Time-variable medical education innovation in context

Abstract

Background

Medical education is undergoing robust curricular reform with several innovative models emerging. In this study, we examined current trends in 3-year Doctor of Medicine (MD) education and place these programs in context.

Methods

A survey was conducted among Deans of U.S. allopathic medical schools using structured phone interview regarding current availability of a 3-year MD pathway, and/or other variations in curricular innovation, within their institution. Those with 3-year programs answered additional questions.

Results

Data from 107 institutions were obtained (75% survey response rate). The most common variation in length of medical education today is the accelerated 3-year pathway. Since 2010, 9 medical schools have introduced parallel 3-year MD programs and another 4 are actively developing such programs. However, the total number of students in 3-year MD tracks remains small (n=199 students, or 0.2% total medical students). Family medicine and general internal medicine are the most common residency programs selected. Benefits of 3-year MD programs generally include reduction in student debt, stability of guaranteed residency positions, and potential for increasing physician numbers in rural/underserved areas. Drawbacks include concern about fatigue/burnout, difficulty in providing guaranteed residency positions, and additional expense in teaching 2 parallel curricula. Four vignettes of alternative innovative and relevant curricular initiatives are also presented in order to place 3-year MD programs in a broader context of medical education reform in the U.S.

Conclusion

Three-year MD pathways are the most common accelerated alternative available at a small number of medical schools for highly selected students. Long-term evaluation of these programs will be essential to determine if these programs are meeting their goals (e.g., increasing the number of physicians in rural/underserved areas). Benefits and shortcomings of such programs should be carefully examined when considering this approach, or others described, as part of MD curricular options designed to individualize medical education.

Keywords:

• pedagogy
• curriculum
• 3-year MD
• medical students
• medical school
• reform

Supplementary material

Responding U.S. Medical Schools

• Albert Einstein College of Medicine

• Baylor College of Medicine

• Boston University School of Medicine

• California Northstate University College of Medicine

• Case Western Reserve University School of Medicine

• Chicago Medical School at Rosalind Franklin University of Medicine and Science

• Columbia University Vagelos College of Physicians and Surgeons

• Dartmouth Geisel School of Medicine

• Drexel University College of Medicine

• Duke University School of Medicine

• East Carolina University Brody School of Medicine

• East Tennessee State University James H. Quillen College of Medicine

• Eastern Virginia Medical School

• Emory University School of Medicine

• Florida International University Herbert Wertheim College of Medicine

• Geisinger Commonwealth School of Medicine

• George Washington University School of Medicine and Health Sciences

• Harvard Medical School

• Hofstra/Northwell Donald and Barbara Zucker School of Medicine

• Howard University College of Medicine

• Indiana University School of Medicine

• Johns Hopkins University School of Medicine

• Loma Linda University School of Medicine

• Louisiana State University School of Medicine in New Orleans

• Marshall University Joan C. Edwards School of Medicine

• Mayo Clinic School of Medicine

• Medical College of Wisconsin

• Medical University of South Carolina College of Medicine

• Meharry Medical College School of Medicine

• Mercer University School of Medicine

• Michigan State University College of Human Medicine

• Mount Sinai Icahn School of Medicine

• New York University School of Medicine

• Northeast Ohio Medical University College of Medicine

• Northwestern University Feinberg School of Medicine

• Oakland University William Beaumont School of Medicine

• Oregon Health & Science University School of Medicine

• Pennsylvania State College of Medicine

• Quinnipiac University Frank H. Netter MD School/North Haven of Medicine

• Rush Medical College of Rush University Medical Center

• Rutgers New Jersey Medical School

• Rutgers Robert Wood Johnson Medical School

• Saint Louis University School of Medicine

• Southern Illinois University School of Medicine

• Stanford University School of Medicine

• Stony Brook University School of Medicine

• Temple University Lewis Katz School of Medicine

• Texas Tech University Health Sciences Center Paul L. Foster School of Medicine

• Texas Tech University Health Sciences Center School of Medicine

• Tufts University School of Medicine

• Tulane University School of Medicine

• University at Buffalo Jacobs School of Medicine and Biomedical Sciences

• University of Alabama School of Medicine

• University of Arizona College of Medicine – Tucson

• University of California, Davis School of Medicine

• University of California, Los Angeles David Geffen School of Medicine

• University of California, Riverside School of Medicine

• University of California, San Francisco School of Medicine

• University of Central Florida Orlando College of Medicine

• University of Chicago Division of the Biological Sciences, the Pritzker School of Medicine

• University of Cincinnati College of Medicine

• University of Colorado School of Medicine

• University of Hawaii at Manoa John A. Burns School of Medicine

• University of Iowa Roy J. and Lucille A. Carver College of Medicine

• University of Kansas School of Medicine

• University of Louisville School of Medicine

• University of Maryland School of Medicine

• University of Massachusetts Medical School

• University of Miami Leonard M. Miller School of Medicine

• University of Michigan Medical School

• University of Minnesota Medical School

• University of Mississippi School of Medicine

• University of Missouri-Columbia School of Medicine

• University of Missouri-Kansas City School of Medicine

• University of Nebraska College of Medicine

• University of Nevada Reno School of Medicine

• University of North Carolina School of Medicine

• University of North Dakota School of Medicine and Health Sciences

• University of Oklahoma College of Medicine

• University of Pennsylvania Raymond and Ruth Perelman School of Medicine

• University of Pittsburgh School of Medicine

• University of South Carolina School of Medicine, Columbia

• University of South Dakota Sanford School of Medicine

• University of South Florida Health Morsani College of Medicine

• University of Texas at Austin Dell Medical School

• University of Texas Health San Antonio Joe R. and Teresa Lozano Long School of Medicine

• University of Texas Health Science Center at Houston McGovern Medical School

• University of Texas Medical Branch at Galveston School of Medicine

• University of Texas Rio Grande Valley School of Medicine

• University of Texas Southwestern Medical Center

• University of Toledo College of Medicine and Life Sciences

• University of Utah School of Medicine

• University of Vermont Robert Larner, M.D. College of Medicine

• University of Virginia School of Medicine

• University of Washington School of Medicine

• University of Wisconsin School of Medicine and Public Health

• Vanderbilt University School of Medicine

• Virginia Tech Carilion School of Medicine

• Wake Forest University School of Medicine

• Warren Alpert Medical School of Brown University

• Washington University School of Medicine

• Wayne State University School of Medicine

• Weill Cornell Medicine Medical School

• West Virginia University School of Medicine

• Western Michigan University Homer Stryker M.D. School of Medicine

• Wright State University Boonshoft School of Medicine

• Yale University School of Medicine

Acknowledgments

The authors would like to thank Jean Robillard, MD, Emeritus Vice President for Medical Affairs & Dean of the Carver College of Medicine at the University of Iowa for his helpful suggestions on the manuscript and support for the project overall. In addition, the authors would like to thank Amber Ryan for assistance with initial data entry and Jamie Holmes for help with data entry and interview scheduling.

Disclosure

The authors report no conflicts of interest in this work.