Neil Osheroff

Department of Biochemistry, Vanderbilt University School of Medicine, United States of America; Department of Medicine (Hematology/Oncology), Vanderbilt University School of Medicine, United States of America

Since the time of the Flexner report, it has been accepted that science is the foundation of clinical practice (Finnerty et al., 2010; Flexner, 1910; Grande, 2009; Haramati et al., 2024; Lindsley et al., 2024; Slivkoff et al., 2019; Weston, 2018; Woods et al., 2006). However, the methods traditionally used to teach sciences to medical students have been questioned in the post-Flexner era (AAMC-HHMI Committee, 2009; Cooke et al., 2010; Fulton et al., 2012; Slivkoff et al., 2019). For nearly 100 years, the foundational sciences were taught in a discipline-oriented fashion, primarily through passive learning approaches (lectures), and largely separated from clinical practice (AAMC-HHMI Committee, 2009; Flexner, 1910). Consequently, in the pre-clerkship phase, scientific details were often overtaught and disconnected from clinical applications. This approach frequently required students to “re-learn” their foundational sciences in the setting of patient care. The disconnect between science and medicine was further exacerbated in the later phases of medical training by physicians who taught in a manner that emphasized pattern recognition over scientific underpinnings. We have come to understand that these pedagogical approaches to medical education are neither efficient nor optimal.