Abraham Fleckner’s Legacy


I recently saw a startling and disturbing presentation about the startling but ultimately not startling roots of racism in medicine. It was not, but it is something that all Nurse Practitioners (NPs) and PAs need to focus on. It happened and has influenced practice today, both personally and systematically.

After the presentation, I remembered hearing about Abraham Flexner, often called the “father of modern medical education.” Although he was not a medical doctor, he was highly regarded as a medical reformer and researcher. He is best known for his 1910 Flexner Report. After visiting all 155 medical schools operating at the time, the report reviewed medical education and recommended sweeping changes. According to his 2020 posting for the Association of American Medical Colleges (AAMC), the Flexner report states that “medical We are calling for major reforms in education.”

Since then, Flexner has been viewed favorably in the medical community. However, this began to change in his 2010s and early 2020s, when his work was reviewed by many in the medical community. As one of his results, the 2021 Abraham Flexner Award for Merit in Medical Education has been renamed his AAMC Award for Excellence in Medical Education.


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Many factors contributed to this shift in attitude, and there was even some reflection on the impact of Flexnor’s famous 1910 report. The report recommends new, stricter standards for medical training centers. Much of it is still used in medical education today, including a model of medical education that included two years of basic science followed by his two years of clinical training. At the time, many medical training facilities lacked the necessary resources to adopt changes in curriculum and training, resulting in the closure of 89 out of 155 medical schools. This included five of his seven schools that focused on training black doctors.

The AAMC report explained the impact of that development on the current status of black physicians, stating that only 5% of American physicians are black, while black Americans make up 13.4% of the US population. I’m here. If all seven black-focused medical training institutions were open, there would have been an additional 35,315 black doctors as of 2020, according to an AAMC report.

His comments about black medical students were equally disturbing. A well-educated black hygienist is very helpful. Essentially untrained blacks with doctorate degrees are dangerous,” wrote Flexner.

Women, like black doctors, were affected by Flexner’s report. The sexist writing contained the following statements:

In 1900, women made up 6% of the nation’s general practitioners, and in 1909 they were accepted into 91 of the 155 medical schools. This includes her three schools dedicated to women’s education. By 1940, however, only 4% of doctors were women. Part of the reason is that many schools that were accepting more women closed and there was a social backlash against the role of women in the health profession,” he said. . report. It wasn’t until her 1960s that women started catching up with men, and “women still lag behind men in pay, leadership positions and research publication.”

Many people will say, “That was over 110 years ago!” But that’s the actual point, the uncomfortable truth. The Flexner Report of 1910 not only reflects the racist and sexist legacy of its medical school origins, but it is also clearly racist and beliefs had a direct impact on ongoing disparities in both. Clinician.

Such reflections by today’s clinicians are undeniably painful, but they are also arguably essential if we are to continue to break free from the racist and sexist roots of our profession.



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