The American Medical Association sponsored a scoping study by Abraham Flexner 115 years ago. At that time, it was recognized that many medical schools were of poor quality and lacked the proper laboratories, clinical training, and qualified faculty. Admissions requirements were often minimal or even nonexistent. There was very little connection between the science of medicine and the art of medicine. Flexner set out to visit every existing medical school at that time to survey and study the process of medical education. The result of this work was the Flexner Report published in 1910. The recommendations of this report was that medical schools should be affiliated with universities; admissions would require at least a school diploma and two years of college science; and education should emphasize scientific research. Schools that did not meet these standards would be closed.

The report had a very profound effect. Over half of the existing medical schools at that time either closed or merged within the following ten years. The biomedical model in medical education became the dominant process. There were negative consequences and these included that many of the medical schools training blacks and women were forced to close and this significantly reduced the diversity in medical education for many decades.

In the 100 years since there have been constant changes in the way we educate physicians. The basic construct of a four year education has remained the same. In that period of time, the science of medicine has exploded and it is now impossible for any person to fully grasp the science of medicine. Artificial intelligence is now a part of our everyday life. Medicine, like other fields, is working hard to embrace the positive aspects of this.

I feel it is time once again to take a broad look at the way we train physicians in light of the current challenges as well as the current resources. In future posts I will offer my opinion on various aspects of this. Our daily lives right now were really science fiction over 100 years ago. We have to adapt to these changes as well as try to predict what lies ahead to prepare a workforce that will continue to provide quality healthcare for the next 100 years.