Accelerated medical programs: A pathway to success or compromised education?

Bharti Jayshankar

October 24, 2024: A recent study from New York University (NYU) Grossman School of Medicine has sparked renewed interest in the efficacy of accelerated medical studies programs. The investigation revealed that students enrolled in a three-year medical degree program performed comparably to their peers in traditional four-year programs, raising questions about the long duration of training for physicians.

The analysis, conducted over seven years from 2013 to 2019, and involving nearly 800 students in both programs, found that students in the accelerated program achieved higher scores on pre-clerkship exams (mean 84.6%) compared to their four-year counterparts (mean 83.4%, P=0.01). While they fell short on Step 1 and Step 2 of the U.S. Medical Licensing Exam (USMLE), their performance on Step 3 surpassed that of traditional students.

The study was led by Dr. Joan Cangiarella, who emphasized that these findings suggest accelerated curriculums can effectively prepare medical students for residency without sacrificing quality.

Implications for medical education

Dr. Cangiarella noted that one of the primary motivations for initiating the accelerated program was to alleviate student debt, a pressing issue in medical education where graduates can face debts exceeding $250,000. NYU’s Grossman School has taken significant steps to address this by offering a tuition-free education, further enhancing the appeal of the three-year track.

The study’s results align with broader trends in medical education, where there is increasing recognition of the need for innovative pathways to address physician shortages and rising educational costs.

The length of medical education has been under scrutiny since the 1970s. The present long format came into being in the 20^th century and kept on evolving; and now medical training, internships, and additional specialisations take a minimum of a decade. It cannot be denied that the rigorous regime has led to better patient treatment and medical competency. However, the present models need a relook.

Perspectives from experts

Experts have expressed cautious optimism regarding accelerated programs. Research indicates that these pathways can produce well-trained physicians who are just as competent as those from traditional programs. A study published in Academic Medicine supports this view, highlighting that graduates from accelerated programs reported feeling prepared for residency without experiencing higher levels of burnout compared to their four-year peers.

However, some concerns remain regarding the long-term implications of such a condensed curriculum. Critics argue that while initial outcomes may appear favourable, there is still uncertainty about how these graduates will fare in their careers compared to those who underwent more traditional training.

The future of medical education

Over 15 schools across North America have adopted the accelerated program, the conversation around medical education continues to evolve. The potential benefits include reduced student debt and a faster transition into residency roles, which could help mitigate ongoing physician shortages. The NYU Grossman School’s model allows students to complete their medical training in three years while also providing options for additional electives or dual degrees if desired. This flexibility is crucial as it accommodates diverse career aspirations among medical students.

The strict training schedule can be made more flexible to suit the interest, competency and performance of the candidates. Since burnout is prevalent among trainees, shortening training could also mitigate burnout.

The research is based on US experiences, but globally too medical programs sometimes run into 5 years with additional training and residency years. Medical schools and residency programs need to remain vigilant about maintaining educational quality while adapting to the changing landscape of healthcare needs. As Dr. Cangiarella stated, “We hope our favorable experience will encourage more medical schools to develop an accelerated medical education pathway program.” The future may hold a blend of traditional and innovative approaches to training physicians, ultimately benefiting both students and patients alike.

The study on the Outcomes of Accelerated 3-Year MD Graduates at NYU Grossman School can be accessed here.