Osler, Flexner, apprenticeship and 'the new medical education'

Abstract

These are bewildering times for doctors who teach medical students. The UK General Medical Council (GMC) has reminded them they have a duty to teach,1 yet stirred up such radical change that their task is unrecognizably different from what they themselves experienced as students.2,3 This essay draws on biographies of two people who changed the face of medical education in the 20th century to trace the origins of this bewilderment and suggest a direction for the 21st century.4,5 Most of today's doctors just associate the name of William Osler with nodes they were taught about but never see. In Michael Bliss's biography, he comes to life as a master clinician, apprentice-master, and humanist role model. I first became aware of Abraham Flexner as the author of a century-old report that got medical education into the mess it is in today. Wrong. He was a visionary educationalist who raised standards of medicine round the world by wedding it with biomedical science. After vignettes of these two men, I describe what the GMC has recommended and read between the lines of its recommendations. To finish, I suggest the wheel has come full circle. Apprenticeship, central to Osler and Flexner's educational visions, needs to be revitalized.