Flexner revisited: the role and value of the basic sciences in medical education

A central tenet of Flexner's report was the fundamental role of science in medical education. Today, there is tension between the time needed to teach an ever-expanding knowledge base in science and the time needed for increased instruction in clinical application and in the behavioral, ethical, and managerial knowledge and skills needed to prepare for clinical experiences. One result has been at least a perceived reduction in time and focus on the foundational sciences. In this context, the International Association of Medical Science Educators initiated a study to address the role and value of the basic sciences in medical education by seeking perspectives from various groups of medical educators to five questions: (1) What are the sciences that constitute the foundation for medical practice? (2) What is the value and role of the foundational sciences in medical education? (3) When and how should these foundational sciences be incorporated into the medical education curriculum? (4) What sciences should be prerequisite to entering the undergraduate medical curriculum? (5) What are examples of the best practices for incorporating the foundational sciences into the medical education curriculum? The results suggest a broad group of experts believes that an understanding of basic science content remains essential to clinical practice and that teaching should be accomplished across the entire undergraduate medical education experience and integrated with clinical applications. Learning the sciences also plays a foundational role in developing discipline and rigor in learners' thinking skills, including logical reasoning, critical appraisal, problem solving, decision making, and creativity.