The Flexner Report 1910 – A Revolution in Medical Education

In 1900, medical school education was fairly informal across much of the United States. Admission standards were lax, and in many cases only a high school education was required. 

One of the turning points in medical history was marked by American educator Abraham Flexner's study Medical Education in the United States and Canada, published in 1910. Much of American medical education today is based on this report's recommendations.

To conduct his research, Flexner visited every medical school in the United States and Canada. Some of the schools he visited, particularly Johns Hopkins University School of Medicine and Wake Forest University School of Medicine, received high praise, while the existing "proprietary" schools caused concern. These schools had become small commercial enterprises run by a few physicians, with no affiliation to a university or college. Many teachers were local physicians who were often unaware of the latest practices and developments.

Flexner believed that medical schools should require a high school education followed by at least two years of basic science education at a university or college. According to the report, only 16 of the 155 medical schools met these criteria. He also recommended that medical education last four years, with the first two devoted to basic sciences and the final two to practical clinical training. Flexner wrote: "Medical education involves both learning and learning how to learn; students cannot acquire knowledge effectively unless they know how to do so." By 1935, only 66 medical schools were operating in the United States. A possible disadvantage of the Flexner Report was the forced closure of rural and small proprietary schools that admitted African Americans, women, and students from lower social classes. After Flexner's recommendations were implemented, medical education generally became accessible only to upper-class white men. The Medical College Admission Test (MCAT) was established in 1928 as a standardized test for admission to medical school.

Description of the Article Image: The John Morgan Building at the Pennsylvania School of Medicine, founded in 1765 as the first medical school in the American colonies

Historical Figures Mentioned in This Article: Abraham Flexner (1866–1959)

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