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March 1, 2000

EducationTime to Heal: American Medical Education from the Turn of the Century to the Managed Care Era

Author Affiliations

Harriet S.MeyerMD, Contributing EditorJonathan D.EldredgeMLS, PhD, Journal Review EditorRobertHoganMD, adviser for new media


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JAMA. 2000;283(9):1211-1212. doi:10.1001/jama.283.9.1211-JBK0301-3-1

In the 19th century US medical education was chaotic. Medical schools were, for the most part, proprietary institutions designed for profit, and few had university affiliations. Students studied the basic sciences of the day, saw very few patients, and treated even fewer. Instruction was didactic, and an ability to memorize arcane "facts" of questionable value was the most important asset a student might have. Another important asset was enough money to pay the tuition for two 16-week terms of lectures. Faculties were small and usually undistinguished. There were no admission requirements, and new doctors appeared every 8 months, charged with the responsibility, but not the ability, to tend to the nation's medical needs. Some aspirants to medical knowledge sought education in the established schools of Europe, but they were a small minority of practitioners.

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