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Article
June 18, 1982

Death of the Clinician: Requiem or Reveille?

JAMA. 1982;247(23):3267. doi:10.1001/jama.1982.03320480073034

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Abstract

Until quite recently, Abraham Flexner had a most agreeable public image. He stood out as the great reformer of medical education who, almost single-handedly, eliminated the unfit medical schools and, through his famous Report of 1910, set medicine on its present-day "scientific" course. Fortunately, the past decade has seen this hagiolatry deflated and, through historical accuracy, the reevaluation of the whole story of educational reform and reassignment of credit. Flexner's role in reform was by no means negligible, but his dogmatism, prejudices, rigidity, and lust for power actually did as much harm as good.

Lepore's book concentrates on one particular aspect: Flexner's insistence that clinical medicine should be taught by full-time salaried staff. The presentation has two major components. One we may call a historical account of the way that Flexner and the General Education Board tried to put through the full-time concept into academic medicine. Lepore uses specific case

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