The History of Academic Medicine: A Notable Year

While the history of medicine is expertly chronicled in many excellent books and journals, much less has been written about the history of academic medicine. And yet, history is made every day at medical schools and teaching hospitals through new discoveries, through improved methods of patient care, and by the development of new and innovative approaches to educating the next generation of physicians and biomedical scientists. History is also made by how and why medical schools and teaching hospitals are born or die, affiliate with one another, and interface with society. These actions and events, studied within the context of the time and place in which they occurred, tell important stories, reveal critical lessons, and have the potential to inform current and future decision making. This year is noteworthy in the history of academic medicine because it marks the 100th anniversary of the publication of the Flexner Report. Academic Medicine devoted its entire February 2010 issue to a reexamination of this historic document through a variety of interesting lenses. Articles in that issue looked at the report from the perspectives of public health, diversity, generalist disciplines, liberal education, professionalism, social and community service, ethics and humanities, medical education in different parts of the world, key historical questions, and other crucial vantage points. In the spirit of creating as complete a record as possible of medical education in the United States and Canada 100 years after the Flexner Report, the journal published a supplement (to the September 2010 issue) that contains structured reports about the educational programs leading to the MD degree for almost every medical school in these two countries. (In the same spirit, the journal has invited each MD-degree-granting school in the United States and Canada that did not submit a structured report for the September supplement to submit one that will be posted online and linked to the supplement.) In addition, the supplement has six articles that take a historically-grounded look at where medical education is headed. In the November 2010 issue, the journal published additional articles and commentaries on Flexner, including the first in-depth examination of Henry Pritchett's introduction to the Flexner Report and a consideration of Flexner's contributions in the 49 years that he lived after the publication of his report. And that brings us to December. In this issue of the journal, you will find two articles and two commentaries that examine important events in the more recent history of academic medicine. In the two articles, John Kastor, MD, recounts and analyzes the circumstances surrounding the merger and subsequent de-merger of two of New York's outstanding academic health centers. And to expand and enrich our understanding of these articles, I invited the current leaders of these august institutions to reflect on what happened, to provide a sense of the current climate, and to share their visions for the future. I am grateful to Robert Grossman, MD, the Saul J. Farber Dean and CEO of NYU Langone Medical Center, and to Ken Davis, MD, the president and CEO of Mount Sinai Medical Center, who provide essential, first-person commentary of pivotal historical events involving their medical schools and teaching hospitals. Studying the history of academic medicine is important. In coming months, the journal will present more articles about historical events that have unfolded at medical schools and teaching hospitals. And I look forward to receiving new submissions from authors who ask penetrating questions, carry out cogent analyses, and produce new insights about historical events. It is this deeper, richer, and more comprehensive understanding of the past that will enable us to form a more sophisticated sense of the present and make the best decisions for the future. Steven L. Kanter, MD

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