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February 24, 1984

XX. The Flexner Report of 1910

Author Affiliations

From the Morris Fishbein Center, University of Chicago.

JAMA. 1984;251(8):1079-1086. doi:10.1001/jama.1984.03340320057029

The so-called Flexner report,1 published in 1910, is probably the most grossly overrated document in American medical history. Its reputation superbly illustrates the post hoc ergo propter hoc fallacy: medical education underwent great changes after the Flexner report appeared; therefore the credit belongs to Flexner. This reasoning has endowed the report with canonical status that has resulted in some horrendous distortion of the historical record.2

Long before 1910, vast changes were gathering momentum, whose force has received all too little attention. Only recently have scholars given us a better perception. In 1959 Jarcho effectively reviewed some of the trends prior to the Flexner report and discussed relevant causal factors. Hudson emphasized that the "the tide of reform was running heavy by 1910" and that Flexner's "enduring legacy" really derived from what he accomplished later through the General Education Board. Chapman, in a cautious reappraisal, admitted that "the effect