Abraham Flexner:
Louisvillian, famous medical educator and an often-untold history
by Steven Lippmann, MD
High quality medical training in the U. S. is indebted to the inspirational reform of Abraham Flexner. His highly regarded Flexner Report upgraded graduate teaching generally and has especially improved physician education.
Abraham Flexner( 1869 – 1959) was a born and raised Louisvillian. He was a nationally renowned educator who once was a teacher at Louisville’ s Male High School, and he developed innovative schooling methods. Abraham Flexner Way was named in his honor, and he and his wife Anne, who was a successful playwright, are buried nearby in Cave Hill Cemetery. His 1908 book, The American College, exposed teaching deficiencies in our higher education system. Being so well received, the Carnegie Foundation requested that he next assess the status of American medical schools.
In 1910, his Flexner Report documented too many medical schools with massive weaknesses, prominently in their teaching. The Report especially cited inadequate academics, too few physician faculty, clinical and laboratory training deficiencies, limited scientific investigation and too little funding. He also sought to close poor-quality private institutions and those that were without university affiliation.
The Flexner Report recommended excellent ways to improve by adding rigorous prerequisites for medical school entry, well-trained educators who were full-time professors, clinical faculty teaching students in university hospitals and emphasis on research. He wanted a scientific approach to education and a laboratory focus built into the curriculum. Advocacy for more funding was stressed, and regulation of physician licensure was mandated. The Report indicated that there were about 160 MD- or DO-type institutions and that most produced poorly trained doctors. That resulted in the closure of lots of U. S. medical schools.
Medical colleges would be reopened under a Flexner Report protocol only if they met criteria comparable to European educational quality, like those demonstrated by Johns Hopkins’ medical school. By 1920, only about half of the lesser institutions still existed, and in the 1930s that number declined even more. Physician education and long-term graduate licensure in this country improved, becoming more rigorous and scientific. Schools got better funding, with increasingly regulated
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