**1. Introduction**

The standard medical educational system during most of the twentieth century was developed in response to the 1910 Flexner report and has served as a successful template for the development of generations of physicians [1]. Yet the new millennium has ushered in major changes that have constituted a revolution in undergraduate medical education (UME) and graduate medical education (GME) [2–4]. Measured change has been supplanted by disruptive innovation with the risk of unintended consequences and potentially detrimental long-term outcomes for academic medicine and clinical practice [1, 5]. This critique is based on the author's experiences over a long career as a physician-scientist engaged in medical education, translational research and clinical practice of autopsy and cardiovascular pathology, and as an academician who also has held several academic leadership positions.
