Q&A: 3-year medical school achieves competency ‘without compromising on the quality’

Key takeaways:

• The program could result in lifetime savings between $250,000 and $400,000, a researcher said.
• The accelerated program also showed similar efficiency to that of 4-year programs.

Assessments of academic and residency performance among medical students enrolled in an accelerated 3-year MD program proved analogous to those in typical 4-year programs, according to a recent analysis published in Academic Medicine.

The data suggest that the advanced program, offered at NYU Grossman School of Medicine, “offer[s] an efficient, cost-effective way to prepare medical students for the next stage of training without compromising on the quality,” Joan F. Cangiarella, MD, the Elaine Langone Professor of Pathology at the institution, said in a press release.

In the analysis, Cangiarella and colleagues compared the performances of 136 students who graduated from the school between 2016 and 2022 and participated in the accelerated program with those of 681 4-year program students who graduated between 2017 and 2023.

They found that the 3-year students performed similarly to their 4-year peers across several metrics in both medical school and residency. Specifically, 3-year students scored an average of 84% on their preclerkship exams, whereas 4-year students scored an average of 83%.

Students also showed similar scores in clinical skills, communication, critical thinking and medical knowledge, regardless of the program length they enrolled in, the release noted.

Healio spoke with Cangiarella to learn more about the program’s cost-effectiveness, what kind of impact it could have on the future of medical education and more.

Healio: Did you expect similar performance among 3- and 4-year students, or was it a surprise?

Cangiarella: We expected it to be the same. A lot of time in the 4th year of medical school is spent in elective content or in rotations that are at another medical school auditioning for residency placement. With this program, the 3-year students had the same core curricular content as the 4-year students so we didn’t really expect any great differences.

Healio: How widespread are 3-year programs like yours across the country, and does NYU’s differ from other accelerated programs?

Cangiarella: Back in 2015, we started a consortium that included other schools that offer this type of program. At that point, there were only eight schools with an accelerated program and most of them started it with the intent to have students go into family medicine or primary care. NYU Grossman’s program was different in that it included a directed pathway to all of our 21 residency programs, such as surgery or radiology. Today, there are about 32 medical schools — approximately 20% of all the medical schools across the country — that have a 3-year MD program. A handful are like NYU’s and offer it across every specialty, some schools offer it specifically for primary care and then, there are others that are mixed. Every year, the number of medical schools in our consortium keeps growing.

Healio: With student debt an ongoing issue in health care, how much could students save by enrolling in a 3-year program?

Cangiarella: Part of our reason for starting the program was to reduce debt with a goal towards our tuition-free status. We calculated that not only would students save a year in tuition, but they would start their career 1 year earlier, so a very conservative estimate was about a quarter of a million dollars. Between $250,000 and $400,000 is the lifetime savings medical students could have by saving a year of tuition and starting their career in medicine a year earlier.

Healio: What are the major implications that a 3-year program could have on medical education and the health care workforce?

Cangiarella: A lot of the changes in medical education are moving toward this type of competency-based education. Also, the period in residency has gotten longer and longer, and it takes a long time to become a physician in this country, so why not give students the opportunity to accelerate this time frame if they already know [what they want to do] and don’t need that 4th year? I remember my fourth year of school — it was very light, and I spent a lot of time doing things that I was never going to do in my career. It was interesting, but students spend a lot of money doing it. As society and medical schools look at how they can get students into career paths sooner, an accelerated pathway can help to lessen the time it takes to finish training to become a physician and enter into the workforce sooner.

Healio: Where does your research go from here?

Cangiarella: We will continue to study these students further out into practice. Because most of these programs just started in the last decade, we don’t have a lot of information on how students do later in residency or in practice but we plan to follow this.

Healio: Do you have anything else to add?

Cangiarella: I think we’ve made great headway with medical schools knowing about these programs. We’re trying to get the word out to the graduate medical education programs because we believe that as these programs grow, there will be more 3-year graduates. When they come to apply for residency, we want those residency programs to know that these students are getting the same training and core content in medical school, and they’re performing just as well as the 4-year students.

References:

• Accelerated three-year medical school students perform as well as peers in traditional four-year programs. Available at: https://nyulangone.org/news/accelerated-three-year-medical-school-students-perform-well-peers-traditional-four-year-programs. Published Oct. 15, 2024. Accessed Nov. 1, 2024.
• Satyamoorthi N, et al. Acad Med. 2024;doi:10.1097/ACM.0000000000005896.