Sullivan Alliance to Transform America's Health Professions, Joint Center for Political and Economic Studies, Washington, DC 20005, USA.
Acad Med. 2010 Feb;85(2):246-53. doi: 10.1097/ACM.0b013e3181c88145.
Although the 1910 Flexner Report recommended the closure of a large number of operating medical schools, its impact was disproportionately felt on minority schools. The report's recommendations resulted in the closure of five out of seven predominantly black medical schools. Also noteworthy about the report was Flexner's utilitarian argument that black physicians should serve as sanitarians and hygienists for black communities in villages and plantations. A century later, despite decades of targeted programs and advocacy, minorities are still vastly underrepresented among medical students, physicians, and medical school faculty of all ranks. Today's arguments about the need for diversity in medicine in many ways echo Flexner's words. They continue to focus on benefits to minority populations, service in underserved areas, and minorities' role in the primary care workforce. These are valid, in fact laudable aspirations, but when made in isolation, they circumscribe the value of minority medical professionals. Minorities in the medical sciences provide immeasurable services to the entire nation, enhancing educational outcomes, expanding and improving the quality of health care provided, and contributing to the breadth and depth of medical research. This article presents how the Flexner Report shaped medical education and created a culture of medical research leading to narrow performance standards that fail to properly reward teaching activities, patient care, and health promotion. Efforts to achieve diversity in medical education should not end at graduation but should be extended to provide minorities opportunities to excel and to lead.
尽管 1910 年的 Flexner 报告建议关闭大量的医学院，但它的影响却不成比例地体现在少数民族学校上。报告的建议导致七所主要黑人医学院中的五所关闭。该报告的另一个值得注意的地方是 Flexner 的功利主义论点，即黑人医生应该担任黑人社区村庄和种植园的卫生员和卫生学家。一个世纪后，尽管经过几十年的有针对性的项目和宣传，少数民族在医学生、医生和各级医学院教师中的代表性仍然严重不足。今天关于医学多样性的必要性的争论在很多方面都呼应了 Flexner 的言论。它们继续关注少数民族群体的利益、在服务不足地区的服务以及少数民族在初级保健劳动力中的作用。这些都是有效的，事实上是值得称赞的愿望，但如果孤立地提出，它们就限制了少数民族医疗专业人员的价值。医学科学界的少数民族为整个国家提供了无法估量的服务，提高了教育成果，扩大和改善了提供的医疗保健质量，并为医学研究的广度和深度做出了贡献。本文介绍了 Flexner 报告如何塑造医学教育，并创造了一种医学研究文化，导致狭隘的绩效标准，无法正确奖励教学活动、患者护理和健康促进。在医学教育中实现多样性的努力不应在毕业时结束，而应扩展到为少数民族提供卓越和领导的机会。
