This study was part of a larger program of research by The Carnegie Foundation for the Advancement of Teaching on preparation for the professions. The work was funded by a grant from the Atlantic Philanthropies and the resulting book, Educating Physicians: A Call for Reform of Medical School and Residency, is a companion to reports on educating the clergy, lawyers, engineers, and nurses. The program was initiated by Carnegie’s then president, Lee Shulman, and guided by Carnegie senior scholars Anne Colby and William Sullivan, and was completed under the leadership of Carnegie’s ninth president, Anthony S. Bryk.
Beginning in 1909, Abraham Flexner went to all 155 of the medical schools in the United States and Canada. In 1910 he released Medical Education in the United States and Canada. Flexner pioneered the idea of site visits as a research protocol, and Carnegie’s researchers took many of their cues from Flexner.
After designing the study protocol and receiving approval from human subject review boards of the Carnegie Foundation and the University of California, San Francisco, the research team visited eleven of the 130 medical schools in the United States currently accredited by the Liaison Committee for Medical Education of the Association of American Medical Colleges. The team also visited residency programs in internal medicine and surgery at the academic medical centers affiliated with those eleven medical schools as well as at three non-university teaching hospitals. (Osteopathic medical schools, which have somewhat different curricula, cost structures and accreditation, were not included in the study.) While each site was selected because of interesting educational innovations, the team also wanted to survey medical education across institutional type and geographic location. The institutions thus represent the array of research intensive and community-based medical schools, academic medical centers, and non-university teaching hospitals where U.S. medical education is located.