Clinics (Sao Paulo).2019;74:e1466.
The role of Academic Health Centers in Transformative Medical Education
Academic Health Centers (AHC) were created in North America in the 20th century, at a time when hospitals worldwide were utilized mostly as charitable housing for aged and chronically ill people. At that time, hospitals were not engaged in treatment and were not involved in medical education or research; moreover, there was no organized teaching or training of future doctors during the undergraduate period (). The turning point in the transformation of these old health systems into modern medicine, including today’s Academic Health Centers, occurred in 1910 when Abraham Flexner, a well-known educator, received a commission from the Institute for Advanced Study in Princeton to write a report about the state of American medical schools. The basis of Flexner’s report, which required the American Medical Association to reform medical education, was the establishment of “requirements of higher standards of admission for applying medical students, a long period of undergrad training linked to clinical and basic research and high teaching quality in medical schools”. The report instigated a profound transformation of medical education in the USA in the following years and nurtured the development of Academic Health Centers over the next decades (). Important medical discoveries, well-qualified doctors, focused research, and translational medicine, all linked to AHCs, flourished in many places, strengthening universities and affiliated hospitals and characterizing the “Golden Age” of medicine that followed the restructuring of medical education in the USA ().
Although Academic Health Centers have been a key characteristic of North American health systems, this concept has only recently been adopted internationally. The Academic Health Center in an organized structure that began to appear in the US by the end of 1940. When the size and complexity of an AHC begins to increase, universities reorganize the health sciences in a specific campus, creating dedicated governance and administrative oversight as well as specialized clinical services (). However, there is not a specific definition of an AHC. From a general point of view, an AHC could be public or private; it must have a medical school, an affiliated hospital and – as of recently – it should be incorporated into the same campus as other schools or courses linked to health. A generic attribute of these complex and highly ranked organizations is engagement in high-quality clinical services, deep involvement with science as well as clinical and basic research, and a permanent commitment to the formal education of health professionals at a high standard ().