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Letters to the Editor

Desperately Seeking Flexner

Time to Reemphasize Basic Science in Medical Education

Kennelly, Peter J., PhD; Bond, Judith S., PhD; Masters, Bettie Sue, PhD; Dennis, Edward A., PhD; Brenner, Charles, PhD; Raben, Daniel M., PhD

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doi: 10.1097/ACM.0b013e3182a225be
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To the Editor: The medical education community is currently engaged in an intensive review and revision of current models for physician training. New medical school curricula feature a substantially increased focus on communications, administrative, and teamwork skills designed to enable tomorrow’s doctors to interact more effectively with patients and seamlessly collaborate within today’s evolving care delivery structure.

These curriculum revisions are occurring as a new age dawns in medicine. Genomics, proteomics, and metabolomics will enable physicians to examine patients with a comprehensiveness unimagined by their forebears. Access to personalized data for each patient will yield more accurate diagnoses and the selection of optimized treatments. The ability to directly observe subtle perturbations in metabolism and gene expression will transform our capacity for the early detection and treatment of cancer, diabetes, atherosclerosis, hypertension, and Alzheimer’s, among others.

To leverage these revolutionary developments, future physicians will require the type of firm grounding in basic sciences recommended by Flexner1 in 1910. Paradoxically, recently many medical schools have substantially reduced basic science education. Although acceleration of the preclinical curriculum has the obvious benefit of giving students more time to develop clinical skills, we believe that this approach will have the unintended consequence of preventing the majority of future physicians from understanding the genomic, proteomic, and metabolomic data that patients can now obtain. In additional to training in clinical and interpersonal skills, we urge our colleagues to reemphasize basic science in the preclinical years. This will allow us to train individuals who will be able to practice molecular medicine and collaborate with basic research scientists to leverage new information and technologies to advance biomedical knowledge and practice.

Peter J. Kennelly, PhD (Department of Biochemistry, Virginia Polytechnic Institute and State University), Judith S. Bond, PhD (Department of Biochemistry and Molecular Biology, The Pennsylvania State University School of Medicine), Bettie Sue Masters, PhD (Department of Biochemistry, The University of Texas Health Science Center at San Antonio), Edward A. Dennis, PhD (Department of Chemistry and Biochemistry and Department of Pharmacology, University of California, San Diego, School of Medicine), Charles Brenner, PhD (Department of Biochemistry, University of Iowa Carver College of Medicine), and Daniel M. Raben, PhD (Department of Biological Chemistry, Physiology, and Oncology, The Johns Hopkins University School of Medicine); [email protected]


1. Flexner A Medical Education in the United States and Canada: A Report to the Carnegie Foundation for the Advancement of Teaching. Bulletin No. 4. 1910 Boston, Mass Updyke
© 2013 by the Association of American Medical Colleges