From Flexner to artificial intelligence: 100 years of Academic Medicine

As Academic Medicine celebrates a century of contributions to medical education, it is worth examining the questions that drove the inaugural issues of the journal and what lessons these may provide today. Although 1926 was a year adjacent to many global shocks that influenced medicine, the journal was keenly focused on the 1910 Flexner Report and the existential reforms being implemented across medical schools. The reports in these issues provide insights on a community grappling with disruption. These first authors helped reshape medical education in the United States; the effects of many of the changes they proposed or studied 100 years ago can still be seen in medical education and/or practice. Today, with the rapid acceleration of generative artificial intelligence, medical education and health care delivery face disruption at a scale analogous to or even greater than that encountered in the aftermath of the adoption of the Flexner Report recommendations. In 1926 and 1927, several themes emerged including discussions on integrating new technologies, exploring of biases, and consensus building and articulating values around what is required for a student to enter medical training and what the curriculum should deliver to matriculants. Insights around these themes helped to direct the academic medicine community as new expectations for medical education and the role of physicians were emerging. Change, especially disruptive change, presents both opportunity and risk. The inaugural issues of the journal demonstrate the value of creating a community of informed stakeholders that can debate, generate data, and share experiences. The journal remains critical in 2026 for developing and supporting medical educators, students, and trainees and the patients they serve. The relevance of Academic Medicine, particularly in articulating values, exploring biases, and building consensus will likely only increase through the transformative disruptions that are inevitable over the next 100 years.