“Many of these schools have robust scientific and educational capabilities that could make enormous contributions to understanding health disparities and the teaching of social mission,” Dr Mullan writes.

One reason some medical schools lack a focus on social mission is the legacy of Abraham Flexner, the American educator whose thinking dominated the US medical education system through the 20th century. 

In 1910, Flexner published recommendations for medical education that urged collaboration with research universities to enhance scientific standards, but did not mention the role schools should play in social reform. That omission resulted in a “marginalized social mission in health professional education,” Dr Mullan argues.

Continue Reading

Since Flexner’s time, a growing body of research has detailed the social determinants of health that have led to current and widely documented health disparities, and the situation calls for a move “beyond Flexner,” Dr Mullan writes.

“These concepts provide academicians and others with tools that make social mission more concrete and actionable, and allow an institution to examine health equity in its community and region with greater precision,” Dr Mullan says.

Given this situation, he calls for “academic health centers, and teaching hospital[s] to place their commitment to social mission alongside their dedication to education, research, and service in pursuit of a healthier and fairer society.”


Mullan F. Social mission in health professions education beyond Flexner. JAMA. 2017;318(2):122-123. doi: 10.1001/jama.2017.7286

Related Articles