Celebrating Birthdays: An Update on the Status of Undergraduate Medical Education

Abstract

The Council on Medical Education in Pediatrics (COMSEP) interrupts our “attributes of great clinical teachers” series to celebrate a birthday and 3 births! Although primarily medical educators have celebrated these events, COMSEP feels that all pediatricians should commemorate these milestones. One hundred years ago, in 1910, Abraham Flexner published a Carnegie Foundation–sponsored report about the status of medical education in Canada and the United States.1 His findings and recommendations led, in large part, to the transformation of medical education in North America. In 2010, on the anniversary of Flexner's seminal report, 2 new reports on the state of medical education in North America were released.2,3 In addition, a landmark conference was held to discuss ways to reform medical education in the 21st century.4 The purpose of this article is to provide the reports and conference background and highlight the main recommendations. In a subsequent article, we will evaluate pediatric education systems in relation to the 2010 recommendations. When the Carnegie Foundation for the Advancement of Teaching published Flexner's Medical Education in the United States and Canada ,1 medical education in the United States and Canada was chaotic, unregulated, and of poor quality. Few standards for admission or promotion existed, basic science instruction was mostly nonexistent, and few students were carefully supervised in hospital-based clinical practice. Within a decade of the Flexner report (Table 1), the number of medical schools had decreased by one-third, entrance requirements to medical school had been standardized and enforced, curricula had been standardized (2 years of basic science followed by 2 years of clinical science), medical schools had forged links to universities, … Address correspondence to William V. Raszka Jr, MD, Department of Pediatrics, University of Vermont College of Medicine, Given Courtyard, Burlington, VT 05405. E-mail: william.raszka{at}uvm.edu