Shorter Medical Degree Program Outcomes Just as Good

Medical students in an accelerated 3-year graduate program performed similarly to students in a 4-year program at the same institution, according to a new single-institution study.

An analysis of New York University Grossman School of Medicine students over 7 years showed that individuals in the accelerated 3-year medical degree program had higher scores on the pre-clerkship exam compared with those in the traditional 4-year program (mean 84.6% vs 83.4%, P=0.01).

While students in the accelerated program did not perform quite as well as those in the traditional program on Step 1 or Step 2 of the U.S. Medical Licensing Exam (238.3 vs 243.9, PP=0.01), the accelerated students performed better on Step 3.

Clerkship exams, board subject exams, and peer assessment scores were all statistically similar between the two programs, researchers led by Joan Cangiarella, MD, of NYU Langone Health in New York City, and co-authors reported in Academic Medicine.

“Our findings suggest that accelerated curriculums offer an efficient, cost-effective way to prepare medical students for the next stage of training without compromising on the quality,” Cangiarella, who serves as director of the 3-year degree program, said in a press release.

She added that these outcomes will hopefully show how well this program can work for its students as well.

“We wanted to get this paper out to let the graduate medical education world know that these students are performing just as well as 4 year students,” Cangiarella told MedPage Today. “If you see an accelerated student apply to your residency program, [you’ll] know what curriculum they took and know that they’ve performed just as well as a student in the 4-year [program].”

Cangiarella added that part of the goal in starting the accelerated program was to reduce student debt, although NYU Grossman School of Medicine became tuition-free shortly after the program began. The school also guarantees students a spot in its residency programs as well, which Cangiarella noted helps alleviate any potential added stress from applying to those programs during the shorter 3-year degree.

The school now offers all students the same 3-year accelerated program to start their training, beginning with 1 year of pre-clerkship training. All students will now be able to begin residency after the third year, Cangiarella explained.

However, students will also have the option to continue with a fourth year by taking additional elective courses or continue for 2 more years by pursuing an additional degree, such as a Master of Public Health or a Master of Business Administration. The first class in this new program will graduate in 2026.

Josué Zapata, MD, MBA, of the University of California San Francisco, told MedPage Today that the idea of shortening medical school has been debated for decades, dating back to the 1970s. Even now, physicians outside the U.S., such as those in Canada and Europe, already train for less time, he said.

“What this paper really shows is, with the right group of people who are effectively selected, you can create really well-trained doctors who have indistinguishable outcomes from those who are in 4-year programs,” said Zapata, who was not involved in the study.

He added that while the study came from a single institution, it was helpful to see how graduates from both programs performed side-by-side within the same training environment. He also noted that the authors chose compelling outcomes to prove their case for the accelerated program as well.

“They looked at the types of things that we really could measure that make me think of someone who is a well-trained clinician,” Zapata said.

He noted that this is a relatively new program, so he would be interested to see how the program and its graduates are doing 10 years from now as well. He also emphasized that since NYU Grossman School of Medicine is a unique program — it’s based in a highly desirable location and offers a tuition-free program — it might not be generalizable to other programs with different approaches.

To conduct the analysis, the authors used outcomes data from 7 years of graduating classes (2013-2019) from both the accelerated program and the traditional program. In total, there were 136 students in the 3-year program and 681 in the 4-year program.

The authors noted that students in the accelerated program averaged approximately 5 months older at admission (22.9 vs 22.3 years). They also had higher multiple mini-interview scores than those in the traditional program (mean 3.6 vs 3.5).

Students in the accelerated program also had comparable clinical reasoning outcomes among the internal medicine interns. The authors also noted there was no statistically significant difference in the rate of becoming chief residents between the two programs.

“We will continue to assess these students, reporting on their outcomes into practice and their overall well-being in the hopes of further demonstrating the success of our accelerated 3 [year] MD pathway,” the researchers wrote. “We hope our favorable experience will encourage more medical schools to develop an accelerated medical education pathway program.”

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