Commentary: Flexner and Dutch Medical Education: A Misinterpretation?
Bibliographic record
Abstract
Abraham Flexner's 1910 report, Medical Education in the United States and Canada, was hardly noticed in the Netherlands, and though his 1925 book, Medical Education: A Comparative Study, was extensively discussed in the Dutch Medical Journal, it did not and could not affect medical education in the Netherlands. Until the 1970s, the medical curriculum in the Netherlands consisted of four phases: the propaedeutic year (premedical sciences), two preclinical years, two theoretical clinical years, and one-and-a-half to two years of clerkships. When in the 1970s interest in curriculum innovation arose in the Netherlands, it was based on developments in North America that challenged "Flexnerian" norms in medical education. As hardly anyone in the Netherlands cared to study Flexner's work closely, his name became synonymous with the conventional curriculum just as it had in North America. However, the Dutch conventional curriculum was quite different from the American conventional curriculum, so attributing its origins to Flexner's work was a serious misrepresentation. In this commentary, the author clarifies common misconceptions about the history of Dutch medical education and argues that the curriculum as Flexner saw it differed considerably from the Dutch medical curriculum a century ago.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.012 | 0.088 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.007 | 0.013 |
| Scholarly communication | 0.005 | 0.009 |
| Open science | 0.006 | 0.004 |
| Research integrity | 0.034 | 0.034 |
| Insufficient payload (model declined to judge) | 0.004 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".