Mount Sinai School of Medicine, New York, New York 10029, USA.
Acad Med. 2010 Feb;85(2):302-9. doi: 10.1097/ACM.0b013e3181c88434.
Abraham Flexner's focus on science in medical school curricula was not intended to exclude or marginalize the importance of service in training American physicians. The erosion of service in academic medicine in the century after his report was the result of forces as wide ranging as research priorities, health care financing, and industry's influence. The authors review the historical context of these changes and make the case that reintroducing service into medical school curricula has never been more important. They describe the impact that neglecting service has had on society, patients, the medical profession, medical students, and medical education. After defining what is meant by social, public, or community service, they go on to detail signature programs at University of Texas Medical Branch, University of New Mexico Health Sciences Center, and Mount Sinai School of Medicine, focusing on the two major categories of health care delivery and education. These examples, in geographically and demographically disparate schools of medicine, demonstrate that it is possible to successfully reintegrate service into the missions of academic medical centers and medical schools.
亚伯拉罕·弗莱克斯纳关注医学院课程中的科学，并非旨在排除或边缘化服务在培养美国医生方面的重要性。在他的报告发布后的一个世纪里，学术医学中的服务不断减少，这是研究重点、医疗保健融资和行业影响等多种因素共同作用的结果。作者回顾了这些变化的历史背景，并提出将服务重新引入医学院课程比以往任何时候都更为重要。他们描述了忽视服务对社会、患者、医疗行业、医学生和医学教育的影响。在定义了什么是社会、公共或社区服务之后，他们详细介绍了德克萨斯大学医学分部、新墨西哥大学健康科学中心和西奈山医学院的特色项目，重点介绍了医疗服务和教育这两个主要类别。这些来自地理位置和人口统计学上差异很大的医学院的例子表明，成功地将服务重新融入学术医疗中心和医学院的使命是有可能的。
