Medicine as a Career

In seeking to become a physician, you are planning to join a fraternity of professional men and women who have a profound influence, both physically and emotionally, on the lives of many millions of people. The roots of medicine penetrate deeply into the history of humankind. Cave paintings reveal the existence of “healers” as far back as theIce Age. The medical practitioners of ancient China developed acupuncture and a smallpox vaccination method. Western medicine is indebted to the “scientific” approach developed in ancient Greece and Rome by men such as Hippocrates and Galen. These advances were preserved through the Dark Ages by the Arab world. In medieval Europe medical science stagnated until the rebirth of learning and experimentation in the Renaissance.

In the United States during the colonial era, medicine was largely a hit-or-miss affair. The pushing of the frontiers westward developed a pioneer type of doctor. A step forward was achieved in the last half of the eighteenth century when medical schools in the United States began conferring the MD degree and it was no longer necessary to journey abroad to obtain one. In 1910 the Flexner report, Medical Education in the United States and Canada, brought about a revolution in medical education and placed it on a sound basis by establishing standardized requirements of medical education. Flexner's basic recommendations included the following:

1. Medical education should be conducted in the context of a university. This would help ensure that students would gain a scientifically oriented foundation for the practice of medicine.
2. Schools should be changed from a “diploma mill” or trade school status to that of providing a professional school education.
3. The upgraded medical schools should be provided with a full-time faculty, because practicing physicians lacked time to devote themselves adequately to teaching.

Flexner's report resulted in a drastic reduction in the number of then-existing medical schools.

The impact of the Flexner report extended far beyond improving the quality of medical education. Ultimately it was responsible for the preeminence in biomedical research and the development of specialty medicine in this country.

Well before the turn of this century, Americans made major contributions to medical science, especially in the battle against infectious diseases. In the last half of the twentieth century, American medicine has become a world leader. Thus, to become a physician means entering a fellowship with a healing tradition that extends back to the beginnings of civilization.

Major highlights in American medical education are summarized below:

• 1765 — University of Pennsylvania opens the nation's first medical school.
• 1848 — Elizabeth Blackwell is the first American woman to receive a medical degree.
• 1870 — An estimated 15,000 Americans travel to Germany and Austria over the course of the next four decades for modern medical education.
• 1893 — Johns Hopkins University Medical School opens and is the first to require a baccalaureate degree for admission and four years of study for a medical degree.
• 1910 — The Flexner report recommends closing half of American medical schools.
• 1952 — Case Western University introduces an organ system-based curriculum.
• 1956 — Federal Health Facilities Research Act enhances research efforts in medical schools.
• 1968 — McMaster University of Canada introduces problem-based learning.
• 1992 — About 18% of U.S. physicians and 42% of medical students are women.
• — Number of students applying to medical schools reaches an all-time high.
• 1993–1996 — A record number of medical school applicants during these years.