NYU Promotes Three-Year Medical Degree

While effectively a radical rethinking of medical education, the educators stress that the change can increase the number of productive years that clinicians and physician scientists spend in the workforce, as well as reduce student debt by 25%.

The essay describes how it has been more than 100 years since Abraham Flexner proposed the current model for medical education in North America—two years of basic science instruction followed by two years of clinical experience. The educators claim that cutting the average duration of medical training by approximately 30% can be accomplished without compromising physicians' competence or the quality of care provided. NYU School of Medicine began offering a three-year medical degree pathway for selected students in 2013. The perspective essay was published online on September 18, 2013, in the New England Journal of Medicine (NEJM).

“This article presents a compelling argument that a more effective medical education process is needed,” said lead author Steven Abramson, MD, vice dean for education, faculty, and academic affairs and chair of the department of medicine at the NYU School of Medicine. “We are hopeful that this article will encourage continued discussions focused on restructuring medical education to meet the changing health care needs of the population.”

“A four-year program for all graduates made sense when postgraduate training lasted two or three years. Now, residencies and fellowships routinely extend the postgraduate period to six years or more, which means that many physicians don't enter practice until their early or mid-30s,” continued Dr. Abramson. “Indeed, data from the American Medical Association show that since 1975, the percentage of physicians under the age of 35 has decreased from 28 percent to 15 percent.”

“We are at a point of inflection whereby alignment of training across the levels of medical education with regulatory standards and our health care delivery system is critical to train physicians and physician scientists who are passionate care providers across specialties,” added coauthor Robert Grossman, MD, dean and CEO of NYU Langone medical center. “In the years ahead, developing a uniform set of milestones and competencies that assess physicians throughout medical school, residency, fellowship, and ultimately clinical practice will be a major task for medical educators.”

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