US Medical Education Reform Reports, 1910 to 2024
William C. McGaghie, Krystal L. MadkinsImportance
Since the early 20th century, prominent private foundations, medical organizations, and government agencies have published reports calling for reform of medical education; however, it is unclear whether these reports contain repetitive messages about improving medical education, are a source of curriculum improvement, and are an antidote to medical education inertia.
Objective
To replicate and amplify findings of a similar analysis of reports published between 1910 and 1993 that advocated for reform in medical education using reports published from 1995 to 2024 and to identify recurring themes and potential sources of inertia in medical education.
Evidence Review
PubMed, Scopus, Education Resources Information Center, and Google were searched on February 4, February 13, and March 19, 2025, using search terms addressing medical education, reform, and recommendations to identify reports on reform in medical education. A descriptive and interpretive content analysis of the medical education reports spanning 114 years was conducted from February 2025 to May 2026.
Findings
A total of 47 reports, including 19 analyzed in the previous study, were identified and analyzed. Consistent coding of content in the 47 reports was achieved. One of 4 core reform objectives of medical education, serve changing public interest, increased in endorsement over time. The other 3 core objectives—address physician workforce needs, cope with burgeoning knowledge, foster generalism—decreased or were unchanged. Four secondary reform objectives—apply new educational methods, address the changing nature of illness burden, address the changing nature of practice, increase quality and standards of education—increased in prevalence. Proposed methods of educational reform varied over 114 years, shaped by conceptual updates and technology advancements. None of the reports expressed criticism of traditional apprenticeship clinical education. Few reports displayed knowledge or awareness of the science of expertise in medical education.
Conclusions and Relevance
In this study of medical education reports issued over 114 years, 3 basic values emerged: reform medical education, affirm core social and professional values, and protect the profession from outside intrusion. Proposed reform objectives and the means to achieve them displayed both stability and change longitudinally. The time-honored apprenticeship approach to clinical education was unquestioned. Despite a growing body of evidence from the science of expertise, proposed medical education reforms have produced insignificant curriculum change.