Historical Document Archive (1820 ~ 1980)

by faithgibson on August 19, 2015

The Amazing Logistics of Flexner’s Fieldwork ~ Mark D. Hiatt, MD, MBA ~ 2000

Medical Sentinel 2000;5(5):167-168. 2000 Association of American Physicians and Surgeons (AAPS).

Dr. Hiatt is a resident in diagnostic radiology at the University of Virginia in Charlottesville, Virginia. His e-mail is hiatt@medscape.com.

“The Flexner Report(1) is one of the most cited evaluations of medical education in the twentieth century. Published in 1910 by the Carnegie Foundation, the Report arose from research conducted by Abraham Flexner, who claimed to have visited and objectively evaluated 155 graduate and twelve postgraduate medical schools in the United States and Canada. His recommendations have met with high regard in the ensuing nine decades,(2,3) but the underlying research has gone virtually unquestioned. The suspect motives and means behind the Report, as well as its equivocal legacy, have been described elsewhere.(4) This article explores in greater depth the amazing logistics of Flexner’s fieldwork.”

AMA-doc_CME & Flexner1899-1910 – original document with citations

A 3-page PDF titled “The AMA, NMA, and the Flexner Report of 1910″ from the AMA’s web site.

This report was originally prepared sometime after 1982 by AMA member Ololade Olakanmi for the Writing Group on the History of African Americans and the Medical Profession.

Taken from AMA records and other materials, it documented the many different schemes by the AMA to close all medical schools that accepted non-white students, immigrants and women, as well as medical schools that taught any discipline other than allopathic (drugs and surgery). This included naturopathy, homeopathy, osteopathy, the medicinal use of herbs, acupuncture, and Chinese medicine.

This included the transcript of a meeting held in December of 1908 between members of the AMA’s ‘Council on Medical Education’ and President Pritchett of the Carnegie Foundation, Foundation employ Abraham Flexner.  As quoted below, the meeting was to arrange a scheme in which work done by the AMA’s educational Council in 1904-1905 would be passed off as coming from a highly-respected and neutral “third party”, in this case, the Carnegie Foundation.

The purpose and practical impact of the Flexner Report ~ an excerpt from Wikipedia:

The Flexner Report is a book-length study of medical education in the United States and Canada, written by the professional educatorAbraham Flexner and published in 1910 under the aegis of the Carnegie Foundation. Many aspects of the present-day American medical profession stem from the Flexner Report and its aftermath.

The Report (also called Carnegie Foundation Bulletin Number Four) called on American medical schools to enact higher admission and graduation standards, and to adhere strictly to the protocols of mainstream science in their teaching and research. Many American medical schools fell short of the standard advocated in the Report, and subsequent to its publication, nearly half of such schools were forced to merge or were closed.

The Report also concluded that there were too many medical schools in the USA, and that too many doctors were being trained.

A repercussion of the Flexner Report resulting from the closure or consolidation of university training, was reversion of American universities to male-only admittance programs to accommodate a smaller admission pool.

This was a reversal of a trend by universities, which had begun opening and expanding female admissions as part of women’s and co-educational facilities only in the mid-to-latter part of the 19th century with the founding of co-educational Oberlin College in 1833 and private colleges such as Vassar College and Pembroke College.