Does Pathology Need a Modern Day Flexner Report?

Happy New Year! I hope that everyone has been having a great holiday season so far. I just wanted to share some brief musings I recently had as we start our new year…

Most of us have heard of the famous 1910 Flexner Report but for those who are unfamiliar, it is not exaggerating to state that it transformed and birthed the modern concept of biomedical education that we know today. Originally entitled “Medical Education in the United States and Canada”, it was study commissioned by the Carnegie Foundation for the Advancement of Teaching (CFAT), an American educational policy and research “think tank” founded in 1905. The report’s author, a former secondary school teacher and principal and not a physician, toured all the existing medical schools in both the U.S. and Canada and recommended reforms that would result in the standardization of the structure of medical curricula with Johns Hopkins as their ideal model. Medical education went from for-profit apprenticeships, varying in quality, to an academic model of basic science study followed by practical hands-on training in patient care. Eventually with standardized accreditation requirements, most medical school curricula, despite their differences in implementation, had their core foundation in common: didactic years to learn and clinical years to apply (under supervision).

Like the proprietary “medical” training institutions of yesteryear that existed prior to the Flexner report, do our pathology training programs need a global re-evaluation and an overhaul? Despite the existence of ACGME accreditation criteria and visits, do we have programs that need serious reform or termination to meet an ideal? Do our accreditation standards need to change to create a new ideal? And must we come together now to adapt our expectations and training objectives to meet the challenges of our rapidly evolving health care landscape? What is and should be the role of the pathologist on the interdisciplinary clinical health care team? And so the core question becomes, what are the most important things that we need to teach our trainees and how do we go best about it? I’d love to hear your thoughts…

And to encourage scholarship in the Flexner tradition that also emphasized the role of research in our education…for those who would like to submit an abstract for resident poster and platform presentations, submission periods for these conferences are currently open (except for CAP) with the following deadlines (I’ll try to update with more later but these are the most immediate in terms of deadlines in the next quarter):


-Betty Chung, DO, MPH, MA is a third year resident physician at Rutgers – Robert Wood Johnson University Hospital in New Brunswick, NJ.

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