Okay, back at it . . .

Pardon the interruption. The radical discontinuity in 1910 was the famous Flexner report. Abraham Flexner, who worked for the Carnegie Foundation for the Advancement of Teaching, was commissioned to study medical education in the U.S. and Canada. Back then there were 155 medical schools in the former British possessions, all of which he visited. (He is often said to have studied medical education in North America, but, err, Mexico. I digress.)It turned out that most of them were not affiliated with universities, but were owned by one or a few physicians. They had what Flexner considered insufficient curricula and clinical training. States generally did not regulate the practice of medicine or have licensing requirements for physicians. Most important, in Flexner's view, medical training and practice was not uniformly based on science. His ideals were the few university-affiliated medical schools of the time, and particularly Johns Hopkins. Flexner's recommendations led to the current model of medical education based at universities, followed by clinical apprenticeship and university-affiliated hospitals,  taught by clinicians who were also research scientists, based on claims for effectiveness based on scientific knowledge and reasoning. Less directly, his work led to the imposition of standards for medical licensing and practice. These were imposed by the states piecemeal, and I have not come across a comprehensive history, but by now we take it for granted that every s...
Source: Stayin' Alive - Category: Health Medicine and Bioethics Commentators Source Type: blogs