Time-variable medical education innovation in context

Abstract

BackgroundMedical 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.MethodsA 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.ResultsData 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.ConclusionThree-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.

Influence of Student Loan Debt on General Surgery Resident Career and Lifestyle Decision-Making

“…17 Another proposed option is to shorten the time spent in training, effectively decreasing the amount of debt incurred and allowing trainees to enter the work force sooner. 18,19 Yet another solution would be to eliminate medical school debt completely though tuition-free medical school for all students. New York University Medical School started offering this in 2018 and Cleveland Clinic Lerner College of Medicine of Case Western Reserve University has been tuition-free since 2008, although it has a class size of only 32 students.…”

Effect of Reflective Writing on Burnout in Medical Trainees

“…Medical education is currently undergoing a robust period of curricular reform, and further longitudinal studies are needed in order to assess the benefits of new initiatives (Stamy et al, 2018). Engaging with matters of life and death through novels, plays, music, poetry, and other art forms add new meaning and depth to traditional medical education, allowing students to develop a deeper appreciation of their chosen profession as both a science and art (Sklar, 2017).…”

Flexibility in primary medical programs: A scoping review

“…Voluntary, non-remedial decelerated medical education without additional curricular components may enable students in a range of circumstances to complete some of their medical degree part-time (Stamy et al, 2018). A 2004 report found that nearly one third of US medical schools offered formal options for decelerating or extending a student's curriculum, however these were rarely publicised (McGrath & McQuail, 2004).…”

“…In that survey, 37% of students participating in decelerated options were from underrepresented minority groups. Some contemporary programs have been designed with social equity in mind to enable minority, non-traditional or disadvantaged students to access and succeed in medical education (Stamy et al, 2018). The benefits of deceleration include the opportunity to graduate students who possess desirable non-cognitive characteristics despite being at academic risk and to avoid the loss of resources invested in students who fail to meet the requirements of a traditional curriculum.…”