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09/08/2015

Thoughts on Flexner and Professionalism, 1915 and 2015

Education reformer Abraham Flexner (1866-1959) is regarded by many as the father of Modern America’s medical education curriculum. He authored the Flexner Report for the Carnegie Foundation after making site visits to all the country’s medical and osteopathic medical schools of the day. He harshly criticized the vast majority of the schools he visited. His insightful recommendations were adopted for the most part within just a few years and his Report continues to influence medical education today.

In 1915, Flexner addressed the National Conference of Charities and Corrections. The title of his speech was “Is Social Work a Profession?” He answered that it was not. Flexner compared social workers of the day against the “benchmark” professionals of medicine, law, and preaching, and found that those who provided social work services had not yet achieved true professional status. He saw the social worker of the day as a “narrow minded technician.” In deference to social workers, Flexner also viewed nurses and pharmacists the same way.

Flexner identified six characteristics of a profession and its professionals: (1) “professions involve essentially intellectual operations with large individual responsibility”; (2) “they derive their raw material from science and learning; (3) “this material they work up to a practical and definite end”; (4) “they possess an educationally communicable technique” (their own language); (5) “they tend to self-organization”; and (6) they are becoming increasingly altruistic in motivation.” He could not have been more complementary of a trained social worker’s altruism, dedication, and “professional spirit,” but he did not think that social workers’ groundwork was scientifically developed nor their contributions unique. Primarily, Flexner saw social work as not meeting the professionalization mark because what social workers of the day did could also be done by “amateurs,” or non-trained persons who could do the job equally as well as the trained social worker. Of course those who were trained could probably do the job better in some respects; but an outside observer comparing work product performed by an experienced (seasoned) non-trained social worker or a trained one, there was no difference.

Flexner did express the view that professions evolve and that new professions arise all the time. I would think that Flexner – if challenged today – would certainly see social workers, nurses, and pharmacists as professionals. However, given his 1915 criteria, one might wonder how Flexner might feel about the professionalization of such fields as genetic counseling, clinical pharmacy, and clinical ethics consultants?

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI’s online graduate programs, please visit our website.

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