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| title | chunk | source | category | tags | date_saved | instance |
|---|---|---|---|---|---|---|
| Flexner Report | 2/4 | https://en.wikipedia.org/wiki/Flexner_Report | reference | science, encyclopedia | 2026-05-05T08:47:54.714737+00:00 | kb-cron |
== Recommended changes == To help with the transition and change the minds of other doctors and scientists, John D. Rockefeller gave many millions to colleges, hospitals and founded a philanthropic group called "General Education Board" (GEB). In the nineteenth century, it was relatively easy to not only receive a medical education, but also to start a medical school. When Flexner researched his report, many American medical schools were small "proprietary" trade schools owned by one or more doctors, unaffiliated with a college or university, and run to make a profit. A degree was typically awarded after only two years of study with laboratory work and dissection optional. Many of the instructors were local doctors teaching part-time. There were very few full-time professors, dedicated to medical education. Medical schools did not receive funding, and their only money came from the students' tuitions. Regulation of the medical profession by state governments was minimal or nonexistent. American doctors varied enormously in their scientific understanding of human physiology, and the word "quack" was in common use. Flexner carefully examined the situation. Using the Johns Hopkins School of Medicine as the ideal medical school, he issued the following recommendations:
Reduce both the number of medical schools (from 155 to 31) and the number of poorly trained physicians; Increase the prerequisites to enter medical training; Train physicians to practice in a scientific manner and engage medical faculty in research; Give medical schools control of clinical instruction in hospitals; Hire trained, full-time staff for medical education; Grant medical schools increased funding; Strengthen state regulation of medical licensure Flexner expressed that he found Hopkins to be a "small but ideal medical school, embodying in a novel way, adapted to American conditions, the best features of medical education in England, France, and Germany." To Flexner, Hopkins incorporated the high standards of German medical education, while keeping the American standard of high respect for patients by physicians. In his efforts to ensure that Hopkins was the standard to which all other medical schools in the United States were compared, Flexner went on to claim that all the other medical schools were subordinate in relation to this "one bright spot." In addition to Johns Hopkins School of Medicine, Flexner also considered the medical schools at Harvard, University of Michigan, and the University of Pennsylvania to be strong schools. He said that medical schools that did not meet these high standards must change their approach to medical education or close their doors. Flexner also believed that admission to a medical school should require, at minimum, a high school diploma and at least two years of college or university study, primarily devoted to basic science. When Flexner researched his report, in the nineteenth century, only 16 out of 155 medical schools in the United States and Canada required applicants to have completed two or more years of university education. By 1920, 92 percent of U.S. medical schools required this prerequisite of applicants. Flexner also argued that the length of medical education should be four years, and its content should be what the CME agreed to in 1905. Flexner recommended that the proprietary medical schools should either close or be incorporated into existing universities. Furthermore, he stated that medical schools needed to be part of a larger university since a proper stand-alone medical school would have to charge too much in order to break even financially. Less known is Flexner's recommendation that medical schools appoint full-time clinical professors. During the research of his report, Flexner noted a lack of dedicated, full-time professors. American medical education needed committed professors to teach the next generations of physicians. Holders of these appointments would become "true university teachers, barred from all but charity practice, in the interest of teaching." Flexner pursued this objective for years, despite widespread opposition from existing medical faculty. Flexner was the child of German immigrants, and he had studied and traveled in Europe extensively. He was well aware that one could not practice medicine in continental Europe without having undergone an extensive specialized university education. There were many aspects of German medical education that Flexner, along with other medical educators and physicians who had traveled to Germany, admired, such as their national standards for students and universities, academic freedom, and the expectation of postgraduate training. Furthermore, many physicians who traveled to Europe to receive postgraduate training were impressed with the German dedication to research, innovation, and teaching. In effect, Flexner demanded that American medical education conform to prevailing practice in continental Europe. By and large, medical schools in Canada and the United States followed many of Flexner's recommendations. However, schools have increased their emphasis on matters of public health.