The Medical School, Its Products and Its Problems

The major influences on the thrust of medical education in the United States since the turn of the century are highlighted by the Flexner Report of 1910 and the Carnegie Report in 1970. Striking changes have occurred—largely through influences external to the medical schools—the major one being a vast expansion of biomedical science and research. The nature of the financing of medical research has empha sized the departmentalization of medical schools, making it more difficult to achieve over-all unity and balance. Since World War II there has been a much deeper involvement of the federal and state governments in the support of medical educa tion, with emphasis not only on research but on the develop ment of new schools—thus creating an increasing dependence of all medical schools, both public and private, on governmental financial support. The alignment and partnership of forces now involved would indicate that the rate of change in medical education following the current Carnegie Report will be much more rapid than that which was precipitated by the Flexner Report sixty years ago.