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Ezekiel J. Emanuel, MD, PhD

JAMA. 2006;296:1128-1131.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

A century ago, the American Medical Association created the Council on Medical Education and published the first minimal standards for medical schools and an ideal medical curriculum. Then, the Carnegie Foundation for the Advancement of Teaching funded an evaluation of medical school performance titled Medical Education in the United States and Canada (the Flexner report).¹ While many objected to its highly critical tone, most medical educators endorsed it and implemented significant change.² A major consequence was that the already fading practice-oriented proprietary schools finally died, while medical education was divided into preclinical science training and hospital-based clinical training.

Since Flexner's time, leading physicians and medical organizations have complained about medical education.^3-4 At least 25 reports have proposed reforms in both the methods and content of medical education, including fewer lectures, more case-based learning, earlier introduction of patient interactions, and using simulations, as well as more . . . [Full Text of this Article]

The Need for Change

Author Affiliations: Department of Clinical Bioethics, The Clinical Center, National Institutes of Health, Bethesda, Md.

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