Commentary: The Flexnerian Legacy in the 21st Century

Abstract

The climate of academic medicine today was shaped in part by Abraham Flexner's recommendations in 1910's Medical Education in the United States and Canada. At the celebration of the 100th anniversary of the Flexner Report, however, some wonder whether the times require another look at our complex system of medical education. In fact, an underlying theme of many articles in this special issue of Academic Medicine is that the medical education community's response to the Flexner Report—and the individualistic, expert-centric culture to which it gave rise—may now work against the collaboration needed for greater integration across the medical education continuum, highly networked teams in discovery research, and interprofessionalism in clinical care. The question, as many authors suggest, is not whether medical education is being true to Flexner, but whether academic medicine is responding to the implications of post-Flexnerian education and whether it is able to embrace the cultural change needed to address 21st-century health care needs. This commentary examines this cultural shift and identifies some key trends behind it, concluding by suggesting five success factors for achieving transformational change, including ways the Association of American Medical Colleges is working to support its members in these efforts.