The medical school on the university campus: 20th-century legacy and 21st-century aspirations.

One of the central tenets of Abraham Flexner's seminal report of 1910 was his firm belief that the medical school should be located within a university setting. He made this recommendation in the context of his era, when universities offered the best opportunities for ensuring that medical education would be firmly grounded in science and the scientific method of inquiry. Like many of Flexner's ideas, the organization of medical schools, including the new schools being developed today, continues in the image he propounded. At the same time, over the past decade, many reports have articulated the growing challenges of integrating medical schools-and, perhaps more important, academic medical centers-within the university. Is this relationship, once considered so crucial to the quality of medical education, still a mutually beneficial and symbiotic one? On the 100th anniversary of Flexner's report, the authors of this article explore the relevance and importance of the university-medical school relationship to the quality of medical education and consider the advantages and disadvantages for both medical schools and universities. A century later, the embedding of medical schools within university settings continues to offer unique and highly relevant opportunities to reclaim the foundation on which medical education must rest and to adhere to fundamental ideals that are too often threatened by contemporary challenges.