{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T18:02:50Z","timestamp":1780077770268,"version":"3.54.0"},"reference-count":24,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T00:00:00Z","timestamp":1780012800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Over the past century, medical education has undergone a profound transformation, evolving from unregulated apprenticeships into a highly structured, competency-based continuum of lifelong learning. This review delineates the centenary changes in global medical education, highlighting the structural, pedagogical, and philosophical milestones that have shaped the modern healthcare workforce.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A comprehensive narrative review of historical and contemporary medical education literature was conducted. Electronic databases including PubMed, Scopus, Web of Science, and Google Scholar were searched for peer-reviewed articles, policy declarations, and historical texts published between 1910 and 2025. Search strategies utilized Medical Subject Headings and keywords such as \u201chistory of medical education,\u201d \u201ccompetency-based education,\u201d \u201csocial accountability,\u201d \u201ccurriculum reform,\u201d and \u201cartificial intelligence.\u201d<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The 1910 Flexner Report established the biomedical university-based model, which dominated the 20th century but inadvertently created rigid departmental silos. Subsequent reforms dismantled these silos in favor of integrated, problem-based learning. The 1988 Edinburgh Declaration and the 2010 Lancet Commission catalyzed a paradigm shift toward social accountability, systems-based practice, and Competency-Based Medical Education. Concurrently, regional trajectories in India, Africa, Asia, and Latin America highlight the post-colonial push for standardized, socially responsive curricula. Today, the integration of artificial intelligence and immersive simulations offers unprecedented opportunities for personalized learning, though it presents socio-technical challenges, including the digital divide and algorithmic bias. Additionally, academic medicine faces a crisis in preserving the physician-scientist identity amidst shifting evaluation metrics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>To produce an agile workforce capable of meeting the complex epidemiological demands of 2050, medical education must harmonize relentless technological innovation with the humanistic imperative of socially accountable, equitable patient care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/postmj\/qgag067","type":"journal-article","created":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T12:25:27Z","timestamp":1777724727000},"source":"Crossref","is-referenced-by-count":0,"title":["From Flexner to artificial intelligence: a century of transformation in global medical education"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-9190-6065","authenticated-orcid":false,"given":"Ramya","family":"Munnur","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology, TRR Institute of Medical Sciences , Petancheru, Sangareddy District, Telangana 502319,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2956-0270","authenticated-orcid":false,"given":"Shashank","family":"Chapala","sequence":"additional","affiliation":[{"name":"Department of Radiology, Asian Institute of Gastroenterology Hospital , Mindspace Rd, P Janardhan Reddy Nagar, Gachibowli, Hyderabad, Telangana 500032 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6612-9657","authenticated-orcid":false,"given":"Jonathan","family":"Gibson","sequence":"additional","affiliation":[{"name":"College of Medical and Dental Sciences, University of Birmingham , Birmingham , B15 2TT,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5114-7262","authenticated-orcid":false,"given":"Gaurav","family":"Cheraya","sequence":"additional","affiliation":[{"name":"Department of Radiology, Bridgeport Hospital , 4699 Main Street, Bridgeport, CT 06606,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4379-1266","authenticated-orcid":false,"given":"Karthikeyan P","family":"Iyengar","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Southport and Ormskrik Hospital, Mersey and West Lancashire Teaching NHS Trust , Southport PR8 6PN ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7998-2980","authenticated-orcid":false,"given":"Rajesh","family":"Botchu","sequence":"additional","affiliation":[{"name":"Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital , Birmingham , B31 2AP,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,5,29]]},"reference":[{"key":"2026052913065967800_ref1","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1126\/science.32.810.41","volume-title":"Medical Education in the United States and Canada: A Report to the Carnegie Foundation for the Advancement of Teaching","author":"Flexner","year":"1910"},{"key":"2026052913065967800_ref2","doi-asserted-by":"publisher","first-page":"312","DOI":"10.3109\/0142159X.2014.970998","article-title":"The integrated curriculum in medical education: AMEE guide No. 96","volume":"37","author":"Brauer","year":"2015","journal-title":"Med Teach"},{"key":"2026052913065967800_ref3","doi-asserted-by":"publisher","first-page":"642","DOI":"10.1080\/01421590701746983","article-title":"The CanMEDS initiative: implementing an outcomes-based framework of physician competencies","volume":"29","author":"Frank","year":"2007","journal-title":"Med Teach"},{"key":"2026052913065967800_ref4","doi-asserted-by":"publisher","first-page":"1923","DOI":"10.1016\/S0140-6736(10)61854-5","article-title":"Health professionals for a new century: transforming education to strengthen health systems in an interdependent world","volume":"376","author":"Frenk","year":"2010","journal-title":"Lancet"},{"key":"2026052913065967800_ref5","doi-asserted-by":"publisher","DOI":"10.1525\/9780520315532","volume-title":"An American Transplant: The Rockefeller Foundation and Peking Union Medical College","author":"Bullock","year":"1980"},{"key":"2026052913065967800_ref6","first-page":"65","article-title":"Shortened medical school curricula in the United States","volume":"74","author":"Kassebaum","year":"1999","journal-title":"Acad Med"},{"key":"2026052913065967800_ref7","first-page":"464","article-title":"The Edinburgh declaration","volume":"2","author":"World Federation for Medical Education","year":"1988","journal-title":"Lancet"},{"key":"2026052913065967800_ref8","volume-title":"Defining and Measuring the Social Accountability of Medical Schools","author":"Boelen","year":"1995"},{"key":"2026052913065967800_ref9","doi-asserted-by":"publisher","first-page":"648","DOI":"10.1080\/01421590701392903","article-title":"The ACGME outcome project: retrospective and prospective","volume":"29","author":"Swing","year":"2007","journal-title":"Med Teach."},{"key":"2026052913065967800_ref10","volume-title":"Milestones Guidebook","author":"ACGME","year":"2020"},{"key":"2026052913065967800_ref11","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1186\/s12909-019-1535-9","article-title":"Medical education today: all that glitters is not gold","volume":"19","author":"Buja","year":"2019","journal-title":"BMC Med Educ"},{"key":"2026052913065967800_ref12","doi-asserted-by":"publisher","first-page":"883","DOI":"10.1172\/JCI80933","article-title":"Challenges and opportunities for reinvigorating the physician-scientist pipeline","volume":"125","author":"Daye","year":"2015","journal-title":"J Clin Invest"},{"key":"2026052913065967800_ref13","doi-asserted-by":"publisher","first-page":"e192689","DOI":"10.1172\/jci.insight.192689","article-title":"Paving the physician-scientist career path: from grassroots gathering to national forum","volume":"10","author":"Rhee","year":"2025","journal-title":"JCI Insight"},{"key":"2026052913065967800_ref14","first-page":"419","article-title":"The transition of medical education from traditional to lifelong learning and its impact on health care providers","volume":"6","author":"Elfituri","year":"2023","journal-title":"Alq J Med App Sci"},{"key":"2026052913065967800_ref15","doi-asserted-by":"publisher","first-page":"51","DOI":"10.4103\/0970-258X.308244","article-title":"Reforming medical education in India: evolution before revolution","volume":"33","author":"Jacob","year":"2020","journal-title":"Natl Med J India"},{"key":"2026052913065967800_ref16","doi-asserted-by":"publisher","first-page":"1281","DOI":"10.4103\/jfmpc.jfmpc_285_20","article-title":"Family medicine takes center stage in India: National Medical Commission Act 2019","volume":"9","author":"Kumar","year":"2020","journal-title":"J Family Med Prim Care"},{"key":"2026052913065967800_ref17","doi-asserted-by":"publisher","first-page":"S11","DOI":"10.1097\/ACM.0000000000000355","article-title":"A brief history of medical education in sub-Saharan Africa","volume":"89","author":"Monekosso","year":"2014","journal-title":"Acad Med"},{"key":"2026052913065967800_ref18","doi-asserted-by":"publisher","first-page":"1113","DOI":"10.1016\/S0140-6736(10)61961-7","article-title":"Medical schools in sub-Saharan Africa","volume":"377","author":"Mullan","year":"2011","journal-title":"Lancet"},{"key":"2026052913065967800_ref19","doi-asserted-by":"publisher","first-page":"819","DOI":"10.1016\/S0140-6736(14)61307-6","article-title":"Transformation of the education of health professionals in China: progress and core information","volume":"384","author":"Hou","year":"2014","journal-title":"Lancet"},{"key":"2026052913065967800_ref20","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1080\/01421590500441869","article-title":"Changes, trends and challenges of medical education in Latin America","volume":"28","author":"Pulido","year":"2006","journal-title":"Med Teach"},{"key":"2026052913065967800_ref21","doi-asserted-by":"publisher","first-page":"96","DOI":"10.5505\/amj.2025.63373","article-title":"The digital transformation of the medical education","volume":"25","author":"Akyon","year":"2025","journal-title":"Ankara Med J"},{"key":"2026052913065967800_ref22","doi-asserted-by":"publisher","DOI":"10.53545\/jbm.2025.49","volume":"5","author":"Application of AI in clinical settings","year":"2025","journal-title":"J Bionic Mem"},{"key":"2026052913065967800_ref23","volume-title":"Recommendation on the Ethics of Artificial Intelligence","author":"UNESCO","year":"2022"},{"key":"2026052913065967800_ref24","first-page":"2190","article-title":"Declaration of Geneva","volume":"318","author":"World Medical Association","year":"2017","journal-title":"JAMA"}],"container-title":["Postgraduate Medical Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/pmj\/advance-article-pdf\/doi\/10.1093\/postmj\/qgag067\/68432604\/qgag067.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/pmj\/advance-article-pdf\/doi\/10.1093\/postmj\/qgag067\/68432604\/qgag067.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T17:07:03Z","timestamp":1780074423000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/pmj\/advance-article\/doi\/10.1093\/postmj\/qgag067\/8698112"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,29]]},"references-count":24,"URL":"https:\/\/doi.org\/10.1093\/postmj\/qgag067","relation":{},"ISSN":["1469-0756"],"issn-type":[{"value":"1469-0756","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,29]]},"article-number":"qgag067"}}