Looking at the history of the AMA and medical education

As the College winds down celebrating its 75th anniversary, Stephen Imbeau, MD, FACAAI, Advocacy Council chair, shares the history of how the American Medical Association (AMA) has worked to maintain and strengthen medical education. This is the first installment in his series on the value of AMA membership.

It is historically ironic that the AMA was founded in 1847 by Nathan Davis, MD, of Chicago, intending to confront private medical schools that were shoddily run and poorly equipped, and graduating poorly trained physicians with low medical ethics. The original purpose of the AMA was to strengthen medical education to protect the public and the profession. And it was successful. In its first year, the AMA published a “Code of Medical Ethics” thereafter modeled worldwide; in 1858 the Council on Ethical and Judicial Affaires (CEJA) was formed to provide guidance on and judication of the Code.

The AMA formed the Council on Medical Education (CME) in 1904. In 1908 the new Council successfully petitioned the Carnegie Foundation to fund a sweeping survey of American and Canadian medical schools; the task was accomplished by Abraham Flexner with his famous “Flexner Report” published in 1910 (called “Medical Education in the United States and Canada: A Report to the Carnegie Foundation for the Advancement of Teaching by Abraham Flexner (Bulletin Number Four)”). Flexner favored the medical education model of the Johns Hopkins School of Medicine combining scientific and medical/patient studies over four years post college. American medical schools were soon reduced by over half; many shoddy schools were closed. The Council took an active, hands-on, role to maintain quality medical education thereafter and, later, a similar role in graduate medical education. Since World War II, American medical universities have prospered to become the leaders around the world in both medical education and medical research. Over this same time, the medical specialty societies have also grown and prospered, and now have replaced the AMA as the source of much post-graduate education and continuing medical education. The last AMA convention devoted to Clinical Studies and Science was held in 1976.

However, unexpectedly, at least to the AMA, the medical schools and the specialty societies have evolved a culture of ignoring the AMA or even discounting it, as if they no longer need the AMA, or even that the AMA is only self-serving, and not “noble” in the public interest. But important AMA history is ignored or forgotten. In addition, the AMA continues important work behind the scenes to maintain the quality of ALL medical education, including medical education, graduate medical education and continuing medical education.

Going it alone for many years, the AMA joined with the American Association of Medical Colleges in 1942, to form the Liaison Committee on Medical Education (LCME) to be inclusive and fend off criticism of being self-serving. After the passage of the Medicare Acts of 1965, residency training, or graduate medical education, became very important and since 1972 regulated/certified by the LCGME. Sponsoring members included the American Medical Association (1847), the American Board of Medical Specialties (1933), the American Hospital Association (1937), the Association of American Medical Colleges (1876), and the Council of Medical Specialty Societies (1965), becoming the Accrediting Committee for Graduate Medical Education (ACGME) in 1981. The LCGME took under management the few existing Residency Review Committees (RRC) and then grew their number. The Allergy-Immunology (A/I) Residency Review Committee was organized in the late 1970’s. Current A/I RRC members include R. Katiae; Amal Assa’ad, MD, FACAAI; Paul Dowling, MD, FACAAI; Gailen Marshall Jr., MD, PhD, FACAAI; A Ivami, Thomas Atkinson, MD, PhD; Joseph Yusin, MD, FACAAI; and Stephen Wasserman, MD, FACAAI. Past College leaders included William Dolen, MD, FACAAI, Nelson and Jay Portnoy, MD, FACAAI.

The American College of Allergists (the original name of the College) was organized in 1942. The College was instrumental in organizing the American Board of Allergy and Immunology (ABAI) in 1971. Since its inception the ABAI has worked closely with the AMA through its umbrella organization, the American Board of Medical Specialties. The College also has long been certified for Continuing Medical Education by ACCME – the AMA was one of ACCME’s founding members.

The AMA deserves your membership. The College Advocacy Council wants YOU to belong to the AMA. To keep our Delegate seat and to continue to make a difference, 20% of College members need to be AMA members. That’s why you need to join or renew your membership today.