Medical education reform in the South, 1910-1941
- UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)
- Mike Rubin (Creator)
- Institution
- The University of North Carolina at Greensboro (UNCG )
- Web Site: http://library.uncg.edu/
- Advisor
- Charles Bolton
Abstract: Medical education in colonial America and early nationhood was a derivative of the British system based on the University and affiliated teaching hospital. The American system’s graduates required the approval of state licensing agencies in order to practice. Beginning with the proliferation of proprietary medical schools in the 1820s, state regulations involving the quality of medical schools and their students were ignored, both of which rapidly became substandard. State agencies responsible for licensing restrictions were withdrawn in the Jacksonian era of deregulation for businesses and professions, and these for-profit medical schools prospered to the detriment of the quality of its institutions and graduate physicians. Attempts to reverse this trend by professional organizations, including state medical societies, the American Medical Association (AMA) formed in 1847, and the American Medical College Association (AMCA) formed in 1876, were unsuccessful. It was not until the 1880s that state boards of health were given the authority of its legislatures to deny graduates of the marginal medical schools access to the necessary licensing exams. Together with the AMA and the American Association of Medical Colleges (AAMC, previously the AMCA), they created the first “Reform Coalition.” In the first decade of the twentieth century the AMA developed its Council on Medical Education (CME) that conducted inspection surveys of the nation’s 166 medical schools, and allied with the Carnegie Foundation administered a similar survey in 1909, known as “The Flexner Report,” named after its chief investigator, the educator Abraham Flexner. Evaluating the quality of these institutions, Flexner concluded that only 31 met the necessary criteria to continue operation, which included only 6 southern institutions. Several of the failing institutions, not selected by the CME or Flexner to remain viable, developed unique strategies to improve and become acceptable and eventually accredited medical schools over the next two to three decades. These strategies included the institutions becoming organic departments of state universities shedding their proprietary model, merging with other endangered medical schools and pooling their resources, and developing relationships with local hospitals to control an adequate number of teaching beds for their students’ clinical exposure. These borderline institutions also appealed to their community’s pride and pragmatism and elicited financial support, gifts, and favorable publicity from local agencies, newspapers and politicians to build infrastructure and goodwill. Most importantly, these institutions made overtures to local wealthy benefactors and national medically-oriented philanthropies to build endowments and to develop relationships with regional “pathfinder” institutions to emulate their model, especially with assistance in academic and organizational issues). Employing these strategies during the education reform years sustained the South with fourteen complete medical schools (including three new institutions) and three preclinical institutions. Fortunately for the Allied cause, the last of the medical schools was in place on the cusp of World War II, when the South was able to provide quality healthcare for the region and the increased demand from those in the armed forces.
Medical education reform in the South, 1910-1941
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Created on 5/1/2024
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Additional Information
- Publication
- Dissertation
- Language: English
- Date: 2024
- Keywords
- Abraham Flexner, General Education Board, Medical education reform, Medical schools in the Depression, Reform coalition, Southern Medical Schools
- Subjects
- Flexner, Abraham, $d 1866-1959
- Medical education $z Southern States
- Educational change $z Southern States