Medical education for a healthier population

Reflections on the Flexner report from a public health perspective

Rika Maeshiro, Ian Johnson, Denise Koo, Jean Parboosingh, Jan K. Carney, Neil Gesundheit, Evelyn T. Ho, David Butler-Jones, Denise Donovan, Jonathan A. Finkelstein, Nancy M. Bennett, Barbie Shore, Stephen A Mccurdy, Lloyd F. Novick, Lily Dow Velarde, M. Marie Dent, Ann Banchoff, Laurence Cohen

Research output: Contribution to journalArticle

75 Citations (Scopus)

Abstract

Abraham Flexner's 1910 report is credited with promoting critical reforms in medical education. Because Flexner advocated scientific rigor and standardization in medical education, his report has been perceived to place little emphasis on the importance of public health in clinical education and training. However, a review of the report reveals that Flexner presciently identified at least three public-health-oriented principles that contributed to his arguments for medical education reform: (1) The training, quality, and quantity of physicians should meet the health needs of the public, (2) physicians have societal obligations to prevent disease and promote health, and medical training should include the breadth of knowledge necessary to meet these obligations, and (3) collaborations between the academic medicine and public health communities result in benefits to both parties.In this article, commemorating the Flexner Centenary, the authors review the progress of U.S. and Canadian medical schools in addressing these principles in the context of contemporary societal health needs, provide an update on recent efforts to address what has long been perceived as a deficit in medical education (inadequate grounding of medical students in public health), and provide new recommendations on how to create important linkages between medical education and public health.Contemporary health challenges that require a public health approach in addition to one-on-one clinical skills include containing epidemics of preventable chronic diseases, reforming the health care system to provide equitable high-quality care to populations, and responding to potential disasters in an increasingly interconnected world. The quantitative skills and contextual knowledge that will prepare physicians to address these and other population health problems constitute the basics of public health and should be included throughout the continuum of medical education.

Original languageEnglish (US)
Pages (from-to)211-219
Number of pages9
JournalAcademic Medicine
Volume85
Issue number2
DOIs
StatePublished - Feb 2010

Fingerprint

Medical Education
Public Health
public health
Population
education
health
physician
Health
Physicians
obligation
Disease
reform
Clinical Competence
Quality of Health Care
Disasters
Medical Schools
medical student
Medical Students
disaster
deficit

ASJC Scopus subject areas

  • Medicine(all)
  • Education

Cite this

Maeshiro, R., Johnson, I., Koo, D., Parboosingh, J., Carney, J. K., Gesundheit, N., ... Cohen, L. (2010). Medical education for a healthier population: Reflections on the Flexner report from a public health perspective. Academic Medicine, 85(2), 211-219. https://doi.org/10.1097/ACM.0b013e3181c885d8

Medical education for a healthier population : Reflections on the Flexner report from a public health perspective. / Maeshiro, Rika; Johnson, Ian; Koo, Denise; Parboosingh, Jean; Carney, Jan K.; Gesundheit, Neil; Ho, Evelyn T.; Butler-Jones, David; Donovan, Denise; Finkelstein, Jonathan A.; Bennett, Nancy M.; Shore, Barbie; Mccurdy, Stephen A; Novick, Lloyd F.; Velarde, Lily Dow; Dent, M. Marie; Banchoff, Ann; Cohen, Laurence.

In: Academic Medicine, Vol. 85, No. 2, 02.2010, p. 211-219.

Research output: Contribution to journalArticle

Maeshiro, R, Johnson, I, Koo, D, Parboosingh, J, Carney, JK, Gesundheit, N, Ho, ET, Butler-Jones, D, Donovan, D, Finkelstein, JA, Bennett, NM, Shore, B, Mccurdy, SA, Novick, LF, Velarde, LD, Dent, MM, Banchoff, A & Cohen, L 2010, 'Medical education for a healthier population: Reflections on the Flexner report from a public health perspective', Academic Medicine, vol. 85, no. 2, pp. 211-219. https://doi.org/10.1097/ACM.0b013e3181c885d8
Maeshiro, Rika ; Johnson, Ian ; Koo, Denise ; Parboosingh, Jean ; Carney, Jan K. ; Gesundheit, Neil ; Ho, Evelyn T. ; Butler-Jones, David ; Donovan, Denise ; Finkelstein, Jonathan A. ; Bennett, Nancy M. ; Shore, Barbie ; Mccurdy, Stephen A ; Novick, Lloyd F. ; Velarde, Lily Dow ; Dent, M. Marie ; Banchoff, Ann ; Cohen, Laurence. / Medical education for a healthier population : Reflections on the Flexner report from a public health perspective. In: Academic Medicine. 2010 ; Vol. 85, No. 2. pp. 211-219.
@article{47adb40b3b5e4938ae6599a401a5ac4a,
title = "Medical education for a healthier population: Reflections on the Flexner report from a public health perspective",
abstract = "Abraham Flexner's 1910 report is credited with promoting critical reforms in medical education. Because Flexner advocated scientific rigor and standardization in medical education, his report has been perceived to place little emphasis on the importance of public health in clinical education and training. However, a review of the report reveals that Flexner presciently identified at least three public-health-oriented principles that contributed to his arguments for medical education reform: (1) The training, quality, and quantity of physicians should meet the health needs of the public, (2) physicians have societal obligations to prevent disease and promote health, and medical training should include the breadth of knowledge necessary to meet these obligations, and (3) collaborations between the academic medicine and public health communities result in benefits to both parties.In this article, commemorating the Flexner Centenary, the authors review the progress of U.S. and Canadian medical schools in addressing these principles in the context of contemporary societal health needs, provide an update on recent efforts to address what has long been perceived as a deficit in medical education (inadequate grounding of medical students in public health), and provide new recommendations on how to create important linkages between medical education and public health.Contemporary health challenges that require a public health approach in addition to one-on-one clinical skills include containing epidemics of preventable chronic diseases, reforming the health care system to provide equitable high-quality care to populations, and responding to potential disasters in an increasingly interconnected world. The quantitative skills and contextual knowledge that will prepare physicians to address these and other population health problems constitute the basics of public health and should be included throughout the continuum of medical education.",
author = "Rika Maeshiro and Ian Johnson and Denise Koo and Jean Parboosingh and Carney, {Jan K.} and Neil Gesundheit and Ho, {Evelyn T.} and David Butler-Jones and Denise Donovan and Finkelstein, {Jonathan A.} and Bennett, {Nancy M.} and Barbie Shore and Mccurdy, {Stephen A} and Novick, {Lloyd F.} and Velarde, {Lily Dow} and Dent, {M. Marie} and Ann Banchoff and Laurence Cohen",
year = "2010",
month = "2",
doi = "10.1097/ACM.0b013e3181c885d8",
language = "English (US)",
volume = "85",
pages = "211--219",
journal = "Academic Medicine",
issn = "1040-2446",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - Medical education for a healthier population

T2 - Reflections on the Flexner report from a public health perspective

AU - Maeshiro, Rika

AU - Johnson, Ian

AU - Koo, Denise

AU - Parboosingh, Jean

AU - Carney, Jan K.

AU - Gesundheit, Neil

AU - Ho, Evelyn T.

AU - Butler-Jones, David

AU - Donovan, Denise

AU - Finkelstein, Jonathan A.

AU - Bennett, Nancy M.

AU - Shore, Barbie

AU - Mccurdy, Stephen A

AU - Novick, Lloyd F.

AU - Velarde, Lily Dow

AU - Dent, M. Marie

AU - Banchoff, Ann

AU - Cohen, Laurence

PY - 2010/2

Y1 - 2010/2

N2 - Abraham Flexner's 1910 report is credited with promoting critical reforms in medical education. Because Flexner advocated scientific rigor and standardization in medical education, his report has been perceived to place little emphasis on the importance of public health in clinical education and training. However, a review of the report reveals that Flexner presciently identified at least three public-health-oriented principles that contributed to his arguments for medical education reform: (1) The training, quality, and quantity of physicians should meet the health needs of the public, (2) physicians have societal obligations to prevent disease and promote health, and medical training should include the breadth of knowledge necessary to meet these obligations, and (3) collaborations between the academic medicine and public health communities result in benefits to both parties.In this article, commemorating the Flexner Centenary, the authors review the progress of U.S. and Canadian medical schools in addressing these principles in the context of contemporary societal health needs, provide an update on recent efforts to address what has long been perceived as a deficit in medical education (inadequate grounding of medical students in public health), and provide new recommendations on how to create important linkages between medical education and public health.Contemporary health challenges that require a public health approach in addition to one-on-one clinical skills include containing epidemics of preventable chronic diseases, reforming the health care system to provide equitable high-quality care to populations, and responding to potential disasters in an increasingly interconnected world. The quantitative skills and contextual knowledge that will prepare physicians to address these and other population health problems constitute the basics of public health and should be included throughout the continuum of medical education.

AB - Abraham Flexner's 1910 report is credited with promoting critical reforms in medical education. Because Flexner advocated scientific rigor and standardization in medical education, his report has been perceived to place little emphasis on the importance of public health in clinical education and training. However, a review of the report reveals that Flexner presciently identified at least three public-health-oriented principles that contributed to his arguments for medical education reform: (1) The training, quality, and quantity of physicians should meet the health needs of the public, (2) physicians have societal obligations to prevent disease and promote health, and medical training should include the breadth of knowledge necessary to meet these obligations, and (3) collaborations between the academic medicine and public health communities result in benefits to both parties.In this article, commemorating the Flexner Centenary, the authors review the progress of U.S. and Canadian medical schools in addressing these principles in the context of contemporary societal health needs, provide an update on recent efforts to address what has long been perceived as a deficit in medical education (inadequate grounding of medical students in public health), and provide new recommendations on how to create important linkages between medical education and public health.Contemporary health challenges that require a public health approach in addition to one-on-one clinical skills include containing epidemics of preventable chronic diseases, reforming the health care system to provide equitable high-quality care to populations, and responding to potential disasters in an increasingly interconnected world. The quantitative skills and contextual knowledge that will prepare physicians to address these and other population health problems constitute the basics of public health and should be included throughout the continuum of medical education.

UR - http://www.scopus.com/inward/record.url?scp=76549108822&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=76549108822&partnerID=8YFLogxK

U2 - 10.1097/ACM.0b013e3181c885d8

DO - 10.1097/ACM.0b013e3181c885d8

M3 - Article

VL - 85

SP - 211

EP - 219

JO - Academic Medicine

JF - Academic Medicine

SN - 1040-2446

IS - 2

ER -