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Modern History of Medical Education

Informal medical education dates back to historical figures like the Hindu physician, Charaka and the Greek physician, Hippocrates. Yet formalization medical education is a relatively a phenomenon of modern history. Even through the Renaissance medical education was often quite theoretical and book driven, relying memorizing ancient texts from Galen and Hippocrates. With rising popularity of medicine, there was a petition in England to set up formal university requirements for medical degrees. The enforcement of this petition was not perfect and over this time period. Also during this time, groups of barber-surgeons incorporated, were officially recognized by the parliament, and given a monopoly to teach anatomy and surgery. Similarly, physicians formalized and focused on drugs.

Over time, the need to formalize medical education became clear and Thomas Linacre founded the Royal College of Physicians in order to establish a better system to license the ability to practice medicine. This marked the beginning of the modern era of medical education.. This new, transition era began with figures like Francis Bacon with his publication of The Advancement of Learning and Harvey with his work on the circulation of the heart. The division and incorporations which had formed earlier were all formalized by the 18th century, each had their own laws and systems of educating people within their own fields. However, there was some clear overlap between the various different groups of 'medical' domains which created conflicts. Until about the mid-nineteenth century, the various fields went through various transitions and there were still a number of unqualified physicians, surgeons, and apothecaries. It became clear that in addition to formal systems, there was a need for uniformity and clarity within the profession.

There were a number of students who sought out French and German schools in the nineteenth century, including American students who would then return with their knowledge to the United States and spread what they had learned. The American medical education system was deeply influenced by the systems in Edinburgh and London's apprenticeship systems. It was fairly standard in each state to require people to be licensed in order to practice medicine. In the 1890's, Johns Hopkins stood out as by requiring an undergraduate degree in order to study medicine and become a physician. Yet, the education system before the twentieth century was still unstandardized. The different medical schools at the time had a huge variance of curriculum. The turning point for medical education came in 1910 with the publication of the Flexner report which reviewed the major problems in medical education and advocated for greater standardization, in large part based off of the model that Johns Hopkins had already set out. This report led to the establishment of the following formal requirements in order of completion: an undergraduate degree, two years of science training, and two years of clinical work in a hospital. . After World War 1, the practice of doing an internship after medical school became standard. In the 1930s and 1940s there was a rise in specialization and the way to become a specialized practitioner was to go through a medical residency program at a hospital. This specialization continued to grow after World War 2 and there was greater investment from the government through organizations like the National Institute of Health.