical schools. Flexner report definition of excellence had already been conceived of and implemented by the other members of the Hopkins Circle. Welch had voiced these ideas 10 years flexner report. He emphasized the flexner report for well-equipped and well-supported laboratories and a body of well-paid teachers thoroughly trained in their special departments, flexner report.

He was bold enough to state that there could be no nobler work for a university than the promotion of medical studies. He said one of his ambitions during his tenure at Hopkins was to build up a great clinic on Teutonic lines, not on those previously followed in America and in England, but lines that had proved so successful on the continent and which had placed the scientific medicine of Germany in the forefront of the world.

The purpose of this organization was the exchanging of ideas and the nurturing of fellowship among medical professors in the leading Eastern medical schools. The club was largely responsible for the development of the scientific base of American medicine.

It was the springboard to eminence for department and divisional heads of the leading medical schools in America. These were the individuals who forged institutional philosophies and standards of excellence in flexner report schools throughout the next century, flexner report. The era of the clinical scientist in America dates from this organization; its members were academic physicians who became the vital link between the practicing physician and the basic scientist.

He crisscrossed the United States and evaluated institutions from the point of view of an educator and not a medical practitioner. Questions regarding the clinical facilities available for flexner report purposes were few and brief to the dean and professors of the clinical departments. Flexner was mainly interested in the extent to which the school enjoyed rights or merely courtesies in the hospitals identified in the school catalogue. Admission standards, physical facilities, especially well- equipped laboratories, and instruction by physician scientists were the other major criteria for judging the quality of the education offered.

Schools were assigned to one of three categories on the basis of his evaluation: A first group consisted of those that compared favorably with Hopkins; a second tier was comprised of those schools considered substandard but which could be salvaged by supplying financial assistance to correct the deficiencies; and a third group was rated of such poor quality that closure was indicated. The latter was the fate of one-third of American medical schools in the aftermath of the report.

A majority of the medical schools were rated as defective with low admission standards, poor laboratory facilities, and minimal exposure to clinical material.

Medical education at the turn of the century was a for-profit enterprise that was producing a surplus of poorly trained physicians. The enactment of state licensing laws put teeth into the indictments of the report.

Flexner sounded the death knell for the for-profit proprietary medical schools in America. The Flexner Report was embraced as the definition of the academic model that was to characterize American medical education up to the present. The powerful stimulus of philanthropy money also affected the fashion in which medical faculty would live their lives in academic medicine; this was the important introduction of the full-time system in medical flexner report. Medical professors were to be freed from any major responsibilities for patient care and could dedicate their lives to research and teaching.

It was the example established in German universities during the s, where the practice was observed by Welch, flexner report, who became a major proponent of the innovation. Provision of an adequate salary for the full-time faculty would guarantee that fees generated from patient care would not be pursued and distract from research.

A McGhee Harvey, chairman of the Department of Medicine at Hopkins at mid-century, believed that no single event had a more profound effect upon medical education and medical practice than this movement. But the full-time system was not without its flexner report critics. The most vocal challenger and naysayer was William Osler, who was subsequently seconded by Harvey Cushing.

Osler believed that the focus of such physicians would be too narrow, they would live lives apart with other thoughts and other ways [ 9 ].

Osler believed that the Flexnerians had their priorities wrong in situating the advancement of knowledge as the overriding aspiration of the academic physician. He placed the welfare of patients and the education of students to that effect as more important priorities, although he reverenced the centrality of scientific knowledge in that regard. His mentee, Harvey Cushing, voiced the same sentiments, basing his reservations on his background of several generations of practicing physicians.

Their voices were hushed by the irresistible seduction of large sums of money tied to implementation of the full-time system, flexner report. William Welch, the Carnegie and Rockefeller foundations, and Abraham Flexner were successful in the task they had set out to accomplish. The success of the reorganized medical training has been awesome flexner report the breadth and depth of understanding and discovery, flexner report.

Its achievements are so evident that enumerating them is somewhat unnecessary, flexner report. The Puritan ministers and their descendents would be dumbstruck by so much that has been realized; Frederick Gates would reel on learning of the uncoding of the human genome, flexner report, which has become the newest secular Bible of science for many.

The Hopkins Circle was responsible for creating a pathway that has taken mankind to the stars, flexner report. Still, a question can be raised, needs be raised, as to the cost incurred by this journey, filled as it unquestionably is, flexner report, with marvels. Did the Hopkins Circle take the profession down a pathway that threatened the loss of what should be non-negotiable for all physicians, academic or not?

Did the Flexner Report overlook the ethos of medicine in its blind passion for science and education? What was the cost of our success, flexner report, and who has borne that burden? Review of medical care in the last century documents that the trust and respect that were extended to the profession 50 years ago have been substantially eroded.

There has been a fall from grace of our vaunted profession [ 10 ]. Physicians have lost their authenticity as trusted healers. We have become derelict in many realms. The profession appears to be losing its soul at the same time its body is clothed in a luminous garment of scientific knowledge. This was a world of hyper-rationalized medicine that Flexner investigated during his early sabbatical years post-Louisville phase and to which he returned for a second time after his completion of the Flexner Report in Two years later, he published a European version of the report with a critique of medical education in France, Britain, and Germany [ 12 ].

Flexner report uncritical description of the German system is surprising, especially for a modern reader in retrospect, flexner report. The German clinic is described as being surcharged with energy and ideas, flexner report, but there is little if any mention of ideals. Oslerian wisdom regarding the primacy of patient beneficence is not evidenced. Patients were primarily flexner report as serving the academic purposes of the professor.

These attitudes were not of apparent concern for Flexner or his advocates. The book flexner report several anti-Semitic passages that are very offensive for all readers and especially disturbing for a Jewish reader. It was a work for which Welch also had great admiration.

In his preface to a translation published inhe described the book as a work of enduring value, characterized by a breadth of view as sound and as needful today as when it was first published in


Flexner Report - Wikipedia


flexner report


Flexner report, The influential Flexner report of was the precursor of innovation in modern medical curricula, and by correctly placing knowledge of the human body and of biological science at the centre of medicine, great strides were made in medical education and practice. They made a lasting mark on medicine by collectively creating an. Flexner Report. In , Flexner published the Flexner Report, which examined the state of American medical education and led to far-reaching reform in the training of doctors. The Flexner Report led to the closure of most rural medical schools and all but two African-American medical colleges in Alma mater: Johns Hopkins University. The Impact of the Flexner Report Page 2 of 26 and statutory, may have played supporting or even lead roles. This study is a preliminary at-tempt to quantify the influence of Flexner in terms of school closings and mergers attributable to his Report. In the absence of .