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Medicine
Date
Jan 9, 2024
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1
Changes in Medical Education
Connie Osiecki
Capella University
BHA-FPX4002: History of the United States Health Care System
Dr. Shad Smith
October 2023
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Changes in Medical Education
The landscape of medical education has dramatically changed from the 1800s to today. In
the 1800s, most medical students never attended college, and some barely knew how to read or
write. Medical support staff was non-existent; therefore, doctors practiced alone and collected
payments themselves. By the mid-century 1900s, medical schools grew, but their diplomas were
considered licenses. There were support staff as well, such as nurses and secretaries. Fast
forward to the 2000s, we have multiple types of physicians, specialists, and medical support
staff, and the education dramatically differs depending on the level of the support staff.
Apprenticeship Model vs. Academic Model
Description and Comparison of Both Models
Most of our early history of the healthcare profession had few regulations for education.
Providers were primarily "learned gentlemen" with few effective practical skills (Groccia &
Ford, 2020). After the war in 1812, medical schools were rapidly increasing, but education
needed to be more consistent. Moving into the 1900s, the American Medical Association (AMA)
helped restructure medical education as physicians had to complete apprenticeships. The
apprenticeship system incorporated hands-on instruction from a practitioner and involved
supervision as they learned as medical students. The apprenticeship system grew due to the
World Wars, as there were shortages of medical staff due to men being out fighting for the
country. The AMA suggested students complete a minimum of one year in college. Despite the
efforts of the AMA's attempt to standardize medical education, it was Flexner who helped reform
medical education. Apprenticeships were just the building block of the academic model. The
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academic model was an era where strict adherence to medical education was a must. Doctors
wanting the ability to practice medicine came with having to do four years of a medical school
curriculum, two years of basic science education, followed by two requirements, including a high
school diploma and a minimum of two years of college science (Groccia & Ford, 2020). Flexner
proposed this medical school curriculum, and only 66 medical schools survived the reform. In
addition to medical schools being reformed, they also partnered with hospitals, enhancing the
student experience. Once the academic model was in place, medical schools started standardized
testing for admission. The standardized testing was called the Medical College Admission Test
(MCAT). The development of the MCAT was a significant step in the beginning of the quality of
medicine.
Analysis of Evolution and Impact
The apprenticeship model, being the backbone of the academic model, proves the quality
of medical education has grown very strictly as healthcare demands continue to grow
exponentially. Healthcare, from no medical education to strenuous and vigorous training of years
of ongoing medical education, has an enormous impact on the survivors of sickness and diseased
patients. In the 1900s, an apprenticeship with another practicing physician was better than no
medical education in the early 1800s, proving that science education helped sustain and keep
patients alive. The evolution of medical education continues to address the vulnerabilities and
inefficiencies in healthcare. Continuous medical education is essential to caring for complex
patients, as well as non-complex patients. Once medical schools became standardized and a high
school diploma, as well as a higher education, was mandatory, the quality of healthcare became
considerably better, and deaths became significantly lower. The academic model has continued to
have a considerable impact in modernizing medical education. As we move forward into the
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future, the healthcare industry is doing more scientific research. The healthcare field continues to
learn and grow from this research, allowing those going into the medical field to learn and grow.
Importance of Understanding History of Medicine