Beyond Flexner: Medical Education in the Twentieth Century

Beyond Flexner: Medical Education in the Twentieth Century

Beyond Flexner: Medical Education in the Twentieth Century

Beyond Flexner: Medical Education in the Twentieth Century

Synopsis

This book provides a comprehensive review of medical education in the 20th century. It takes the themes articulated in the Flexner Report of 1910 and traces their development. Those themes, many of which have not been discussed in other books, include the basic sciences, the clinical curriculum, women in medicine, black medical education, and sectarian medical education. Also covered are the evolution of the health care delivery system, trends in financing medical education, the use of outpatient settings for clinical education, the current status of the medical curriculum and needed changes, and health manpower needs. The final chapter discusses the current proposals for changes and how they relate to the problems and reforms of the Flexner era.

Excerpt

For decades, educators, historians, and social commentators accorded to the Flexner Report major responsibility for the reform of the medical education system in the United States. In recent years, however, a number of historians have both challenged the impact of the report and questioned the desirability of the changes in medical education that were attributed to it. Some of the revisionist arguments are grounded in new research about the educational reforms at leading schools in the halfcentury prior to Flexner's study and the activities of organizations such as the American Medical Association, the Association of American Medical Colleges, and the Federation of State Medical Boards around the time of the report. In contrast, the distinguished scholar Thomas Bonner has forcefully argued that many historians in the 1970s and 1980s with "a strong presentist perspective" have fashioned their positions on ideology rather than new knowledge, and thus have blamed Flexner for a variety of problems in modern medical education. According to Bonner, such revisionist writing has been characterized by "an extravagance of language, a political partisanship, and a shrillness of tone unknown a generation before." Whether or not one agrees with Bonner's assessment, an undeniable point is that among historians and medical educators the Flexner Report still generates much heated debate.

The goal of this volume is to trace a number of elements articulated in the Flexner Report as they evolved during the twentieth century. Flexner's ideas on medical education serve as a "lens" through which one can observe and evaluate the many changes that have occurred in the past eighty years. While the recent important works by Kenneth Ludmerer , Learning to Heal (New York: Basic Books, 1985) and William Rothstein , American Medical Schools and the Practice of Medicine (New York: Oxford University Press, 1987) have extended our knowledge of the . . .

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