3-year med school as a way to decrease physician debt...

[circulus vitios]

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Yes, MS-0, but then you would have no 4th year to do audition electives, if you wanted to do something that isn't primary care, and which doesn't have a corresponding MS-3 clerkship.

Compress the preclinical curriculum to 1.5 years like Duke, Penn, Vanderbilt, etc. have already done and compress 3rd year to 0.5 years. I don't want to do peds or obgyn so why waste my time on peds and obgyn clerkships?

 

[DermViser]

Compress the preclinical curriculum to 1.5 years like Duke, Penn, Vanderbilt, etc. have already done and compress 3rd year to 0.5 years. I don't want to do peds or obgyn so why waste my time on peds and obgyn clerkships?

Yes, let everyone cherry pick which MS-3 clerkships they want to do. That makes so much sense.

 

[circulus vitios]

Yes, let everyone cherry pick which MS-3 clerkships they want to do. That makes so much sense.

It makes plenty of sense to me -- about $70,000 plus interest.

 

[PL198]

Again, it's not going to get cheaper because it's shorter. Medical school costs what it does because of it's perceived value. That value doesn't really change if you make it 4 years instead of 3. Instead, the extra year's cost would be thrown into the 3.

 

[amichel]

I'll be starting a 3 year MD school in Canada in 3 weeks. (Ahhhh!!!) We do not have to pick our specialities before hand, and my school's match rates and distribution of specialties are very similar to the rest of Canada. First year is 10 months, second year is around 8, and then clerkship makes up the rest. 2-4 weeks of vacation/year. We get around 10 weeks of electives, which is obviously less than many US schools, but lots of schools in canada have a rule that 4th years cannot exceed a certain number of weeks in any one speciality (usually 8), so it's not too much of a disadvantage. The one big disadvantage is that a good portion of electives come before core rotations. Apparently, it's not too big of a deal as clerkship directors across the country are aware of the curriculum structure and assess accordingly. There is also tons of early clinical experience, so that helps too. As for burnout, students I've spoken to say that it is stressful, but that it's actually a nice transition to the real world of residency with very little vacation. They also feel they retain info better without summers off. Most who want to are able to participate in research, and there is actually a course in 2nd year dedicated to pursuing a research project. The program I'll be attending has only ever been a 3 year program, since it's creation, and they seem to do well. Just thought I'd share my perspective, as my program seems to be quite different than the 3 year programs in the US.


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[LiamNeesons]

Yes, MS-0, but then you would have no 4th year to do audition electives, if you wanted to do something that isn't primary care, and which doesn't have a corresponding MS-3 clerkship.

The point is: it's possible to pass steps 1 and 2 and interview for residency in 3 years. Trash the research year, shorten summer breaks, shave 3-4 days of each core clerkship. It's possible to graduate in 3 years and to do an elective or two.

 

[DermViser]

The point is: it's possible to pass steps 1 and 2 and interview for residency in 3 years. Trash the research year, shorten summer breaks, shave 3-4 days of each core clerkship. It's possible to graduate in 3 years and to do an elective or two.

Yes, but you still need a year to interview, go thru the match, etc.

 

[LiamNeesons]

Yes, but you still need a year to interview, go thru the match, etc.

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[DermViser]

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Yes there's this thing called the NRMP. Might want to look it up.

 

[Mass Effect]

Duke, NYU, and Vanderbilt are all switching to three year programs. I believe they're eliminating one of the preclinical years.

And adding a research year in order to back up the preclinical material.

Compress the preclinical curriculum to 1.5 years like Duke, Penn, Vanderbilt, etc. have already done and compress 3rd year to 0.5 years. I don't want to do peds or obgyn so why waste my time on peds and obgyn clerkships?

More insight from an MS-0.

 

[LiamNeesons]

Yes there's this thing called the NRMP. Might want to look it up.

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[PL198]

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It's easier to communicate rather than writing an ellipsis multiple times. Clearly he thinks you wouldn't have enough time to apply to the match, clearly you think you would. Do tell. Don't understand why basic communication is so difficult.

 

[Psai]

It's easier to communicate rather than writing an ellipsis multiple times. Clearly he thinks you wouldn't have enough time to apply to the match, clearly you think you would. Do tell. Don't understand why basic communication is so difficult.

Well to be fair it's probably difficult to make cogent arguments when you're a premed with no knowledge of or experience with medical education

 

[maxxor]

As long as competitive specialties require applicants to jump through the many hoops to even be taken seriously enough to apply, and then attend 15+ interviews, there will be a need for a fourth year. The only way I could see 3 year schools work out is if you must stay at your school for residency (a la NYU). All my classmates applying in Orthopedics had to do at least 3 months of ortho electives, one of which was a required away rotation. The field is so competitive that program directors can demand that level of commitment. This is despite my school not allowing people to do more than 8 weeks in one specialty; these people had to use a "vacation/interviewing" month just to complete the requirements for applying into their specialty of choice. Then, after applying to ERAS, they had to hope they applied broadly enough that conflicting interview dates didn't screw them out of the match. Many competitive specialties will only offer 1 or 2 dates for the entire interview season (a common complaint about derm...) That really sucks when 3 of your interview invitations ONLY offer interviews on 2 dates. I don't know how someone could expect to be in internship / 3rd year-esque clinical rotations and be able to jet off to interview at any time.

I would love for medical education to copy dentistry, even if it extends things out to 5 years with internship integrated. When you're done and have an MD/DO, you are deemed fit to practice independently. Why the hell are PAs/NPs/DMD-DDS/ODs just fine after getting their professional degree, and we, the supposed leader of the team, are too stupid to do anything useful with our professional degree?

I'm all about reforming medical education, but I don't think simply cutting the basic sciences to make things quicker is the way to go. By saying our professional degree is useless, we've made our training look inferior to midlevel training.

 

[PL198]

Yet TBH I don't get the intern concept. I don't really see how in some specialties, the students are good to go and starting training right away, vs others where they need more experience first. Sounds like a load of BS to me. I'm sure you learn **** tons during intern year, but at the same time, it can't be enough that it's invaluable for all specialties, right?

 

[maxxor]

Yet TBH I don't get the intern concept. I don't really see how in some specialties, the students are good to go and starting training right away, vs others where they need more experience first. Sounds like a load of BS to me. I'm sure you learn **** tons during intern year, but at the same time, it can't be enough that it's invaluable for all specialties, right?

Gonna need some examples here. Almost all surgical subspecialties have a gen-surg prelim component so they can learn how to care for surgical patients, in general.

I think internship has remained as a relic of the old state licensing regime, even though GPs were phased out in the 70s with the introduction of Family Practice as a "specialty".

Radiology used to have internship optional. I wonder if Radonc used to be optional as well?
Pathology does not require internship. Do they lose prescribing rights?
Other advanced residencies--Derm, Ophtho, Anesthesia, PMR, and Neuro--do make some sense to have a foundational medicine year, if you agree with the assumption that we are too stupid after medical school to know anything.

If we were to restore value to the MD degree, I'd argue internship should disappear. But, again, I think it's state laws requiring completion of internship for licensure that keep it around...

 

[Mass Effect]

I would love for medical education to copy dentistry, even if it extends things out to 5 years with internship integrated. When you're done and have an MD/DO, you are deemed fit to practice independently

This was proposed in the DO world not too long ago. The proposal would make students primary care ready after 5 years of med school. Those who choose other specialties can go right into them without an internship year since that would be considered the 5th year of med school. Not sure how popular the idea is.

Yet TBH I don't get the intern concept. I don't really see how in some specialties, the students are good to go and starting training right away, vs others where they need more experience first. Sounds like a load of BS to me. I'm sure you learn **** tons during intern year, but at the same time, it can't be enough that it's invaluable for all specialties, right?

The only specialty where the newly minted doctors are "good to go" is pathology, as far as I know. Every other specialty requires training in internal medicine or surgery, for good reason. When you get your medical license, it's not just for your chosen specialty -- it's for medicine and medicine doesn't happen in a vacuum. Skin lesions aren't just about the skin any more than brain lesions are just about the brain.

 

[SicEmBears]

Again, it's not going to get cheaper because it's shorter. Medical school costs what it does because of it's perceived value. That value doesn't really change if you make it 4 years instead of 3. Instead, the extra year's cost would be thrown into the 3.

That's a really interesting point... I know Texas Tech's FMAT program doesn't increase the price, but I wonder if NYU has the same tuition or something similar. Maybe they will only increase the price of yearly tuition in a 3 year curriculum if it is for non-specific programs where you can go into any residency. Very interesting!