Modern American Medical Education

  • Medicine & Health
  • 1910

Andrew Carnegie did not have a strong personal interest in medicine. He believed in the power of education to promote wealth and well-being in society, though, so when the American Medical Association Council on Medical Education approached Carnegie in 1906 he was highly supportive of its efforts to restructure medical education in America. The Carnegie Foundation for the Advancement of Teaching became keenly interested in educator Abraham Flexner, who published a critique of American higher education in the same year. Henry Pritchett recruited Flexner to lead a study of medical education and present a report with recommendations.

Published in 1910, Flexner’s book-length Medical Education in the United States and Canada set off a firestorm of controversy among educators and physicians. Though he praised a few medical schools, Flexner condemned the majority. When he asked a Washington state medical school if they had lab facilities, the dean replied, “Surely, I have it upstairs”—then went up and brought back down a small blood-pressure measuring device.

Flexner called for higher standards, more hands-on clinical work, more research. This prompted Robert Brookings, a wealthy merchant, to request a meeting with him so they could plan a reconstruction of the medical school at Washington University. Yale also instituted changes recommended in the Flexner report. Other universities responded defensively.

The Rockefeller Foundation hired Flexner in 1913 to advise its General Education Board. The foundation then systematically funded reforms at several medical schools, including Washington University at St. Louis, Yale University, the University of Chicago, and Vanderbilt University. In 1923, the Rockefeller Foundation gave additional money to reform public medical schools in Iowa, Colorado, Oregon, Virginia, and Georgia. These efforts established a single high standard for medical education in the United States, and launched American medicine to international prominence, a prestige it continues to possess today.