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Rethinking the traditional four-year medical curriculum

Rethinking the traditional four-year medical curriculum

In an effort to meet the needs of medical students, physicians and patients, a number of universities are considering ways to shorten the traditional four-year medical curriculum without compromising quality of care. The New York Times reports that “a recent, unpublished survey of 120 medical schools, conducted by the New York University School of Medicine, found that 30 percent were considering or already planning to start three-year programs” and notes that the American Medical Association is among those advocating for such innovative approaches. Denise Grady writes:

More than a dozen medical schools already have programs to move students more quickly from the classroom to the clinic, but by shortening premedical studies rather than medical school. Among them are Albany Medical College, Northeast Ohio Medical University and the medical schools at Boston University, Drexel, George Washington, Howard, Jefferson, Meharry and Northwestern. Gifted high school seniors or early college students are guaranteed admission to medical school if they perform well during freshman year of college. Combined bachelors/M.D. programs have been around for half a century, but these students complete both degrees in six or seven years instead of the usual eight.

“I absolutely think it’s doable,” said Dr. Charles G. Prober, senior associate dean for medical education at Stanford School of Medicine, which is considering such a program. Well-designed programs to accelerate doctors’ training “don’t send them out prematurely, but send them out with adequate tools, recognizing that they will grow,” said Dr. Prober, who writes and speaks extensively on medical education reform. “Real learning begins when you are actually beginning to take care of patients, doing what you were trained to do.”

While research is scant, a few studies show promising results. Comparisons of graduates of three-year programs at the University of Calgary and McMaster University to graduates of four-year Canadian medical schools found “equivalent performance.” And a small study at Marshall University in the 1990s, which for almost a decade incorporated fourth-year requirements with the first year of residency in family practice, declared it a success for “carefully selected candidates.”

Indeed, educators make clear that not all students can handle the accelerated curriculum. Dr. Prober notes that with the explosion of medical information, students more than ever must learn to work smart, figuring out what they need to memorize and how to find out the rest. Part of the education process today is learning to collaborate and tap the expertise of others.

Previously: A closer look at using the “flipped classroom” model at the School of Medicine, Combining online learning and the Socratic method to reinvent medical school courses, Rethinking the “sage on stage” model in medical education and Stanford professors propose re-imagining medical education with “lecture-less” classes

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