AMA and medical education: 100 years of progress

AMA Leader Commentary. By J. James Rohack, MD, Aug. 2, 2004.

AMA LEADER COMMENTARY

A few words about current events in medical practice

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A message to all physicians from the chair of the AMA Board of Trustees, J. James Rohack, MD.

Before the creation of the American Medical Association in 1847, physicians in North America were more like tradesmen than professionals, splitting their time between mixing and selling medicines and cutting hair.

The AMA was formed in great part to counter this lack of professionalism, and one of the AMA's earliest missions was to establish and uphold the highest standards of medical education and training -- a tradition that continues today.

At the time of the American Revolution, however, only about 10% of the doctors in the original 13 colonies had any formal medical education. Even physicians who did have so-called training didn't necessarily have much to offer their patients.

In those days, and even later, getting into medical school was easy -- and so was getting out. Typically, medical schools required applicants to have a high school diploma and to pay a fee. But for some schools, the fee was the only requirement. Standards for graduation were also slack. In many schools, students did not get grades and took few examinations. The standard course of study lasted 16 to 20 weeks and consisted primarily of lectures, with little interaction between the student and patients.

The AMA's founder, Dr. Nathan Davis, understood that the bedrock of any profession is education. Thus, the first committee ever created by the American Medical Association was a Committee on Medical Education. But the AMA had not yet established formal working relations with the growing number of state and county medical societies. Thus, the standards suggested by the AMA committee remained largely theoretical, since physicians were licensed under state, not federal, law.

This situation persisted until 100 years ago, when the AMA created the Council on Medical Education with the full support of the newly formed Federation of Medicine.