Overview

The 20th century was a period of momentous change in both physician education and advances in patient care. Early on during this interval, medical education was placed on a sound scientific footing as a result of publication of the famous Flexner Report in 1910. The consequence of this report was the closing of many institutions claiming to train physicians, in conjunction with a coexisting apprenticeship system. All surviving and newly established medical schools were mandated to offer a structured curriculum for the training of medical students, utilizing distinct basic and clinical science departments. During the course of the last few decades of the 20th century, there occurred several major innovations in the medical school curriculum design. Consequently, each school now has its own unique program specifically designed to fulfill its mission.

Physicians during the first half of the century were trained to serve as general practitioners. For those seeking specialty training prior to World War II, a residency at a European medical center, especially in Germany and Austria, was a common occurrence. As the quality of our medical education establishments gradually improved, attractive postgraduate training opportunities in this country rapidly multiplied. In addition, subspecialty areas emerged as offshoots, for the most part, from the fields of internal medicine and general surgery. New subspecialties have come intobeing in recent years (e.g., emergency medicine and geriatrics) and more can be anticipated (e.g., trauma surgery and sports medicine).