The Flexner Report is a long study of medical education books in the United States and Canada, written by Abraham Flexner and published in 1910 under the auspices of the Carnegie Foundation. Many aspects of the American medical profession today come from the Flexner Report and consequently.
The Report (also called Carnegie Foundation Bulletin Number Four) calls on American medical schools to enforce higher acceptance and graduation standards, and to strictly adhere to the mainstream science protocols in their teaching and research. The report talks about the need to reform and centralize medical institutions. Many American medical schools fail to meet the standards advocated in the Flexner Report and, after publication, nearly half of such schools are merged or closed down. College in electrotherapy is closed.
Homeopathy and natural drugs are ridiculed; some doctors were imprisoned.
The report also concludes that there are too many medical schools in the United States, and too many doctors are trained. The impact of the Flexner Report , resulting from the closure or consolidation of university training, is the return of American universities to male-specific admittance programs to accommodate smaller entry pools. The University has begun to open and expand women's acceptance as part of women's facilities and educational facilities only in the mid to late 19th century with the establishment of Oberlin College education in 1833 and private universities such as Vassar College and Pembroke. College.
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In 1904, the American Medical Association (AMA) established the Council on Medical Education (CME) aimed at restructuring American medical education. At its first annual meeting, the CME adopted two standards: one set minimum minimum education required for admission to medical school; the other defined a medical education consisting of two years of training in human anatomy and physiology followed by two years of clinical work in an educational hospital. In general, the board seeks to improve the quality of medical students, seeking to attract from the upper class, educated students. In 1908, the CME requested the Carnegie Foundation for the Advancement of Teaching to survey American medical education, to promote the CME reformist agenda and expedite the abolition of medical schools that failed to meet CME standards. Carnegie Foundation President Henry Pritchett, a staunch advocate of medical school reform, chose Abraham Flexner to conduct the survey. Flexner is not a physician, scientist, or medical educator, although he holds an art degree and operates a nonprofit school in Louisville, Kentucky.
At that time, 155 medical schools in North America differed significantly in the curriculum, assessment methods, and requirements for acceptance and graduation. Flexner visited 155 schools and generalized them as follows: "Every day students are subjected to endless lectures and repetitions.After a long morning of surgery or a series of quiz parts, they may sit wearily in the afternoon through three or four or even five lectures delivered methodically by part-time teachers.Nights are given to read and prepare for reading.If lucky enough to enter the hospital, they observe more than participate. "The report became famous for its harsh description of a particular company, for example describing 14 Chicago medical schools as "a disgrace to a State whose law allows its existence... indescribable... the place of the plague of the nation."
Nevertheless, some schools received praise for excellent performance, including the Western Reserve (now Case Western Reserve), Michigan, Wake Forest, McGill, Toronto, and especially Johns Hopkins, described as 'models for medical education'.
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Suggested changes
To help transition and change the minds of other doctors and scientists, Rockefeller provided over $ 100 million to colleges, hospitals and set up a philanthropic front group called "The Board of Public Education" (GEB).
When Flexner examines his report, many American medical schools are small "proprietary" trades schools owned by one or more doctors, who are not affiliated with colleges or universities, and run for profits. Degree is usually given only after two years of study. Laboratory and dissection work is not necessarily required. Many instructors are local doctors who teach part-time, whose own training leaves something to be desired. The regulation of the medical profession by the state government is minimal or non-existent. American doctors vary greatly in their scientific understanding of human physiology, and the word "quack" develops.
Flexner carefully examined the situation. Using Johns Hopkins Medical School as the ideal, he issued the following recommendations:
- Reduce the number of medical schools (from 155 to 31) and less-trained doctors;
- Increase the prerequisites for entering medical training;
- Train doctors to practice in a scientific way and involve medical faculty in research;
- Give medical school control of clinical instruction in hospital
- Strengthen state regulation of medical license
Flexner even stated that he found Hopkins as "a small but ideal medical school, manifested in a new way, adapted to American conditions, the best features of medical education in England, France and Germany." In his quest to ensure that Hopkins is the standard by which all other medical schools in the United States are compared, Flexner goes on to claim that all other medical schools are subordinate with respect to this "one bright spot". Flexner believes that admission to medical school must require, at a minimum, a high school diploma and at least two years of college or university studies, primarily aimed at basic science. When Flexner examined his report, only 16 out of 155 medical schools in the United States and Canada required applicants to complete two or more years of university education. By 1920, 92 percent of US medical schools required these applicants. Flexner also argues that the duration of medical education should be four years, and the content must be in accordance with the CME in 1905. Flexner recommends that medical schools that have the opportunity to close or be included in the existing university. Medical schools should be part of larger universities, as stand-alone medical schools have to charge too much to break even financially.
Less well known was Flexner's recommendation that medical schools appoint full-time clinical professors. Holders of this promise will be "true university teachers, banned from all but charitable practices, for the sake of teaching." Flexner pursued this goal for many years, despite the widespread opposition of existing medical faculties.
Flexner is a child of German immigrants, and has studied and traveled in Europe. He is well aware that one can not practice medicine in continental Europe without undergoing a large specialized university education. As a result, Flexner demanded that American medical education be consistent with practices in continental Europe.
In general, medical schools in Canada and the United States have followed Flexner's recommendations to this day. Recently, however, schools have increased their emphasis on public health issues.
Consequences of the report
To an extraordinary extent, aspects of the medical profession in North America today are a consequence of the Flexner Report:
- In a very short time, the medical colleges are all simplified and homogenized (all students learn the same)
- Treatment is about the use of patent drugs
- A doctor receives at least six, and preferably eight, years of post-secondary formal instruction, almost always in a university setting;
- Medical training is very close to the scientific method and is entirely based on human physiology and biochemistry. Medical research fully adheres to scientific research protocols;
- The average physician quality has improved significantly;
- No medical school can be created without permission from the state government. Likewise, the size of existing medical schools is subject to state regulations;
- Each branch of the American Medical Association state has supervision over a conventional medical school located within the state;
- Medicine in the US and Canada has become a paid and respected profession.
This report is now remembered for succeeding in creating a model of medical education, characterized by a philosophy that has survived to the present day. "Education in medicine," writes Flexner, "involves both learning and learning how, students can not effectively know, unless he knows how." Although the report is over 100 years old, many of its recommendations are still relevant - particularly with regard to physicians as "social instruments... whose function quickly becomes social and preventive, rather than individual and curative."
Closing of medical school
Flexner seeks to reduce the number of medical schools in the US to 31, and to cut the annual number of medical graduates from 4,400 to 2,000. The majority of American institutions that awarded the MD or DO title on the Reporting Date (1910) are closed in two to three decades. (In Canada, only medical schools in the Western University were deemed inadequate, but none were closed or merged after the Report.) In 1904, there were 160 M.D. providing institutions with more than 28,000 students. In 1920, there were only 85 M. D giving institutions, educating only 13,800 students. In 1935, there were only 66 medical schools operating in the United States.
Between 1910 and 1935, more than half of American medical schools merged or closed. This dramatic decline is partly due to the implementation of the Report's recommendation that all "proprietary" schools are closed, and that subsequent medical schools should all be connected to universities. Of the 66 MD-granting institutions that were still alive in 1935, 57 were part of the university. An important factor driving the merger and closure of medical schools is that all state medical boards are gradually adopting and enacting the Report's recommendations. In response to the Report, some schools dismiss senior faculty members as part of the reform and renewal process.
Impact on doctors and African-American patients
Flexner sees blacks as inferior and advocates closing all but two historically black medical schools. His opinion followed and only Howard and Meharry were left open, while five other schools were closed. The perspective is that black doctors should only treat black patients and must serve a role that is subject to a white doctor. The closure of these schools and the fact that black students were not accepted in many medical schools in the United States for 50 years after Flexner contributed to the low number of American dermatologists and their branching still more than a century later.
Furthermore, given his adherence to germ theory, he argues that, if not properly trained and treated, African-Americans pose a health threat to middle-and-upper-class white skin.
"The practice of the Negro doctor will be limited to his own race, which in turn will be better treated by a good Negro doctor than by a poor white man.But the physical well-being of the Negro is not just from the moment to Ten million of them living in close contact with six tens of millions of white people, not only the Negro himself suffering from hookworm and tuberculosis, he communicates with his white neighbors, just like a fool who knows nothing and pollutes him, less than humans offer heavy advice on this, > self-interest seconds of philanthropy Negro should be educated not only for himself but for us he, as far as the human eye can see, the permanent factor in this country. "
Impact on alternative treatments
When Flexner examines his report, "modern" treatment faces strong competition from some quarters, including osteopathic treatment, chiropractic medicine, electrotherapy, eclectic medicine, naturopathy and homeopathy. Flexner clearly doubts the scientific validity of all forms of medicine other than those based on scientific research, assuming any approach to drugs that do not advocate the use of treatments such as vaccines to prevent and cure diseases is tantamount to shamanism and spirits. Medical schools that offer training in a variety of disciplines including electromagnetic field therapy, phototherapy, eclectic medicine, physiomedicalism, naturopathy, and homeopathy, are told to drop the program from their curriculum or lose their accreditation and underwriting support. Some schools refuse to temporarily, but ultimately all comply with Reports or close their doors.
Impact on osteopathic drugs
Although nearly all alternative medical schools listed in the Flexner report are closed, the American Osteopathic Association (AOA) is able to bring in a number of osteopathic medical schools to comply with Flexner's recommendations and produce evidence-based practice. The curriculum of DO and MD of medical schools is now almost identical, the main difference being additional instruction in osteopathic schools of osteopathic manipulative drugs [citation needed].
See also
- The Ten Committees
References
Further reading
Beck's Andrew H. (5 May 2004). "Flexner's report and standardization of American medical education" (PDF) . The Journal of the American Medical Association . 291 (17): 2139-40. doi: 10.1001/jama.291.17.2139. PMIDÃ, 15126445 . Retrieved November 24 2012 .External links
- The Flexner Report (PDF) from the Carnegie Foundation for Teaching Progress
- "Transformation Med School Flexner Report", All Things to Consider , August 16, 2008.
- Flexner Report - 100 Years Later (September 2011)
Source of the article : Wikipedia
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