In the early 1900s, the American Medical Association(AMA) formed the Council on Medical Education(CME) to restructure medical education. Why? Because it was a hodgepodge of inconsistency. The AMA wanted better doctors, better medical education, and better quality of care. Why? Because it was necessary to ensure the safety and care of the public. The CME, with the support of the Carnegie Foundation, decided to perform a survey of all medical schools in North America (of which there were 155) in an effort to find the standard they sought. Abraham Flexner, an esteemed educator (and unapologetic racist), was selected to execute the survey. Flexner ultimately settled on six institutions which he believed set the standard the AMA was seeking. His recommendations became known as the Flexner Report. His number one choice was Johns Hopkins, the medical model that continues to be followed today, 100+ years after his report. Substandard institutions were either absorbed by larger centers of education or closed down completely. Ultimately, the 155 medical schools were whittled down to 31 which had more rigorous admission requirements and standardized curricula.
As a result of the actions initiated by the AMA, medical education in the U.S. and Canada subsequently became the best in the world. This is exactly how education should function. Strive for the best to be the best. Everyone will not succeed; that is to be expected. If 100% of individuals could accomplish a set goal, surely one must question just how valuable the goal. One aspect of achievement is the work invested; the accomplishment gives one a sense of pride for a job well done. Isn’t that acknowledgement the reward? Isn’t the Olympics about those who have achieved excellence in their sport and recognition for that triumph? It takes years to attain that level of success. Because nothing worth having ever comes easy.
Today, there appears to be a paradigm shift occurring in which truncated “accomplishments” are rewarded with degrees, titles, job offers, financial compensation, etc. False equivalence to earned success when it is, in fact, not comparable. Time spent pursuing one’s honorable goals is ridiculed by others. As one who has lectured frequently on the value of education, this laissez faire mentality angers me. As a descendant of slaves who would be lynched for daring to learn how to read, this lackadaisical approach to education as a whole offends me. Online “Doctorate” degrees abound. Programs that are non-standardized, non-vetted, without oversight of any legitimate accrediting body and without stringent admission criteria exists in multiple disciplines, including health care. No one wants to do the work. No one wants to make the sacrifices. No one wants to pay the price. Let’s just find the alternate, easier pathway to obtain that all important but superfluous “degree” that is not worth the toilet paper on which it is written. Paper that would be worth more if I wiped my a** with it.
Education is about investment. Investment in ourselves. Investment in our craft. Investment in our future. Like all meaningful investments, the return is delayed. Patience is a virtue in such situations. We know there will be a return…with interest. That interest is the knowledge gained. That is the value of medical education, which by itself can do nothing. However, when that education is absorbed, incorporated, processed and utilized, it becomes knowledge. And that knowledge can then be shared with our next generation of physicians. It is the gift that keeps on giving. Do not allow others(insert corporate medicine here)to demean it. Do not take it for granted. Do not abuse it. Honor it. It deserves no less. Surely if the forefathers of medicine saw its value 100+ years ago, how can we not? Most importantly, respect those within it who have paid the price so that they could fulfill the objectives set by the AMA one hundred years ago–to ensure the safety and care of the public.