The Flexner Report, presented in 1910 by Abraham Flexner to the Carnegie Foundation, has been lauded as the turning point for medical education by imposing new qualifications at every training stage. 1 The report sought to legitimize the medical profession by standardizing the foundation of education and priming future physicians to make scientific discoveries. It required university education before medical school to raise the academic standards of admission. Flexner emphasized the importance of this premedical coursework as critical to the foundation of medicine. The consequence of this shift in medical education, however, was that the same wealthy white men filled the seats of medical schools in the early twentieth century, because they were the only ones who could afford the prerequisite university education. Now, they at least had “qualifications,” according to Flexner, to learn the art and science of medicine.

Little has changed. In 2017, 24% of United States medical students had a family income in the top 5% of income earners. 2 The percentage of medical students from families in the highest quintile of household income has not dropped below 48% since the 1980s, and the percentage of students from the lowest income quintile has never risen above 5.5%. 3 Although the total number of medical students graduating