A Compelling Call for Quality in Medical Education

Abraham Flexner, a headmaster of a high school in mostly rural Kentucky, published his landmark paper nearly one hundred years ago on reforming North American medical education. His report, Carnegie Foundation Bulletin Number Four, is often seen as the most influential publication in the field of medical education. During his time, North America experienced a mushroom-like growth of privately funded and for-profit medical schools (Flexner used the word “proprietary”) churning out medical degrees to virtually anyone with financial means. Flexner’s report was commissioned by a philanthropic organization, the Carnegie Foundation, and not by a public organization. His report, widely known as the Flexner Report, contained forceful statements about the lack of quality in medical education in North America and recommended closure of medical schools that failed to improve. As a direct result of that report, many privately funded, for-profit medical schools were forced to close. However, the surviving schools became stronger and many emerged as global leaders.