A century after the Flexner Report on medical education in North America, which revolutionised the training of medical doctors all over the world, it is time to revisit this famous document and analyse symptoms and signs of a return to pre-Flexnerian conditions. With the ongoing mushroom growth over the last decades of small, proprietary educational institutions of low quality and driven by for-profit purposes, medical education is in a threatened position. This trend is of general international interest because of the increasing migration of medical doctors. There is a need for discussion of what should be the rational criteria and basic requirements for establishing new medical schools.