Graduates who went to medical school for three years performed equally well on tests of skill and knowledge as their peers who followed a four-year program, a new study shows.
The accelerated three-year MD pathway offered by NYU Grossman School of Medicine beginning in 2013 was designed to help students earn their medical degrees sooner with reduced debt, which some experts say reaches $250,000 on average by graduation. The school was the first in the United States to offer a three-year MD program that provides a direct pathway to all of its 21 residency training programs, wherein new physicians become specialists in areas such as such as internal medicine, emergency medicine, and surgery. However, whether the shorter track provides as rigorous an education as more typical ones had until now remained unclear.
While experts have previously examined academic performance in such training systems, the authors say their new study, publishing online Oct. 15 in the journal Academic Medicine, is the largest evaluation of programs opening in the last decade.
In the new analysis, the study authors found that 136 accelerated graduates scored comparably on metrics taken during medical school and residency as 681 of their four-year-program peers. For example, the three-year students earned an average score of 84% on their preclerkship exams, which evaluated their grasp of topics that included anatomy, cell biology, and biochemistry. Their four-year counterparts scored 83% on average. Both groups also achieved similar marks on medical knowledge and clinical skills exams, as well as on tests of critical thinking and communication based on multiple mini-interviews.
"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," said study senior author Joan Cangiarella, MD. Cangiarella is the pathway's director and the Elaine Langone Professor of Pathology in the Department of Pathology at NYU Grossman School of Medicine.
In four-year schooling, students spend much of their fourth year taking electives, such as surgery, orthopedics, and otolaryngology, among others, to decide what specialty to pursue. Then, they apply to be matched with openings in residencies available in hospitals throughout the country.
By contrast, the fast-tracked option was developed for those who have chosen their career path early on in their studies, notes Cangiarella, also the senior associate dean for education, faculty, and academic affairs at NYU Grossman School of Medicine. Although they learn the same core curriculum as their peers, these students also receive research opportunities and individualized mentorship from faculty members in their chosen specialty. Then, provided they continue to perform well academically, they have a direct pathway to a residency within NYU Langone Health or can instead elect to be matched elsewhere after completing year three. NYU Grossman School of Medicine is part of a consortium, of which Cangiarella is the chair, of over 30 medical schools in the United States with a three-year program.
For the research, the study team collected demographic data and test scores from those who graduated from the school's condensed program between 2016 and 2022 and from those who graduated from its standard track between 2017 and 2023.
"Accelerated medical-school paths not only benefit students by saving a year of tuition and by enabling an extra year of earnings, they also provide residencies with trainees who are tailor-made for them," said study co-author Steven Abramson, MD. Abramson is the Frederick H. King Professor of Internal Medicine in NYU Grossman School of Medicine's Department of Medicine, for which he also serves as chair, and is the school's executive vice president and vice dean for education, faculty, and academic affairs.
"The clear success of our fast-tracked system has prompted major changes in our overall curriculum," said study co-author Elisabeth Cohen, MD. "As of 2023, we now enable all students to graduate in three years if they choose, whether they proceed directly to a residency here or get matched elsewhere." Cohen is a professor and vice chair for academic affairs in the Department of Ophthalmology at NYU Grossman School of Medicine and is the advisor to its accelerated students.
Although graduates of the condensed program scored equally well as their four-year counterparts on preclinical and clinical knowledge exams, they earned lower scores on parts of the U.S. Medical Licensing Exam taken during medical school, according to the study results. This is likely because they had less time to study and had a direct pathway to a residency, the authors say. Still, they performed just as well as their four-year peers on the part of the exam that is taken at the end of the first year of residency.
Cohen adds that the authors plan to expand their study to include graduates of similar training systems in medical schools worldwide.
Study funding was provided by the Josiah Macy Jr. Foundation.
Along with Cangiarella, Abramson, and Cohen, other NYU Langone investigators involved in the study are lead author Nivedha Satyamoorthi, MS, and co-authors Marina Marin, MSc; Peter Ludlow, MPhys; Marc Triola, MD; and Colleen Gillespie, PhD.
A graduate of the accelerated three-year MD pathway is available for comment upon request.
