Abraham Flexner, a headmaster of a high school in
mostly rural Kentucky, published his landmark paper
nearly one hundred years ago on reforming North
American medical education. His report, Carnegie
Foundation Bulletin Number Four, is often seen as
the most influential publication in the field of medical
education.1 During his time, North America
experienced a mushroom-like growth of privately
funded and for-profit medical schools (Flexner used
the word “proprietary”) churning out medical degrees
to virtually anyone with financial means.