Is three years of medical school as good as four?

Even in medical school, sometimes less is more.

Three-year medical degree programs are becoming more common, and new research now shows that student outcomes in at least one such program are on par with traditional four-year programs.

“The vast majority of students, with the right mentoring and a level of supervision that can happen earlier, can easily graduate in three years,” said Dr. Joan Cangiarella, director of the accelerated medical degree program at New York University’s Grossman School. medicine, which has been offering a three-year program since 2013.

“The world of general medicine has been stuck with a four-year training program for 100 years,” she said, noting that because three-year programs are not the norm, some residency directors may be skeptical of graduates from accelerated programs. “We want people to know that these (three-year) students are just as good.”

New data appears to support this, according to a study from the New York University Medical Program that Cangiarella and a team of other researchers published in the journal peer-reviewed journal Academic medicine last month.

Looking at student performance over seven years, researchers found that graduates of New York University’s three-year medical program performed as well as their four-year peers in medical school and residency, including on licensing exams.

In fact, according to the study, three-year students scored on average about one percentage point higher on the preliminary exams than four-year students.

Although accelerated students scored slightly lower on the Medical Licensing Exams Levels 1 and 2, which assess basic scientific and clinical knowledge, and on the clinical skills portion of the comprehensive exam, they scored comparatively higher on the Level 1 exam. 3, which assesses knowledge and skills. in-depth clinical knowledge.

The study also found that compared with internal medicine residents who completed a four-year program, residents in a three-year program performed slightly better on benchmarks set by the Accreditation Council for Graduate Medical Education, including those related to patient care. , medical knowledge and professionalism.

“The apparent success of our accelerated system has led to major changes in our overall curriculum,” said Dr. Elizabeth Cohen, co-author of the study. stated in the press releasenoting that as of 2023, NYU allows “all students to graduate within three years if they choose, whether they go directly into residency here or find a position elsewhere.”

Save money, start work earlier

When NYU’s three-year program was first launched more than a decade ago as part of the medical school’s broader efforts to expand access and update the curriculum, it was one of only a few such programs in the country. There are now more than 30, including at Texas Tech University, Pennsylvania State University and the University of California at Davis.

Proponents of accelerated medical degree programs say they save students a year of tuition and allow them to become doctors faster. This is important given that most doctors have, on average, more than $200,000 in student debt and work for relatively low wages during residency programs, which can last three to seven years—or more—depending on the specialty.

“Postgraduate education is constantly becoming longer. And once you get into your specialty, most of your training happens in residency,” said Cangiarella, who is also a member of the Consortium of Accelerated Medical Training Programs. “How long will it take us to get people to become doctors? Once they achieve their (core competencies), the next stage of training will occur in residency.”

Dr. Dorothy Andriol, senior director of medical education research at the Association of American Medical Colleges, said some students may be better suited for the accelerated program than others.

“For those students who are confident enough in choosing their major early on—and since most of these programs have a direct path to residency programs (including NYU) at the same institutions—and know where they want to stay geographically, it’s a great option to consider,” she said, noting that the setup allows students to become familiar with the department before residency.

Although a three-year program may mean less tuition income for a medical school, it offers many potential institutional benefits. This can help schools differentiate themselves from other programs, attract a more diverse applicant pool, and secure grants or philanthropic donations to support curriculum innovation.

“The programs build a school’s reputation as innovative and student-focused and can increase recognition among applicants,” the release said. document published earlier this year in the magazine Teacher of Medical Sciences. “As a result, the school will be able to enroll higher-level students into all of the programs it offers who might not otherwise attend.”

The paper also notes that some three-year programs have exceptionally diverse student populations; 29 percent of Penn State’s accelerated family medicine program students come from people underrepresented in medicine, as do 90 percent of students in the UC Davis program.

But Andriole pointed out potential disadvantages for students enrolled in the shortened program.

“They may simply not have the amount of time to do electives, study rotations, research and other extracurricular activities that they would otherwise want to do during medical school,” she said. “This is a great program for select students.”

Not “In the Crosshairs of Time”

For Dr. David Rea, a clinical instructor in the Department of Cardiology at New York University Grossman School of Medicine who was in his first year of a three-year fellowship at New York University, enrolling in the accelerated program was one of the best decisions of his career. far.

New York University School of Medicine went for free for training in 2018, but when Rea applied a few years earlier, it was still expensive. The opportunity to save on a year’s tuition and loans by enrolling in a three-year program immediately appealed to him.

“It also gave me a little flexibility,” he said, adding that he used the year to take a chief resident position — and pursue his interests in medical education and management — after he completed three years of internal medicine. residence. “If I was under time pressure and worried about finishing my studies and starting to make money, I wouldn’t do it.”

Rhee’s year as chief resident solidified his passion for training the next generation of physicians, he said. He now believes the entire health care system would benefit from greater adoption of the three-year medical school program.

“The problem is that it takes a Herculean effort to implement it, and you need the support of the whole village,” he said. “But once you can design it and run it, it will benefit students, doctors and ultimately help patients.”