A hundred years of basic science in medical education

For a century, we have been trying to integrate basic science into medical education, beginning with the Flexner report. Flexner, a high school teacher, an outsider to the practice of medicine and medical education, was commissioned to re-evaluate the medical education system [1]. He was chosen for his expertise as an educator, having critiqued the American schooling system and having explored pedagogical techniques. The for-profit, disjointed, non-standardized North American system was losing the respect of the public. Flexner laid the groundwork for a marriage between professors of university science and physician trainers in clinical arts. Flexner’s suggested curriculumwith two years of laboratory-based science followed by clinical training was modelled after a system already in place at Hopkins, itself an import from Germany credited to William Welch. The revolution of medical education, spurred by the Flexner report, instilled scientific rigour into medical education curricula. Instruction by physician scientists even became a quality indicator [1]. This transition of medical education from the for-profit sector to the university setting was accomplished through the integration of basic science. Basic science was a tool to gain public trust through academic rigour. Basic science became an aid to protect and preserve professional autonomy. The inclusion of basic science, and the new breed of academic physician scientists, minted to fulfil these new university roles, was not without critique. The famous William Osler feared that this new brand of clinician scientists would be too far removed from the lives of patients to understand the complexities of clinical care. Dr Duffy, haematologist